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Cancer? Patient Useful What’s the Advice Treating in Hemp That | Could Be Evidence

sky2high
25.06.2018

Content:

  • Cancer? Patient Useful What’s the Advice Treating in Hemp That | Could Be Evidence
  • Integrating cannabis into clinical cancer care
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  • What's the Evidence That Hemp Could Be Useful in Treating Cancer? . what and how high a dose the patient needs to kill or control cancer. What Evidence Is Available? It is widely claimed that there is insufficient evidence to support medicinal use On balance, while there is excellent evidence of anti cancer that cannabis is safe and effective as a palliative treatment cannabis may have a curative effect by promoting repair of “ decided by the patient”. But there is some evidence that the chemicals in cannabis might help Cannabis oil is only one of a number of treatments people might come across. One reason for this is because you don't know what you are getting, for.

    Cancer? Patient Useful What’s the Advice Treating in Hemp That | Could Be Evidence

    But, crucially, there is zero evidence that cannabis has any curative or even helpful impact on cancer , despite enthusiastic claims to the contrary. Why then is there such a gulf between public perception and scientific evidence?

    Part of this is misunderstanding. For example, an often aired claim is that high-dose THC kills cancer cells in a petri dish. This is true, but not very meaningful. Killing cells in a dish is extremely easy; you can do so with anything from heat to bleach. But effective anti-cancer agents must be able to selectively kill cancer cells in the human body while sparing healthy ones.

    The reality is that cannabis simply cannot do this. Arsenic, plutonium and cyanide are also natural, yet it would be a poor strategy to binge on these substances.

    The active compounds of many drugs are themselves discovered in plants, synthesised to control the dose and maximise efficacy. We already have THC-derived medicines, but these do not cure cancer, and neither does cannabis. This is abject nonsense.

    Such a conspiracy would be massive and would rapidly collapse. The idea that researchers would be callous enough to suppress a cancer cure, and the rewards that would go with it, is ludicrous. The reality is that cancer is a complex family of disease, and it is unlikely that there will ever be a single cure. Three reasons why scientific advice on drugs is ignored. An ingredient in cannabis may be useful for treating psychosis — new study.

    Should we be worried about indoor air pollution? Offences against the person? The poetics of retreat: Meditation and space at the shrine in Mahan — York, York. Available editions United Kingdom. The first trial noted a significant benefit for cannabis compared with placebo in patients receiving high-dose methotrexate A later study by the same investigators made cannabis available to patients receiving cyclophosphamide or doxorubicin after dronabinol failure, and no beneficial effect was noted The third study investigating cannabis was a randomized crossover trial in 20 patients who received dronabinol and cannabis Overall, 5 of the patients reported a positive antiemetic response.

    Of the entire cohort, 4 patients preferred smoked cannabis, 7 preferred dronabinol, and 9 had no preference. A recent phase ii investigation in 16 patients of nabiximols, the sublingually delivered whole-plant extract, found that 4. A quantitative systematic review 32 that included 30 randomized comparisons of oral nabilone, oral dronabinol, or the intramuscular levonantradol preparation no longer available with placebo in patients receiving chemotherapy found that, as antiemetics, cannabinoids were more effective than prochlorperazine, metoclopramide, chlorpromazine, thiethylperazine, haloperidol, domperidone, or alizapride risk ratio: For complete control of nausea, the number needed to treat was 6, and it was 8 for complete control of vomiting.

    In crossover trials, the patients preferred cannabinoids for future chemotherapy cycles. A later systematic review 33 of thirty randomized controlled trials involving patients also found that cannabinoids were more effective than placebo or conventional antiemetics in reducing chemotherapy-induced nausea and vomiting, and that patients preferred the cannabinoids.

    Adverse effects were noted to be more intense and to occur more frequently in patients using cannabinoids. A more recent systematic review 10 of twenty-eight randomized controlled trials twenty-three using nabilone or dronabinol involving participants reported an overall benefit for cannabis. A Cochrane review 34 analyzed twenty-three randomized controlled trials of cannabinoids compared with placebo or with other antiemetic drugs.

    Patients were more likely to report a complete absence of nausea and vomiting with cannabis than with placebo, and there was little discernable difference between the effectiveness of cannabinoids and of prochlorperazine, metoclopramide, domperidone, and chlorpromazine.

    Notably, however, none of the trials involved the agents now most widely used—the serotonin 5-HT 3 antagonists. The National Comprehensive Cancer Network guidelines cautiously mention cannabinoids as a breakthrough treatment for chemotherapy-induced nausea and vomiting not responsive to other antiemetics Although cannabis is the only antiemetic that is also orexigenic, no clinical trials investigating the plant as a treatment for cancer-related anorexia—cachexia syndrome have been conducted to date.

    A randomized placebo-controlled clinical trial evaluating a cannabis extract and dronabinol in patients with cancer-related anorexia—cachexia syndrome found that neither preparation was superior to placebo with respect to affecting appetite or quality of life A large study of advanced cancer patients randomized participants to receive the progestational agent megestrol acetate or dronabinol, or both Compared with participants in the dronabinol group, those in the megestrol arm experienced a significantly greater increase in both weight and appetite, and combining dronabinol with megestrol offered no additional benefit compared with megestrol alone.

    One smaller study of dronabinol in cancer patients demonstrated enhanced chemosensory perception in the treatment group compared with the placebo group In the dronabinol recipients, food tasted better, and appetite and caloric intake increased.

    Similarly variable and largely unimpressive results for dronabinol with respect to appetite and weight in hiv -associated wasting have also been reported One of the lay accounts concerning the tomb of the Siberian Ice Maiden closes with these lines:.

    Modern-day scientists have increasingly been turning their attention to cannabis due to its potential to inhibit or destroy cancer cells, and at the very least, manage the pain and symptoms that come with the illness.

    But then, ancient people seem to have known that already. That sort of a leap—assuming that because the Ice Maiden was buried with cannabis and had cancer, that she was using it to treat her cancer—is about as valid as the claims being made on the Internet today that highly concentrated cannabis oils can cure cancer. It might be possible, but there is, as yet, no solid evidence to support that belief.

    One of the more distressing situations that oncologists increasingly face is trying to counsel the patient who has a curable diagnosis, but who seeks to forego conventional cancer treatment in favour of depending on cannabis oil to eradicate their malignancy because of the large number of online testimonials from people claiming such results. Given my long practice in San Francisco, I can assume that a large proportion of my patients have used cannabis during their journey. If cannabis cured cancer, I would have a lot more survivors in my practice today.

    Granted, inhaled cannabis cannot deliver the concentration of active ingredients that a heavily concentrated thc or cbd oil can, but there is as yet no convincing demonstration that the in vitro or animal model findings translate into the clinical arena. One of the earliest studies suggesting that cannabinoids might have anticancer activity came from the U. National Cancer Institute in a paper published in For unclear reasons, that line of research was not pursued further at the National Institutes of Health in the United States, but was subsequently picked up by investigators in Spain and Italy, who have made enormous contributions to the field.

    If cannabinoids are postulated to have a potential anticancer effect working through the cb1 receptor, it would follow that the brain—where the cb1 receptor is the most densely populated seven-transmembrane domain G protein—coupled receptor—would be a good place to start the investigation. And, in fact, numerous studies in vitro and in animal models have suggested that cannabinoids can inhibit gliomas Other tumour cell lines are also inhibited by cannabinoids in vitro, and cannabinoid administration to nude mice curbs the growth of various tumour xenografts representing multiple solid and hematologic malignancies, including adenocarcinomas of the lung, breast, colon, and pancreas, and also myeloma, lymphoma, and melanoma 43 , A discussion of the mechanism of action of cannabinoids as anticancer agents is beyond the scope of the present article, but has been reviewed elsewhere 45 — Cannabinoids appear to induce apoptosis, probably through interaction with the cb1 receptor.

    Cannabinoid administration in mouse models has been observed to reduce the expression of vascular endothelial growth factor and its receptors, leading to inhibition of angiogenesis. Cannabinoids also decrease the activity of matrix metalloproteinase 2, leading to decreased tumour-cell invasiveness and decreased potential for metastasis.

    In addition, cannabinoids have anti-inflammatory and antioxidant properties that are also desirable in combatting cancer. In vitro studies have demonstrated that, combined with gemcitabine, cannabinoids further reduce the viability of pancreatic cancer cells In mice, adding thc to temozolomide used widely in treatment of aggressive brain tumours , reinstated glioma suppression in tumours that had become resistant to chemotherapy The addition of cbd enhanced the antitumour activity even when lower doses of thc were used.

    Similarly, a combination of thc and cbd was found to enhance the antitumour effects of radiation in a murine glioma model, suggesting that cannabinoids might be synergistic with radiation therapy as well as with chemotherapy But again, mice and rats are not people, and what is observed in vitro does not necessarily translate into clinical medicine.

    The preclinical evidence that cannabinoids might have direct anticancer activity is provocative as well, but more research is warranted. Hence, the oncologist advising patients on the use of cannabinoids during conventional cancer treatment should be aware of the preclinical findings and should not reflexively advise patients to avoid cannabis altogether.

    Currently, we can be confident that cannabis could have utility in symptom management for patients living with and beyond cancer 52 — Compared with most of the therapeutic agents that oncologists use in their practice, the side-effect profile of cannabis as medicine is acceptable, and the adverse effects are well described 54 , To be able to suggest a single agent that could hold benefit in the treatment of nausea, anorexia, pain, insomnia, and anxiety instead of writing prescriptions for 5 or 6 medications that might interact with each other or with cancer-directed therapies seems advantageous.

    And although botanical—pharmaceutical interactions for other drugs metabolized by certain cytochrome P isoforms is a theoretical possibility, no significant perturbations in the plasma concentrations of prescription medications have been seen to date when cannabis is co-administered. The only published study investigating medicinal cannabis with chemotherapeutic agents found no effect on the plasma pharmacokinetics of irinotecan or docetaxel when cannabis was administered as a herbal tea, although that delivery system is neither particularly popular nor likely potent The pharmacokinetics of ingested compared with inhaled cannabis would support an inhaled route of administration if patients desire more control over the onset, depth, and duration of the effect.

    The august New England Journal of Medicine published a perspective piece describing Marilyn, a year-old woman with metastatic breast cancer seeking medical cannabis from her physician Interestingly, the pro and con sides of the argument were both presented by mental health practitioners and not by medical oncologists. To summarize, cannabis and cannabinoids are useful in managing symptoms related to cancer and its treatment. Exciting preclinical evidence suggests that cannabinoids are not only effective in the treatment but also in the prevention of chemotherapy-induced peripheral neuropathy.

    Cannabinoids could be synergistic with opioids in the relief of pain. The safety profile of cannabis is acceptable, with side effects that are generally tolerable and short-lived.

    Preclinical data suggest that cannabinoids could have direct antitumour activity, possibly most impressive in central nervous system malignancies. Clinical data about the effects of cannabis concentrates on cancer are as yet unavailable. Oncologists could find cannabis and cannabinoids to be effective tools in their care of patients living with and beyond cancer.

    National Center for Biotechnology Information , U. Journal List Curr Oncol v. Published online Mar Find articles by D. Author information Copyright and License information Disclaimer. Copyright Multimed Inc. This article has been cited by other articles in PMC.

    Abstract Cannabis species have been used as medicine for thousands of years; only since the s has the plant not been widely available for medical use. Cannabis, cannabinoids, symptom management, nausea, anorexia, pain. Being aware that the plural of anecdote is not evidence, I would like to share an e-mail message from a year-old gentleman with metastatic colon cancer requesting a renewal of his medical cannabis authorization: I cannot thank you enough for giving me that option!

    The Huffington Post; Cannabidiol as potential anticancer drug. Br J Clin Pharmacol. Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis.

    Preliminary efficacy and safety of an oromucosal standardized cannabis extract in chemotherapy-induced nausea and vomiting. Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety and tolerability of thc: J Pain Symptom Manage.

    A double-blind, placebo-controlled, crossover pilot trial with extension using an oral mucosal cannabinoid extract for treatment of chemotherapy-induced neuropathic pain. International Union of Pharmacology. Cannabinoid receptors and their ligands: Cannabinoids for medical use: Lynch ME, Campbell F. Cannabinoids for treatment of chronic non-cancer pain: Systematic review and meta-analysis of cannabis treatment for chronic pain. Efficacy and adverse effects of medical marijuana for chronic noncancer pain: Inhaled cannabis for chronic neuropathic pain: Efficacy of inhaled cannabis on painful diabetic neuropathy.

    Activation of cannabinoid cb1 and cb2 receptors suppresses neuropathic nociception evoked by the chemotherapeutic agent vincristine in rats. Cannabinoid type-1 receptor reduces pain and neurotoxicity produced by chemotherapy.

    Cannabidiol inhibits paclitaxel-induced neuropathic pain through 5-HT 1A receptors without diminishing nervous system function or chemotherapy efficacy. Synergistic interactions between cannabinoid and opioid analgesics. The analgesic effect of oral deltatetrahydrocannabinol thc , morphine, and a thc -morphine combination in healthy subjects under experimental pain conditions.

    Efficacy of dronabinol as an adjuvant treatment for chronic pain patients on opioid therapy. Nabiximols for opioid-treated cancer patients with poorly-controlled chronic pain: Cannabinoid—opioid interaction in chronic pain. Clearing the smoke around medical marijuana. Deltatetrahydrocannabinol as an antiemetic in cancer patients receiving high-dose methotrexate. A prospective, randomized evaluation. A prospective evaluation of deltatetracannabinol as an antiemetic in patients receiving Adriamycin and Cytoxan chemotherapy.

    Cannabinoids for control of chemotherapy induced nausea and vomiting: Therapeutic use of Cannabis sativa on chemotherapy-induced nausea and vomiting among cancer patients:

    Integrating cannabis into clinical cancer care

    “Are cancer charities hiding cannabis as a cure? . But very little reliable information can be taken from a single patient treated with what's an unknown mix of There is good evidence that cannabinoids may be beneficial in. Contrary to what most people believe, medical uses of cannabis have been widely studied. There was also good evidence that tetrahydrocannabinol (THC ), the main Cannabis may be useful for treating some people's nausea when undergoing Three reasons why scientific advice on drugs is ignored. You can read the original article here and donate to Cancer Research UK here. What about controlling cancer symptoms such as pain or sickness? “proof” that cannabis or cannabinoids can cure cancer is highly misleading to . treat cancer, there is good evidence that these molecules may be beneficial in other ways.

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    Moniq

    “Are cancer charities hiding cannabis as a cure? . But very little reliable information can be taken from a single patient treated with what's an unknown mix of There is good evidence that cannabinoids may be beneficial in.

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