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Use of Cannabis as anti tumor agents in Oncology: The Pitfalls.



Cannabis, also known as Marijuana, is a plant that has been used for herbal medicinal purposes as far back as ancient China, before being recognized in the European academic space in the 19th century. Scientists have discovered several biologically active components in cannabis called cannabinoids. Of the discovered cannabinoids, delta-9-tetrahydrocannabinol (commonly known as THC), and cannabidiol (CBD) are the two most common. THC and CBD have similar effects when ingested into the system of a human being, but there are also notable differences. Based on reports from users, supported with scientific research, THC causes a "high" effect and can help as an antioxidant, relieve pain and nausea, and reduce inflammation. Cannabidiol (CBD), on the other hand, counteracts the 'high' and calms the user by reducing anxiety and paranoia. Despite studies going back decades ago, there have been recent developments in the research into cannabis' impact in the medical field, asides from its recreational use.


Cannabis and Oncology: Research and uses


The study and medical care of cancer are ever-evolving due to the progressive outcomes of research leading to several clinical trials. With the legalization of cannabis, subsequent to over forty years of prior research into its components, scientists have been investigating in an attempt to establish grounds for the incorporation of cannabis for the treatment of cancer. The primary basis for cannabis research is the endocannabinoid system, which consists of receptors, endogenous ligands (endocannabinoids), and metabolizing enzymes. The endocannabinoid system is studied in neuroscience in relation to the clinical use of cannabinoids to establish the reaction between the chemical components and the biological system as it pertains to physiological and pathological effects. In an article published in the Bosnian Journal of Basic Medical Sciences, it was established that the interaction between phytocannabinoids/synthetic cannabinoids and components of ECS or other cellular pathways can affect the development of diseases in humans.


An article in the Journal of Neurology and Neuromedicine mentions that cannabinoids have remarkable pain-relieving properties, spasmolytic effects in multiple sclerosis, and antiemetic potential in cancer therapy. Research into cannabinoids has also created a large body of evidence to support the anti-tumorigenic potential of some cannabinoid derivatives. Although, there has been only one clinical trial that encapsulated the safety aspects in its investigation of the antitumor prospective function of cannabinoids in human malignancies in vivo. A pilot phase I study was conducted among patients with advanced, recurrent glioblastoma multiforme by administering regulated THC. While the study can be faulted for not being statistically representative in its sample size, there were still responses recorded in 9 of the patients that suggested downstream signal transduction pathways previously identified in vitro studies were successfully confirmed in patient tumor tissue in vivo. Another case study, involving a terminally ill 14-year-old girl suffering from a highly aggressive, refractory form of acute lymphoblastic leukemia (BCR-ABL1 positive, Philadelphia-ALL) .The standard bone marrow transplant, chemotherapy and radiation were revoked as she had failed multiple lines of treatment. She was placed under palliative care .Given no other solutions available, the family opted for treatment with hemp oil extracts and found that cannabinoid therapy was tolerated in her system as a rapid, dose-dependent decrease of leukocytes (starting with WBC > 300 000/microL) until blast clearance in the peripheral blood was observed. However, the research into cannabis as a treatment option in oncology is still ongoing.


Pitfalls in the use of cannabis as anti-tumor agents


Previous studies provide an evidence-based foundation but, they do not have all the answers to pitfalls in the administration of cannabis on a full medical scale. Beyond symptomatic treatment, there is a lag in the research to prove the efficacy of cannabinoids in cancer treatment.


- Drug Interactions with cannabis


There are cancer models that show that cannabinoids may modulate tumor growth but, due to their interactions with other drugs and their effects on the neurocognitive, pathological, and psychological function of humans, introducing cannabis into frontline medical treatment is a sort of slippery slope. Any antitumor effects that cannabis has over the course of treatment are likely to be more as a result of its interactive dependency on other medication and, of course, the type of cancer in context. While scientific research continues to uncover components of cannabis that may aid the treatment of cancer, there is no outright claim of cannabis being an anti-tumor agent. Rather, it is supported as a form of palliative care by helping cancer patients with their pain and nausea, while stimulating appetite, all together supporting their body throughout the treatment process.


- Abuse, addiction, and after-effects


The use of cannabis for medicinal purposes is an age-long practice, beginning with traditional Chinese communities. However, upon incorporation into western medical practices, it has been approached cautiously and with controlled use. Cannabis has pain-relieving and anti-inflammatory effects but it is classified as a Schedule I agent, which refers to a drug with a high potential for abuse. Using cannabis to treat symptoms without prescription may lead to abuse, addiction, and other after-effects. Health care professionals are best informed on the harmful effects of cannabis on cancer care.


- Research and Clinical trials


Despite nearly a century of research, most of the studies focused on the effects of CBD on cancers have yet to reach the clinical trial phase, as a result, there is limited understanding of the safety and efficacy of cannabis as related to inhibiting tumor growth. Currently, there are no human clinical cannabis trials that investigate the use of cannabis as an anti-cancer agent. Patients must remember that animal or test tube studies do not translate into human studies or their benefits in humans.


Conclusion


For patients looking for alternative treatments for their cancer and bypassing evidence-based oncology treatment options, they do so at their own risk. At the moment, cannabis should only be used in treating specific symptoms of different illnesses and diseases -with controlled quantities. As an anti-tumor agent, however, there is no strong research to support the use of cannabis in oncology. While it can help oncology patients to deal with certain symptoms of their cancer variants, it doesn't necessarily inhibit the growth of cancerous tumors unlike Doxorubicin liposomal, Epirubicin, Idarubicin, Valrubicin, and other immunotherapy drugs. For more information on the use of cannabis for treating symptoms,


you can view a comprehensive list for medical use of cannabis at https://www.drugs.com/illicit/cannabis.html Please consult with your healthcare professional before ingesting cannabis for medical purposes.

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