One of the unavoidable side effects of chemotherapy drugs used to treat cancer is the killing of healthy cells. Hence, following the chemotherapy treatments, the patient may experience various adverse effects like nausea, vomiting, loss of appetite and loss of control over the body. Medical marihuana is an effective natural antiemetic, which helps in overcoming nausea, thus allowing the patient to enjoy meals.
Traditional Cancer Treatments
Lung cancer, prostate cancer, breast cancer – in fact, most types of cancer all start the same basic way. Something causes cancer cells to divide and grow without pause, spreading badly damaged DNA. Those cells invade other tissues and, in most cases, form tumours.
Cancer studies have taken leaps and bounds as far as finding treatments to slow, and sometimes stop, the spread of cancer. However, two of the most important treatments, chemotherapy and radiation therapy, also cause damage and, often, severe side effects.
For instance, some of the most powerful, toxic chemicals are used in chemotherapeutic agents. Both treatments kill cancer cells, but healthy cells as well. Chemotherapeutic agents such as Adriamycin (doxorubicin) and Platinol (cisplatin) can, and have, caused immune suppression and multiple organ damage, but they also cause severe nausea and vomiting.
The vomiting can last over a period of days, to the point that some patients have actually torn their esophagus. Due to the vomiting and lack of appetite, severe dehydration and weigh loss is normal. In fact, many cancer patients begin having a reaction before chemotherapy begins, in “anticipation” of the side effects. Unfortunately, although chemotherapy and/or radiation therapy may be an integral part of their survival, many cancer patients decide not to take the therapies because the side effects are so severe.
Because of this, many are given a mix of anti-nausea drugs. Often, the anti-nausea drugs work. However, the drugs only give partial symptom control, while for others they give no control at all. In addition, those who take traditional medications may also suffer fever, bone pain, fatigue, anxiety, sleep problems and changes in heart activity, among other issues. This leaves cancer patients to suffer from the effects of the cancer itself, the side effects of the treatments, and the side effects of medications used to alleviate the initial side effects of the treatments.
Medical Marihuana for Cancer Patients
It has proven in many studies, performed by prestigious scientific and medical organizations and individuals, that medical marihuana can (and does) relieve pain and nausea. In fact, some of these studies go as far back as the 1970s and older.
For instance, in 1975, the New England Journal of Medicine published the results of a “double-blind” study on the effects of oral (ingested rather than smoked) tetrahydrocannabinol on nausea and vomiting. According to the study, “No patient vomited while experiencing a subjective “high”. Oral tetrahydrocannabinol has antiemetic properties and is significantly better than a placebo in reducing vomiting caused by chemotherapeutic agents.”
A 1999 report by the Institutes of Medicine concluded, “In patients already experiencing severe nausea or vomiting, pills are generally ineffective, because of the difficulty in swallowing or keeping a pill down, and slow onset of the drug effect. Thus an inhalation (but, preferably not smoking) cannabinoid drug delivery system would be advantageous for treating chemotherapy-induced nausea.” A possible option for patients who do not want to smoke marihuana is inhalation using a vaporizer.
Although freedom from nausea and vomiting are two of the most noticed benefits of medical marihuana use, many have reported a reduction in the severity of wasting away. As well, they’ve notice a lessening in depression and other “side effects” brought on by the disease, including an increase in appetite. All of these things together have helped many cancer patients live a better, happier, more comfortable life.
Over twenty major studies in the past nine years have shown that cannabinoids (the chemicals in cannabis) actually fight cancer cells. In fact, it’s been shown that cannabinoids arrest cancer growths of many different forms of cancer, including brain, melanoma and breast cancer. There’s even growing evidence that cannabinoids cause direct anti-tumour activity.
Since the possibility was first realized, many more studies have been conducted, focused on the possibility of cannabinoids have anticarcinogenic effects. A 2007 study by the Institute of Toxicology and Pharmacology in Rostock, Germany focused on human cervical cancer (HeLa) cells. The cells were treated with specific cannabioids and THC. Even at low concentrations, MA and THC “led to a decrease in invasion of 61.5% and 68.1% respectively.”
The benefits of medical marihuana for cancer patients are clear when it comes to increased appetite, reduction of pain, wasting, vomiting and nausea, as well as depression. Although its anticarcinogenic effects aren’t quite as clear, ongoing research further points to the possibility that medical marihuana may actually be what many claim it is – a truly miraculous drug.
Nausea and Vomiting
Some anticancer drugs cause nausea and vomiting because they affect parts of the brain that control vomiting and/or irritate the stomach lining. The severity of these symptoms depends on several factors, including the chemotherapeutic agent(s) used, the dose, the schedule, and the patient’s reaction to the drug(s). The management of nausea and vomiting caused by chemotherapy is an important part of care for cancer patients whenever it occurs. Although patients usually receive antiemetic drugs that help control nausea and vomiting, there is no single best approach to reducing these symptoms in all patients. Doctors must tailor antiemetic therapy to meet each individual’s needs, taking into account the type of anticancer drugs being administered; the patient’s general condition, age, and related factors; and, of course, the extent to which the antiemetic is helpful. There has been much interest in the use of cannabis to treat a number of medical problems, including chemotherapy-induced nausea and vomiting in cancer patients. Two forms of cannabis have been used: compounds related to the active chemical constituent of cannabis taken by mouth and inhalation of cannabis. Dronabinol (Marinol®), a synthetic form of the active cannabis constituent delta-9-tetrahydrocannabinol (THC), is available by prescription for use as an antiemetic. In 1985, the U.S. Food and Drug Administration approved its use for the treatment of nausea and vomiting associated with cancer chemotherapy in patients who had not responded to the standard antiemetic drugs.
National Cancer Institute (NCI) scientists feel that other antiemetic drugs or combinations of antiemetic drugs have been shown to be more effective than synthetic THC as “first-line therapy” for nausea and vomiting caused by anticancer drugs. Examples include drugs called serotonin antagonists, including ondansetron (Zofran®) and granisetron (Kytril®), used alone or combined with dexamethasone (a steroid hormone); metoclopramide (Reglan®) combined with diphenhydramine and dexamethasone; high doses of methylprednisolone (a steroid hormone) combined with droperidol (Inapsine®); and prochlorperazine (Compazine®). Continued research with other agents and combinations of these agents is under way to determine their usefulness in controlling chemotherapy-induced nausea and vomiting. However, NCI scientists believe that synthetic THC may be appropriate for some cancer patients who have chemotherapy-induced nausea and vomiting that cannot be controlled by other antiemetic agents. The expected side effects of this compound must be weighed against the possible benefits. Dronabinol often causes a “high” (loss of control or sensation of unreality), which is associated with its effectiveness; however, this sensation may be unpleasant for some individuals.
Marihuana cigarettes have been used to treat chemotherapy-induced nausea and vomiting, and research has shown that THC is more quickly absorbed from marihuana smoke than from an oral preparation. However, any antiemetic effects of smoking marihuana may not be consistent because of varying potency, depending on the source of the marihuana contained in the cigarette.
To address issues surrounding the medical uses of marihuana, the National Institutes of Health convened a meeting in February 1997 to review the scientific data concerning its potential therapeutic uses and explore the need for additional research. The group of experts concluded that more and better studies are needed to fully evaluate the potential use of marihuana as supportive care for cancer patients.
Anorexia and Cachexia
Anorexia, the loss of appetite or desire to eat, is a common symptom in cancer patients. It may occur early in the disease or later, if the cancer grows and spreads. Cachexia is a wasting condition in which the patient has weakness and a marked and progressive loss of body weight, fat, and muscle. Anorexia and cachexia frequently occur together, but cachexia may occur in patients who are eating an adequate diet but have mal-absorption of nutrients. Maintenance of body weight and adequate nutritional status can help patients feel and look better, and maintain or improve their overall health. It may also help them better tolerate cancer therapy.
There are a variety of options for supportive nutritional care of cancer patients, including changes in diet and consumption of foods, enteral or parenteral feeding (delivery of nutrients by tube), and the use of drugs. An NCI-supported study to evaluate the effects of THC and megestrol acetate (a synthetic female hormone) used alone and in combination for treatment-related and cancer-related anorexia and cachexia completed patient accrual earlier this year. Researchers will compare the appetite, weight, and rate of weight change among patients treated with THC to patients treated with megestrol acetate or with both therapies. Researchers will also evaluate the effects of the drugs alone or in combination on nausea and vomiting, assess for toxic effects of the drugs, and evaluate differences in quality of life among those patients who were treated with THC.
The Institute of Medicine (IOM), part of the National Academy of Sciences, has published a report assessing the scientific knowledge of health effects and possible medical uses of marihuana. The IOM project was funded by the White House Office of National Drug Control Policy. The IOM released its report on March 17, 1999.
Copies of the report, Marihuana and Medicine: Assessing the Science Base, are available from National Academy Press, Lockbox 285, 2101 Constitution Avenue, NW., Washington, DC 20055; (202) 334–3313 or 1–888–624–8373. The full text of the IOM report is also available at http://www.nap.edu/catalog.php?record_id=6376 on the Internet.