Cannabis can be used medicinally for pain and nausea relief, particularly during cancer treatment, but can it have preventative or curative potential?
A recent report of an 80-year-old woman who regularly consumed cannabidiol (CBD) oil as an “alternative treatment” for her lung cancer, which led to the shrinking of a nodule, has sparked much interest (and confusion) over how cannabis interacts with cancer.
It’s well known that cannabis – the genus term for the hemp plant – can be used medicinally for pain and nausea relief, particularly during cancer treatment. But case studies such as these also beg the question: does it also have preventative or curative potential?
We spoke with internist Brooke Worster, MD, who leads the Cannabis Medicine program at Thomas Jefferson University, as well as medical oncologist Michael Rotkowitz, MD, to better understand how cannabis can impact our health and when it can be used.
Understanding the ‘Types’ of Cannabis
When many people think of cannabis, they think solely of the stereotypical “weed” or marijuana that gets you “high,” notes Dr. Worster. However, cannabis actually entails various phytocannabinoids (classes or components), the two most common being tetrahydrocannabinol (THC) – which is responsible for the “high” or psychological effects – and cannabidiol (CBD) – which yields more non-psychoactive benefits.
“A lot of cannabis products are hemp-derived,” said Dr. Worster. “They’re all from the same base plant, but CBD products contain less than .3 percent THC.”
How Cannabis Interacts with Natural Cannabinoids in Our Body
The way these substances interact with our body is through our endocannabinoid system, explains Dr. Worster, which is a set of receptors throughout the central nervous system. CBD primarily binds to the receptors outside of the brain, whereas THC more strongly interacts with the receptors in the brain.
“Our bodies already naturally produce substances structurally similar to both CBD and THC, just in low quantities” continues Dr. Worster. “When you ingest cannabis, it’s at a significantly higher concentration, which stimulates the endocannabinoid system, which can lead to a number of physical and mental health benefits.”
Known Health Benefits of Cannabis
Historically, cannabis has been used for analgesic, sedative, anti-inflammatory, and antispasmodic (suppresses muscle spasms) effects, explains Dr. Rotkowitz. In some cases – even though it isn’t strong enough for severe pain – it has been used as an alternative, non-addictive form of pain relief, to reduce the need for opioids. It may also take the place of the use of common NSAIDs, such as Advil or Aleve, which, when used in excess, can result in kidney damage and ulcers.
This is because many properties of cannabis – CBD and THC alike – are anti-inflammatory, adds Dr. Worster. “Cannabis reduces overall immune activity, in a good way, similar to NSAIDs; however, the relationship is quite complex. While, ideally, it would always help the immune system, there is a risk of suppressing it too much.”
Studies also point to promising benefits in those with Parkinson’s disease and muscle tremors; irritable bowel syndrome (IBS); Crohn’s disease; Multiple Sclerosis (MS); epilepsy; anxiety; chronic migraines; HIV/AIDs; opioid use disorder; and more. Both the New Jersey and Pennsylvania state medical marijuana programs list these and others as conditions appropriate for utilization. Some conditions respond better to CBD, while others favor THC, notes Dr. Worster.
In terms of cancer treatment, specifically, cannabis can assist in overall symptom management, providing relief from both the physical implications and stress of dealing with the illness, says Dr. Rotkowitz. Most significantly, it can reduce chemotherapy-induced nausea, stimulate appetite, and help improve sleep. For some people, it’s as effective or more effective than most other anti-nausea medications, adds Dr. Worster.
“Finding the right therapeutic dosage is a very individualized process for each patient,” said Dr. Rotkowitz. “It is incredibly important for the patient, physician, and medical cannabis care team to work together for the best possible outcomes.”
Cannabis as an Anti-Cancer Agent
Experts are still in the early stages of studying the preventative and curative facets of cannabis, explains Dr. Worster. When you consider the benefits and anti-inflammatory mechanisms, these theories make sense, but the evidence that has come out is mixed.
“Many pre-clinical findings – those derived not from humans, but cellular models/petri dishes – show that cannabis ingestion can slow the replication of cancer cells or induce cellular death,” said Dr. Worster. “However, this can’t give us a definitive answer because the components of cannabis are complex. There are various strains and strengths, some of which have indicated an acceleration in cancer progression – the opposite of what we’re aiming for.”
So, did CBD oil help shrink the non-small cell lung nodule that the 80-year-old woman was suffering from? The consensus is that it’s possible, but it’s more likely that it could have spontaneously regressed, as some cancers do.
The Risks of Cannabis
Cannabis ingestion doesn’t come with only “pros” and no “cons.” As comprehensive medical marijuana legalization stretches nationwide, there’s lost oversight in terms of product safety and quality.
The things you need to be cautious of, urges Dr. Worster, are:
- Know where and whom you acquire cannabis from, whether it be CBD or THC. After-market products that hit the gas station shelves are going to be comprised differently than a substance acquired at a state-regulated dispensary. Taking what someone gives you without knowing what is in it – such as harmful or illegal additives – can be incredibly dangerous. You want to make sure your source is safe and reputable.
- Know the make-up and appropriate dosages of the substance you’re going to ingest; talk to your healthcare providers and do your research. Cannabis comes in various strengths and potencies; if you aren’t careful, you can “overdose” – not to the point of it being lethal, but it can make you extremely ill/uncomfortable.
- Smoking anything is never considered “healthy.” Inhaling something that has been burned has a clear and proven detrimental impact on the lungs. Luckily, this is something you can modify – there are oral, sublingual (under the tongue drops), topical, and vaporized products.
What You Can Do Next
The American Cancer Society supports the research and usage of cannabis for medicinal treatment. If you think it might be beneficial, discuss your risks and benefits with your provider to determine whether it can be part of your treatment plan, says Dr. Rotkowitz. This goes for non-cancer-related diseases as well.
“Cannabis products can potentially be well-tolerated and helpful for a lot of people, but there are many questions we need to work through. It’s not a cure-all for everything,” reminds Dr. Worster. “What we do know is that medical guidance is key. Cannabis can be a good fit for you, but don’t try to navigate it by yourself.”
Learn more about your state’s specific regulations on medical marijuana access here: