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The Use of Medical Marijuana in Cancer

  • Integrative Care (C Lammersfeld, Section Editor)
  • Published:
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Abstract

The use of medical marijuana in cancer care presents a dilemma for both patients and physicians. The scientific evidence is evolving, yet much of the known information is still insufficient to adequately inform patients as to risks and benefits. In addition, evidence-based dosing and administration information on medical marijuana is lacking. Medical marijuana is now legal, on some level, in 24 states plus the District of Columbia, yet is not legal on the federal level. This review addresses the current state of the research, including potential indications, risks and adverse effects, preliminary data on anticancer effects, as well as legal and quality issues. A summary of the clinical trials underway on medical marijuana in the oncology setting is discussed.

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References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

  1. California Health and Safety Code Section 11357-11362.9 [Internet]. Available from: http://www.leginfo.ca.gov/cgi-bin/displaycode?section=hsc&group=11001-12000&file=11357-11362.9.

  2. Abrams DI, Guzman M. Cannabis in cancer care. Clin Pharmacol Ther [Internet]. 2015;97:575–86. Available from http://www.ncbi.nlm.nih.gov/pubmed/25777363. Reviews the history of cannabis as medicine, cannabinoid pharmacology, and discusses the research that has been done on cannabinoids in cancer symptom management.

  3. Kramer JL. Medical marijuana for cancer. CA Cancer J Clin [Internet]. 2015;65:109–22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25503438. Provides summary tables comparing the research to date on effect of smoked marijuana on chemotherapy-induced nausea/vomiting, pain, and appetite/weight loss.

  4. Whiting PF, Wolff RF, Deshpande S, Di Nisio M, Duffy S, Hernandez A V., et al. Cannabinoids for medical use: a systematic review and meta-analysis. Jama [Internet]. 2015;313:2456. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2015.6358. A systemic review and meta-analysis of cannabinoids for medical use that included a total of 79 trials and 6462 participants.

  5. Zhang MW, Ho RCM. The cannabis dilemma: a review of its associated risks and clinical efficacy. J. Addict. [Internet]. 2015;2015:707596. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4619948&tool=pmcentrez&rendertype=abstract.

  6. Grotenhermen F, Müller-Vahl K. The therapeutic potential of cannabis and cannabinoids. Dtsch Arztebl Int [Internet]. 2012;109:495–501. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3442177&tool=pmcentrez&rendertype=abstract.

    Google Scholar 

  7. Joshi M, Joshi A, Bartter T. Marijuana and lung diseases. Curr Opin Pulm Med [Internet]. 2014;20:173–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24384575.

    Article  CAS  Google Scholar 

  8. Ruchlemer R, Amit-Kohn M, Raveh D, Hanuš L. Inhaled medicinal cannabis and the immunocompromised patient. Support Care Cancer [Internet. 2015;23:819–22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25216851.

    Article  Google Scholar 

  9. Stout SM, Cimino NM. Exogenous cannabinoids as substrates, inhibitors, and inducers of human drug metabolizing enzymes: a systematic review. Drug Metab Rev [Internet]. 2014;46:86–95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24160757.

    Article  CAS  Google Scholar 

  10. Callaghan RC, Allebeck P, Sidorchuk A. Marijuana use and risk of lung cancer: a 40-year cohort study. Cancer Causes Control [Internet]. 2013;24:1811–20. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23846283.

    Article  Google Scholar 

  11. Thomas AA, Wallner LP, Quinn VP, Slezak J, Van Den Eeden SK, Chien GW, et al. Association between cannabis use and the risk of bladder cancer: results from the California Men’s Health Study. Urology [Internet]. 2015;85:388–92. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25623697.

    Article  Google Scholar 

  12. Huang Y-HJ, Zhang Z-F, Tashkin DP, Feng B, Straif K, Hashibe M. An epidemiologic review of marijuana and cancer: an update. Cancer Epidemiol. Biomarkers Prev. [Internet]. 2015;24:15–31. Available from: http://cebp.aacrjournals.org/cgi/doi/10.1158/1055-9965.EPI-14-102

  13. Chakravarti B, Ravi J, Ganju RK. Cannabinoids as therapeutic agents in cancer: current status and future implications. Oncotarget [Internet]. 2014;5:5852–72. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25115386.

    Article  Google Scholar 

  14. Orellana-Serradell O, Poblete CE, Sanchez C, Castellón EA, Gallegos I, Huidobro C, et al. Proapoptotic effect of endocannabinoids in prostate cancer cells. Oncol Rep [Internet]. 2015;33:1599–608. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4358087&tool=pmcentrez&rendertype=abstract.

    CAS  Google Scholar 

  15. McAllister SD, Soroceanu L, Desprez P-Y. The antitumor activity of plant-derived non-psychoactive cannabinoids. J Neuroimmune Pharmacol [Internet]. 2015;10:255–67. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25916739.

    Article  Google Scholar 

  16. Throckmorton DC. Testimony. Commissioner O of the. Testimony - Cannabidiol: barriers to research and potential medical benefits [Internet]. Office of the Commissioner; [cited 2016 Mar 2]. Available from: http://www.fda.gov/NewsEvents/Testimony/ucm453989.htm.

  17. Title 21 United States Code (USC) Controlled Substances Act - Section 812. [Internet]. [cited 2016 Mar 2]. Available from: http://www.deadiversion.usdoj.gov/21cfr/21usc/812.htm.

  18. Rannazzisi JT. Statement of deputy assistant administrator drug enforcement administration before the caucus on international narcotics control United States Senate for a hearing concerning Cannabidiol: barriers to research and potential medical benefit [Internet]. [cited 2016 Mar 2]. Available from: http://www.dea.gov/pr/speeches-testimony/2015t/062415t.pdf.

  19. Hillig KW, Mahlberg PG. A chemotaxonomic analysis of cannabinoid variation in Cannabis (Cannabaceae). Am J Bot [Internet]. 2004;91:966–75. Available from: http://www.amjbot.org/content/91/6/966.full.

    Article  CAS  Google Scholar 

  20. Recommendations for regulators—Cannabis operations [Internet]. 2014. Available from: http://www.ahpa.org/Portals/0/Documents/AHPA_Recommendations_for_Regulators_Cannabis.pdf.

  21. Title 21 United States Code (USC) Controlled Substances Act—Section 802 [Internet]. [cited 2016 Mar 2]. Available from: http://www.deadiversion.usdoj.gov/21cfr/21usc/802.htm.

  22. Commissioner O of the. Legislation—Controlled Substances Act, Title 21, Chapter 13, Subchapter I [Internet]. Office of the Commissioner; Available from: http://www.fda.gov/regulatoryinformation/legislation/ucm148726.htm.

  23. National Conference of State Legislatures—State Medical Marijuana Laws [Internet]. Available from: http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx.

  24. Americans for Safe Access—Legal Information [Internet]. Available from: http://www.safeaccessnow.org/state_and_federal_law.

  25. NORML State Marijuana Laws State Info [Internet]. [cited 2016 Mar 2]. Available from: http://norml.org/states.

  26. Memorandum for Selected United State Attorneys on Investigations and Prosecutions in States Authorizing the Medical Use of Marijuana | OPA | Department of Justice [Internet]. [cited 2016 Mar 2]. Available from: https://www.justice.gov/opa/blog/memorandum-selected-united-state-attorneys-investigations-and-prosecutions-states.

  27. Justice Department Announces Update to Marijuana Enforcement Policy | OPA | Department of Justice [Internet]. [cited 2016 Mar 2]. Available from: https://www.justice.gov/opa/pr/justice-department-announces-update-marijuana-enforcement-policy.

  28. Cannabis_Cultivation_Recommendations_Regulators.pdf [Internet]. [cited 2016 Feb 29]. Available from: http://www.ahpa.org/Portals/0/PDFs/Committee/CC/Cannabis_Cultivation_Recommendations_Regulators.pdf?ver=2016-02-23-150854-643.

  29. Search of: cannabis and cancer | Exclude Unknown | Interventional Studies | Cancer | cannabis - List Results - ClinicalTrials.gov [Internet]. [cited 2016 Mar 4]. Available from: https://clinicaltrials.gov/ct2/results?term=cannabis+and+cancer&no_unk=Y&type=Intr&cond=Cancer&intr=cannabis.

  30. Search of: safety and pharmacokinetics and cannabis and cancer - List Results - ClinicalTrials.gov [Internet]. [cited 2016 Mar 4]. Available from: https://clinicaltrials.gov/ct2/results?term=safety+and+pharmacokinetics+and+cannabis+and+cancer&Search=Search.

  31. Evaluation prospectively the level of reduction in cognitive functions of cancer patients who are on active oncology treatments and use Cannabis. The second goal is to identify high-risk groups for cognitive impairment due to Cannabis use. - Full Text Vie [Internet]. [cited 2016 Feb 29]. Available from: https://clinicaltrials.gov/ct2/show/NCT01983267?term=NCT01983267&rank=1.

  32. Search of: cannabis, cancer, and pain | Exclude Unknown | Interventional Studies | cancer pain | cannabis - List Results - ClinicalTrials.gov [Internet]. [cited 2016 Mar 4]. Available from: https://clinicaltrials.gov/ct2/results?term=cannabis%2C+cancer%2C+and+pain&recr=&no_unk=Y&rslt=&type=Intr&cond=cancer+pain&intr=cannabis&titles=&outc=&spons=&lead=&id=&state1=&cntry1=&state2=&cntry2=&state3=&cntry3=&locn=&gndr=&rcv_s=&rcv_e=&lup_s=&lup_e.

  33. Investigation of Cannabis for pain and inflammation in lung cancer - Full Text View - ClinicalTrials.gov [Internet]. [cited 2016 Feb 29]. Available from: https://clinicaltrials.gov/ct2/show/NCT02675842?id=NCT02675842&rank=1.

  34. Portenoy RK, Ganae-Motan ED, Allende S, Yanagihara R, Shaiova L, Weinstein S, et al. Nabiximols for opioid-treated cancer patients with poorly-controlled chronic pain: a randomized, placebo-controlled, graded-dose trial. J Pain [Internet. 2012;13:438–49. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22483680.

    Article  CAS  Google Scholar 

  35. Johnson JR, Burnell-Nugent M, Lossignol D, Ganae-Motan ED, Potts R, Fallon MT. Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC: CBD extract and THC extract in patients with intractable cancer-related pain. J. Pain Symptom Manage. [Internet]. 2010;39:167–79. . Available from: http://www.ncbi.nlm.nih.gov/pubmed/19896326.

  36. Johnson JR, Lossignol D, Burnell-Nugent M, Fallon MT. An open-label extension study to investigate the long-term safety and tolerability of THC/CBD oromucosal spray and oromucosal THC spray in patients with terminal cancer-related pain refractory to strong opioid analgesics. J Pain Symptom Manage. [Internet]. 2013;46:207–18. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23141881.

  37. Orexigenic therapy with delta-9-tetrahydrocannabinol in advanced cancer patients with chemosensory abnormalities—a pilot study - Full Text View - ClinicalTrials.gov [Internet]. [cited 2016 Mar 2]. Available from: https://clinicaltrials.gov/ct2/show/NCT00316563?term=NCT00316563&rank=1.

  38. Cannabics capsules as treatment to improve cancer related CACS in advanced cancer patients - Full Text View - ClinicalTrials.gov [Internet]. [cited 2016 Mar 2]. Available from: https://clinicaltrials.gov/ct2/show/NCT02359123?term=NCT02359123&rank=1.

  39. Torres S, Lorente M, Rodríguez-Fornés F, Hernández-Tiedra S, Salazar M, García-Taboada E, et al. A combined preclinical therapy of cannabinoids and temozolomide against glioma. Mol. Cancer Ther. [Internet]. 2011;10:90–103. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21220494.

  40. A study of dexanabinol in combination with chemotherapy in patients with advanced tumours - Full Text View - ClinicalTrials.gov [Internet]. [cited 2016 Mar 2]. Available from: https://clinicaltrials.gov/ct2/show/NCT02423239?term=NCT02423239&rank=1.

  41. A study: pure CBD as single-agent for solid tumor. - Full Text View - ClinicalTrials.gov [Internet]. [cited 2016 Mar 2]. Available from: https://clinicaltrials.gov/ct2/show/NCT02255292?term=NCT02255292&rank=1.

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Correspondence to Shauna M. Birdsall.

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Shauna M. Birdsall, Timothy C. Birdsall, and Lucas A. Tims declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Birdsall, S.M., Birdsall, T.C. & Tims, L.A. The Use of Medical Marijuana in Cancer. Curr Oncol Rep 18, 40 (2016). https://doi.org/10.1007/s11912-016-0530-0

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  • DOI: https://doi.org/10.1007/s11912-016-0530-0

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