The Therapeutic Effects of Cannabis
Medicinal marijuana (Cannabis sativa) has been drawing more attention in oncology research due to the suggested therapeutic benefits of cannabis. Cannabis comprises a wide array of plant constituents, including over one hundred cannabinoids, terpenes, and flavonoids. Among these cannabinoids, delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) have been the most researched, discussed, and applied.
The human endocannabinoid system (ECS) comprises cannabinoid receptors, endogenous ligands (endocannabinoids), and enzymes. ECS plays a vital role in both physiological and pathological processes. Cannabinoids can interact with cannabinoid receptors, specifically cannabinoid 1 (CB1) and cannabinoid 2 (CB2). CB1 receptors are predominately found in the central nervous system, whereas CB2 receptors are in the immune system. CB2 receptors are non-psychoactive and play a role in immunomodulation.
When THC binds with CB1 receptors, it acts as an agonist, leading to psychoactive effects. On the other hand, CBD has a low affinity for either CB1 or CB2 receptors. When THC and CBD are both near a CB1 receptor site, CBD modulates the effect of THC, making it challenging for THC to bind with CB1 receptors and, as a result, decreasing its psychoactive effect. These interactions between certain cannabinoids and ECS can affect the development or progression of various diseases. (Bodine & Kemp, 2022)
Research of Cannabinoids in Cancer Treatment
Even though the biological role of ECS in cancer pathophysiology is not totally clear, studies suggest that cannabinoids have a promising potential for treating cancer. It has been indicated in some studies that the activation of CB receptors by cannabinoids inhibits tumor cell proliferation, induces apoptosis, and blocks angiogenesis and metastasis. (Dariš et al., 2019)
For future research, I can see the need to develop a deeper understanding of how cannabinoids modulate cellular processes involved in tumorigeneses, cell proliferation, cell apoptosis, and the interactions between cannabinoids and the immune system for improving existing treatments and exploring new therapeutic options.
Cannabis for Reducing Chemo-Induced Side Effects
The main challenges that limit the efficacy of cancer therapies include chemotherapeutic resistance, unusual tumor localization, and adverse effects of chemo agents such as chemotherapy-induced nausea and vomiting, pain, and insomnia. Even though it is unlikely to use cannabis as a stand-alone therapy, applying it as an adjuvant therapy has the potential to produce beneficial therapeutic effects. Here are the multi-layer benefits that many compounds in cannabis provide for cancer care:
Besides cannabinoids, cannabis also contains other constituents, including flavonoids and terpenes. Studies have shown the effects of certain flavonoids for blocking different effector pumps associated with multidrug resistance. Also, specific terpenes found in cannabis could facilitate the passage of multiple formulations past the blood-brain barrier for brain cancer.
Studies show that adding THC or CBD to carfilzomib, a chemotherapy drug, has lowered the required carfilzomib concentration. Also, when the THC and CBD were used together, the levels of both compounds needed to have an effect on carfilzomib were reduced, suggesting potential synergistic effects of cannabinoids with the chemotherapeutics as well as THC and CBD with each other.
Multiple compounds in cannabis, such as cannabinoids, terpenes, or flavonoids, may have synergistic effects with current chemotherapeutic agents. This may reduce the dosage of each agent required to produce a therapeutic effect, potentially mitigating adverse effects induced by the cancer treatments. (Tomko et al., 2020)
My Final Thoughts
A personalized approach should be taken to add medicinal marijuana and/or hemp seed products for their health benefits in cancer care. Here are the main reasons:
Individuals may respond to these plant compounds very differently, especially to THC.
All the plant compounds in cannabis (cannabinoids, terpenes, and flavonoids) may exert different effects depending on the type of cancer and the chemo agent used. Some may contraindicate with the chemo drug selected.
While there is great potential for cannabis to be used as a supportive therapy for cancer care, I highly recommend the patient and their integrative oncologist work together to research and weigh the pros and cons first and then make a decision.
Jenny Noland, MS, CNS, CNGS, CKNS, LDN, MBA
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References:
Bodine, M., & Kemp, A. K. (2022). Medical Cannabis Use In Oncology. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK572067/
Dariš, B., Verboten, M. T., Knez, Ž., & Ferk, P. (2019). Cannabinoids in cancer treatment: Therapeutic potential and legislation. Bosnian Journal of Basic Medical Sciences, 19(1), 14. https://doi.org/10.17305/BJBMS.2018.3532
Tomko, A. M., Whynot, E. G., Ellis, L. D., & Dupré, D. J. (2020). Anti-Cancer Potential of Cannabinoids, Terpenes, and Flavonoids Present in Cannabis. Cancers, 12(7), 1–81. https://doi.org/10.3390/CANCERS12071985