Originally treated for pain with morphine, Newton-John was able to wean herself off the morphine by using marijuana, primarily cannabis oil. She claims it also is helping her with anxiety and sleep. Her husband, John Easterling, grows many of the herbs and marijuana in a greenhouse in the backyard of their California home. Olivia says: “I really believe the cannabis has made a huge difference. If I don’t take the drops, I can feel the pain, so I know it’s working.”
In a small pilot study of analgesia involving 10 patients with cancer pain, secondary measures showed that 15 mg and 20 mg doses of the cannabinoid delta-9-THC were associated with anxiolytic effects. Another small placebo-controlled study of dronabinol in cancer patients with altered chemosensory perception also noted increased quality of sleep and relaxation in THC-treated patients.
— The singer and actress updates fans on her battle, but can marijuana help?
Dronabinol, a synthetically produced delta-9-THC, was approved in the U.S. in 1986 as an antiemetic to be used in cancer chemotherapy. Nabilone, a synthetic derivative of delta-9-THC, was first approved in Canada in 1982 and is now also available in the U.S. Numerous clinical trials and meta-analyses have shown that dronabinol and nabilone are effective in the treatment of nausea and vomiting induced by chemotherapy. Both dronabinol and nabilone have been approved by the FDA for the treatment of nausea/vomiting associated with cancer chemotherapy in patients who have failed to respond to conventional antiemetic therapy. The American Society of Clinical Oncology antiemetic guidelines updated in 2017 recommends that the FDA-approved cannabinoids, dronabinol, or nabilone be used to treat nausea/vomiting that is resistant to standard antiemetic therapies.
Although few relevant surveys of practice patterns exist, it appears that physicians caring for cancer patients in the U.S. who recommend medicinal cannabis do so predominantly for symptom management. The potential benefits of medicinal cannabis for people living with cancer include antiemetic effects, appetite stimulation, pain relief, and improved sleep.
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.
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.
What is CBD?
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.
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.
Cannabis/Cannabinoids Administration to Syngeneic Bone Marrow Transplantation Model.
To investigate the effect of THC, CBD, and cannabis extracts on hematopoiesis after BMT in vivo, we utilized a syngeneic transplantation model ( Figure 1A ). Mice underwent lethal whole-body irradiation and were reconstituted with donor bone marrow cells. The cannabinoid treatments were administered intraperitoneally (IP) from the day of transplantation, every other day, for 2 weeks. Once a week, blood was collected for complete blood counts. Surprisingly, all treatments—and especially THC—inhibited lymphocyte reconstitution after transplantation ( Figure 1B ). Only the high-THC extract improved platelet rehabilitation ( Figure 1C ). Indeed, using knockout mice as donors, we have demonstrated that the cannabinoid receptor 2 (CB2), known to be activated by THC, has an inhibitory effect on post-transplant recovery of blood lymphocytes ( Figure 2 ).
CANNABIS AND IMMUNITY IN HEMATOPOIETIC STEM CELL TRANSPLANTATION
Cannabis and cannabinoids are known for their analgesic and anti-emetic effects, and therefore their application has increased for chemotherapy-induced nausea, vomiting, and chronic pain.1 Whether cannabinoids have an anti-cancer affect is yet to be determined. Recent studies suggested that some cannabinoid-based treatments might have anti-tumor properties.2–5 Cannabinoids were found to modulate key cell signaling pathways involved in the control of cancer cell proliferation and survival.6–8 However, most of these studies utilized in vitro methods, a few were done in immune-competent animal models, and the data from human patients are anecdotal. In addition, the heterogeneity of endocannabinoids and their receptors in different tumor types raises the possibility that specific cannabinoid compositions should be used to treat differing cancer subtypes.3,9,10
A: Recipient C57BL/6 mice (R) received lethal whole-body irradiation and were reconstituted with 8×10 6 donor C57BL/6 (D) bone marrow cells. Cannabis/cannabinoids were administered IP every other day, for 2 weeks from the day of transplantation. Blood samples for complete blood counts were obtained once a week. B: Lymphocyte counts (day 21 after transplantation) in pure cannabinoid-treated groups (left) and BDS-treated groups (right) are presented. C: Platelet counts in pure cannabinoid-treated groups (left) and BDS-treated groups (right), day 14 after transplantation. * P<0.05; ** P<0.001; *** P<0.0001. Modified from Figure 4 in Khuja et al.17; reused under creative commons license (CC BY 4.0).
BDS, botanical drug substance; CBD, cannabidiol; IP, intraperitoneally; TCH, Δ9-tetrahydrocannabinol.