Oncologists Should Recommend Cannabis-Based Medicine for Palliative Care
Earlier this June, a review was published that encourages oncologists to recommend cannabis products to their patients as a safe and effective method of palliative care. The opinion piece highlights how cannabis is a useful treatment for a variety of illnesses (nausea, vomiting, sleep, mood, anxiety), and encourages practitioners to prescribe cannabis for their patients so that they can appreciate the safety and effectiveness of the product.
Regulators and mechanisms of anoikis in triple-negative breast cancer (TNBC)- a review
Researchers are always exploring new methods to treat highly aggressive forms of breast cancer. As the scientific culture opens up to cannabis as a natural pharmaceutical factory, eyes have been drawn to the individual chemical components born inside cannabis, namely cannabinoids, terpenoids, and flavonoid compounds. Recently, a group stumbled upon a promising synthetic flavonoid derivative. This derivative, named GL-V9, has been found to have an inhibitory effect on the growth of triple-negative breast cancer (TNBC) tumors and has shown other anti-metastatic properties. The growth-stopping and anti-spreading effects would address two of the central aspects of TNBC that have thus far made it difficult to treat. The growing understanding of flavonoids and their potential therapeutic benefits seem all but sure to enshrine its place among future research regarding cancer treatments.
Dr. Caplan and the #MDTake:
In scientific and medical circles, it’s not uncommon to hear the phrase, “everything causes cancer.” It’s often repeated contemptuously, a tongue-in-cheek expression that calls attention to unknowns associated with the spawning and growth of cancers but also bends to the hurricane force of nature’s impact on living organisms. As living biology, cancers are born and thrive while provided sustenance by particular inputs and supports. Because of this fact, there are also innumerable opportunities to stifle or prevent the birth of tumors and many avenues to interrupt its growth or end the life of cancer cells.
The human cultural history has taught all cultures that sleep, exercise, fruits, vegetables, fiber, and water are all required ingredients for sustained, healthy growth. What is it about fruits and veggies that is healthy? They have fiber that is healthy for the human digestive tract, but they also have natural components, terpenes and flavonoids, which support wellness, healing, and the normal cycling (features of both living and dying) of our cells. Cancer represents the inappropriate over-replication of cells. In a sense, the body’s natural ability to end the cells which are not responding to normal signals is lost. If we know that the cannabis factory happens to produce many of the same compounds that are found elsewhere in vegetation and fruits, is it so surprising that we would see cancer-fighting effects?
“Pancreatic cancer is particularly refractory to modern therapies, with a 5-year survival rate for patients at a dismal 8%. One of the significant barriers to effective treatment is the immunosuppressive pancreatic tumor microenvironment and development of resistance to treatment. New treatment options to increase both the survival and quality of life of patients are urgently needed. This study reports on a new non-cannabinoid, non-psychoactive derivative of cannabis, termed FBL-03G, with the potential to treat pancreatic cancer. In vitro results show major increase in apoptosis and consequential decrease in survival for two pancreatic cancer models- Panc-02 and KPC pancreatic cancer cells treated with varying concentrations of FBL-03G and radiotherapy. Meanwhile, in vivo results demonstrate therapeutic efficacy in delaying both local and metastatic tumor progression in animal models with pancreatic cancer when using FBL-03G sustainably delivered from smart radiotherapy biomaterials. Repeated experiments also showed significant (P < 0.0001) increase in survival for animals with pancreatic cancer compared to control cohorts. The findings demonstrate the potential for this new cannabis derivative in the treatment of both localized and advanced pancreatic cancer, providing impetus for further studies toward clinical translation.
“From the results of this study, the key findings include, observation that a non-cannabinoid derivative of cannabis can enhance radiotherapy treatment outcomes in-vitro and in-vivo as highlighted in Figures 2, 4. Secondly, the sustained delivery of the cannabis derivative FBL-03G from smart radiotherapy biomaterials (SRBs) results in tumor growth inhibition of both locally treated and distant untreated tumors, with and without radiotherapy. The use of smart radiotherapy biomaterials (SRBs) (8, 23) was recently proposed as a novel approach to deliver cannabinoids, allowing for prolonged exposure of tumor cells to these cannabis derivatives, which is expected to be more effective (10). The FBL-03G payload used in this study is a flavonoid non- cannabinoid derivative of cannabis, and the potential to inhibit both local and metastatic tumor progression is remarkable, especially for pancreatic cancer, with a dismal 5-year survival rate of 8% (1).”
“While the results indicate that sustained exposure of tumor cells to FBL-03G can boost both local and metastatic tumor cell kill, the mechanism of such action needs to be further investigated. One hypothesis is that, FBL-03G can serve as an immunotherapy agent, inhibiting growth of locally treated and untreated tumors, representing metastasis. Metastasis accounts for most of all cancer-associated suffering and death, and questionably presents the most daunting challenge in cancer management. Henceforth, the observed significant increase in survival is promising, especially for pancreatic cancer which is often recalcitrant to treatments. Another hypothesis is that sustained delivery allows FBL-03G to reach the untreated tumor over a prolonged period as well. Either way, the FBL-03G results reveal a new potential non-cannabinoid cannabis derivative with major potential for consideration in further investigations in the treatment of pancreatic cancer, where new therapy options are urgently needed.”
Dr Caplan’s Take:
This article is one in a growing collection of impressive data that highlights a critical area of Medicine that has hidden from the scientific community for decades. The goal of the review is NOT to hail praise on cannabis as a panacea, nor even a sole treatment option, for pancreatic cancer. Rather, it highlights that it seems to be working effectively, both in living tumor cells in the lab and in animal models with live tumor cells. For a devastating illness that currently carries a grim prognosis, the proposition here is to learn more.
The milestones between pioneering scientific study and effective medication are many and there is much work to be done. Studies must be reviewed, criticized, replicated, integrated, before pioneering products can be developed, produced, tested, scaled, brought to market, marketed, sold, and consumed. The process is long, but at least there is a seed of hope at the beginning!
Title: Identification of Novel Predictive Biomarkers for Endometrial Malignancies- N-Acylethanolamines
A recent study has demonstrated that specific members of the endocannabinoid system may serve as potential biochemical markers for endometrial cancer. Elevated levels of two products of the endocannabinoid system (N-palmitoylethanolamine and N-arachidonoylethanolamine), reflect the production of endometrial tumors.
By screening for elevated levels of those substances, it may be easier for physicians to more quickly recognize the possible presence of endometrial tumors, leading to a potentially sooner diagnosis and intervention. Further research should be conducted to see if there is an even stronger connection between the dysregulation of the endocannabinoid system and endometrial cancer.
This study highlights the far-reaching arms of the endocannabinoid system that are still so poorly understood. Until the federal government supports the research of cannabis and helps the general public to recognize it as a medically useful substance, research will continue to be limited and stifled. Government-sponsored research is required to boost the growing data that is currently limited by a reliance on private funding. State governments continue to legalize medical marijuana and recognize the medical and economic benefits of cannabis-based medicines. As local legislature demonstrates the success of medical cannabis programs, many patients continue to look to the federal government to follows suit, to further support our fellow citizens in need.
Pediatric oncologists from Minnesota recently published an article justifying their use of medical cannabis as palliative care for their patients.
The majority of patients at the oncology center were approved for medical cannabis use during their first round of treatment, in order to immediately address the negative side effects of chemotherapy such as nausea, pain, and cancer cachexia. The data provided from the center described much higher chemotherapy compliance rates among patients, and that patients have a much better quality of life when utilizing cannabis.
This article highlights a few promising trends and issues with using medical cannabis; one promising trend is the hope for cannabis to provide antitumor effects. Cannabis has been a subject of exploration for antitumor effects and it has shown promising results. But, there are many limitations to the few studies that have been published, leading the authors to defer any definitive conclusions. The center in Minnesota noted that many of the patients diagnosed with brain tumors were especially hopeful that cannabis would aid in curing them of cancer, second to utilizing the drug for nausea. This is a promising trend because it means the greater public is showing interest in the therapeutic possibilities of cannabis and their support and call for research will aid the drive for the federal rescheduling of marijuana.
Also highlighted in this article is that, of all the patients certified to use medical cannabis, a subset of 24% never actually registered through the state to receive it. The authors have no firm explanation for these circumstances but seem to suspect that the $200 annual certification fee, on top of the cost for each additional dispensed product may be limiting of patients abilities to afford cannabis. Without the backing of the federal government, insurance companies are unable to cover medical cannabis. As the depth and reach of cannabis research grow, there are good reasons for patients to feel optimistic about medical cannabis.
A literature review from 2009 (10 years ago) summarizes the anti-cancer properties of cannabis, concluding that various cannabinoids might inhibit cancer cell growth and tumor growth. In particular, cannabis shows promise to help treat colon, skin, prostate, and breast cancer.
Dramatic response to Laetrile and cannabidiol (CBD) oil in a patient with metastatic low grade serous ovarian carcinoma
A recent case study has examined a patient’s response to the consumption of cannabidiol (CBD) as a treatment for a rare type of ovarian cancer. Rather than participate in chemotherapy, which has been shown to only be effective in 5% of patients with low grade serous ovarian carcinoma, an 81-year-old decided to take a combination of amygdalin and CBD. Although CBD has only been shown to have effective anti-cancer properties in murine models the featured patient reported a significant decrease in tumor size, revealing that CBD may, in fact, be an effective treatment for patients looking into alternative care methods.
Although proven ineffective, the use of amygdalin highlights alternative therapies derived from naturally occurring chemicals found in common plants. Flavonoids and terpenes are chemical components of cannabis plants, also found in a variety of fruits and vegetables, that are just now being investigated for their therapeutic benefits. The results of those inquiries may prove useful for similar patients suffering from illnesses that are resistant to the usual treatments.
In a study of 2,970 cancer patients, researchers determined that cannabis as a palliative treatment seems to be well tolerated, effective and a safe option to help patients cope with cancer-related symptoms.
Oxaliplatin is the most commonly used drug to treat colorectal cancer (CRC), but patients often develop resistance to it. So, researchers conducted a study to determine the effect of CBD in overcoming oxaliplatin resistance in CRC cells. They found that elevated NOS3 phosphorylation is an essential part of the development of oxaliplatin resistance, and CBD successfully decreased NOS3 phosphorylation. This effect resulted in cells overcoming oxaliplatin resistance, which suggests that CBD could be a new strategy to treat colorectal cancer.