Lung cancer: medical cannabis as a therapy option
Bronchial carcinoma is the most common cause of cancer death in men after prostate cancer and colon cancer and the second most common cause of cancer death in women after breast cancer and colon cancer. Medical cannabis can be used in chemo/radiation therapy to help alleviate the side effects. In addition, interesting in vitro studies show that cannabinoids may be able to inhibit the growth of lung cancer cells.
There are two types of lung tumours. Approximately one in five patients suffers from small-cell bronchial carcinoma. This aggressive tumour grows very quickly and usually forms early metastases in other organs.
A less aggressive type of lung cancer is non-small-cell lung cancer, which affects approximately 80 percent of patients. Since this tumour consists of larger cells, it usually grows only slowly in a limited area of the lung. The formation of metastases is also slower, so that the tumour can often still be removed in the early stages.
Causes and symptoms of lung cancer
Tobacco smoking is one of the main causes of pulmonary cancer. Only 15 percent of all lung cancer patients are non-smokers. However, other carcinogenic substances, such as asbestos dust or radioactive substances, can also damage the cells of the lung tissue, causing tumours to form.
In addition, lung scars, which can result from inflammation or injury, can also increase the risk of lung cancer. The same applies to an inherited predisposition.
At the beginning of the disease, lung cancer usually causes no symptoms. The first signs could be shortness of breath, chest pain, fatigue and chronic coughing. In the advanced stage, affected persons lose a lot of weight within a short time and frequent sputum with or without blood occurs. Other symptoms such as breathing difficulties, night sweats and fever can also occur.
Lung cancer: division into stages
There are two stages of small cell bronchial carcinoma:
- Stage LD (limited disease): In the limited stage, the tumour is limited to one lung and one side of the chest.
- Stage ED (extensive disease): In the extensive stage, the tumour has spread to the surrounding tissue and the ribcage. In addition, metastases have already formed in the body.
The tumour in non-small cell lung cancer is assessed using the TNM classification. Here, the letter T (tumour) describes the size of the tumour and how far it has spread. N (node) indicates whether the lymph nodes are affected and M (metastasis) indicates whether the tumour has metastasised.
Based on this stage classification, doctors can then plan treatment and follow-up care. It also enables doctors to better assess the course of the disease and the chances of recovery.
Therapy options for pulmonary cancer
The therapy depends mainly on the type of tumour and the stage of the disease. A non-small-cell tumour can be surgically removed, provided that no metastases have yet formed. The chances of recovery are correspondingly good. If the tumour has grown into the neighbouring tissue or if the lymph nodes in the vicinity of the tumour are affected, radiotherapy is usually used. Chemotherapy is usually only given if metastases have formed in other organs.
The treatment of a small-cell lung tumour is far more difficult, because in about 75 percent of all cases metastases have already formed in other organs. Surgical removal of the tumour is only possible if it is still very small. This is rarely the case with small cell tumours. The treatment options available are chemotherapy with cytostatic drugs and then radiotherapy.
Studies: influence of cannabinoids on cancer cell growth
In 2019, researchers from Rangsit University in Thailand published the interesting results of their study (1). In a mouse model they were able to show that the cannabinoids tetrahydrocannabinol (THC), cannabidiol (CBD) and cannabinol (CBN) were able to inhibit the growth of bronchial carcinoma. The researchers attribute the anti-cancer properties mainly to the combination of THC and CBN.
Based on the positive results, the researchers are now planning clinical trials. They also announced that the Medical Research Institute at the university is already working on a manufacturing method to extract pure cannabinoid compounds such as THC and CBN from the cannabis plant. This extract will then be used to develop a new drug.
The fact that the combination of individual cannabinoids seems to play an important role in the inhibition of cancer growth is also confirmed by Israeli researchers in their in vitro study (2). They investigated the effects of twelve cannabinoid combinations on twelve different cancer cell lines. It turned out that especially the combinations with a high THC content showed a strong cytotoxic effect on the cancer cell lines.
Again, Italian researchers came to a different conclusion. In their in vitro study they examined the antitumoral activities of the cannabinoids cannabidiol (CBD), cannabigerol (CBG), cannabichromes (CBC), cannabidiol acid (CBDA) and THC acid (THCA) on tumor cell lines (3). Here it was shown that CBD was the strongest inhibitor of cancer cell growth.
Medical cannabis in the treatment of lung cancer
Chemo- and/or radiotherapy is a heavy burden for cancer patients, both physically and psychologically. Medical cannabis can be used here to alleviate the side effects and improve the quality of life of patients. To date, there are no conclusive studies that would allow a reliable statement to be made as to whether the inhalation of medical cannabis additionally damages the lungs in lung cancer.
In a case-control study at the University of California in Los Angeles, the researchers investigated whether cannabis users showed an increased risk of lung cancer (4). This control study involved 611 lung cancer patients, 601 patients with head and neck cancer and 1040 healthy people. Here, even regular cannabis users did not show an increased risk of lung cancer.
However, researchers from the Medical Research Institute in New Zealand came to a different conclusion (5). In this case-control study, 79 lung cancer patients and 324 controls were enrolled. Here the researchers found that the risk of cancer increased by eight percent for each year of cannabis use. The researchers concluded that long-term cannabis use may increase the risk of lung cancer.
Because of the uncertain study situation, lung cancer patients are advised not to inhale/vaporize medical cannabis. Instead, prescription drugs (oily solutions) or ready-to-use drugs can be used.
(3) Istituto di Chimica Biomolecolare, Consiglio Nazionale delle Ricerche Pozzuoli, Italy, Ligresti A1 et al., 2006, “Antitumor activity of plant cannabinoids with emphasis on the effect of cannabidiol on human breast carcinoma”
(5) Medical Research Institute of New Zealand, Wellington, 2008, „Cannabis use and risk of lung cancer: a case-control study“
About Mary Biles
Mary Biles is a British journalist and blogger with a background in complementary therapies and holistic health. Through her writing she is committed to providing accurate reporting and education about the medicinal uses of cannabis.
Can medical cannabis be a therapy option? Cannabinoids can alleviate the side effects and improve the quality of life of patients.
Cbd oil and lung cancer
Cannabidiol, also known as CBD, is one of many chemicals found in the cannabis plant. It has been touted in some online forums as an alternative treatment, and even a cure, for many illnesses, including cancer. And, some people with cancer say that CBD has helped them as a complementary therapy in managing their symptoms and side effects from standard cancer treatment.
Yet there’s very little research around CBD and its use in treating people with cancer. Here’s what to know about what CBD is and what science currently shows about whether it’s safe and effective for people with cancer to use.
What is CBD?
CBD is 1 of the hundreds of chemicals found in the flowering cannabis plant. CBD does not have the psychoactive, or mind-altering, effects of another chemical found in cannabis called tetrahydrocannabinol (THC). THC is the chemical that causes people to experience a “high.” CBD, on the other hand, is being used by some to help ease pain, anxiety, and sleep issues.
CBD comes from cannabis plants called hemp that are specifically grown with high levels of CBD and low levels of THC. Cannabis plants grown with high levels of THC are usually called marijuana. CBD comes from oil that is extracted from the cannabis plant. That oil can then be ingested as a liquid, a capsule, a gummy, or inhaled through vaping. It can also be added as an ingredient in such products as lotions and skin patches.
There is much about CBD that is still unknown. It has largely gone unstudied because, until 2018, it was considered a schedule I drug by the U.S. Drug Enforcement Administration (DEA). A schedule I drug is a drug that has been declared illegal by the DEA because of safety concerns over its potential for abuse and because there is no accepted medical use for it. Then, in September 2018, the DEA updated CBD’s status to become a schedule V drug. Schedule V drugs have a lower potential for abuse and are deemed to have some medical use.
There is currently 1 CBD treatment approved by the U.S. Food and Drug Administration (FDA) called Epidiolex, which is used to treat a rare and severe form of epilepsy in children. There are not currently any FDA-approved CBD medications for treating cancer or side effects of cancer treatments.
Can CBD help people with cancer?
Studies to answer this question are underway. Some scientists are studying whether CBD could relieve some of the side effects of cancer and its treatment, such as pain, insomnia, anxiety, or nausea. Other scientists are studying whether CBD could potentially slow or stop the growth of cancer.
To date, no large-scale studies have shown CBD to have benefits for the treatment of people with cancer. Most studies that have been done evaluating CBD as a cancer treatment were in mice or in human cells in the lab. For instance, there are some studies that have shown that CBD inhibits the growth of cancer cells in mice with lung cancer or colon cancer. Another study showed that CBD, together with THC, killed glioblastoma cancer cells in the lab. However, no studies have been conducted in people with cancer.
There have been some studies that show that CBD, alone or together with THC, may relieve pain, insomnia, or anxiety, but these studies were not specific to people with cancer. While no studies to date have shown that CBD eases these side effects specifically in people with cancer or people receiving cancer treatment, some people with cancer have reported benefits in taking CBD, such as helping with nausea, vomiting, depression, and other side effects. According to ASCO guidelines, your doctor may consider prescribing cannabinoids for chronic pain management if you live in a state where it is legal. However, ASCO guidelines state that there is not enough evidence to support the use of cannabinoids for preventing nausea and vomiting in people with cancer receiving radiation therapy or chemotherapy.
There are 2 synthetic cannabis medications, nabilone (Cesamet) and dronabinol (Marinol or Syndros), that are FDA-approved to treat nausea and vomiting related to chemotherapy. These medications are made in a laboratory.
Is CBD safe for people with cancer?
You may find stories online of people discussing the benefits of CBD as a cancer treatment or as relief for side effects. Please remember that such personal stories, while they may be well-meaning, are shared without scientific study and do not constitute evidence. The safety and efficacy of CBD for people with cancer still has to be proven in large, randomized, controlled clinical trials.
It is also important to note that some studies have shown that CBD might interfere with how your body processes cancer drugs, called a drug interaction. This might make cancer treatments more toxic or make them less effective. More research is needed on these effects, too. For these reasons, always tell your oncologist if you’re thinking about using CBD before you take it.
You may also be wondering if CBD is legal in your area. Some states allow the sale and possession of cannabis, including CBD and THC, for medical and recreational use. Others have stricter regulations, so state-by-state laws should always be learned before transporting CBD across state lines. Things are more complicated at the federal level. In 2018, the U.S. government recognized that hemp can be grown and manufactured legally as part of the Farm Act. Hemp can be used to make things like rope and clothing, in addition to CBD oil. In other words, hemp is no longer a controlled substance, which means it is not regulated by the government. This means that consumers have to evaluate the safety and quality of CBD products on their own. Some CBD, for example, may have much higher levels of THC than what is labeled.
The bottom line is this: Always talk to your doctor first if you’re thinking about using CBD. Because the research does not yet support the use of CBD in helping people with cancer, it’s important to raise the topic with your doctor before taking it. There are several clinical trials underway studying the use of CBD in cancer care, and you and your oncologist can talk through the possible benefits and risks of you joining a research study to help find answers to some of the questions about CBD, including whether it may reduce side effects or improve quality of life.
Cannabidiol (CBD) has become a buzzword within the cancer community. But while some people with cancer have found CBD to be helpful in managing side effects, research does not yet support CBD’s use for cancer treatment. Here, find out what CBD is, how it is being studied in people with cancer, and whether it is safe, effective, and legal.