Cannabis for Cancer
CHAPTER 1: INTRODUCTION
Cannabis as Medicine: A Brief History
The cannabis plant—also known as marijuana or hemp—has been around for many centuries and has a long history of human use. Ancient people used it as a source of fiber, medicine, and intoxicant. The earliest known descriptions of cannabis appear in Chinese and Indian ancient writings and folklore. Historians believe ancient Chinese and Indians first used marijuana in ritual practices. Eventually, cannabis was put to common use in folk medicine, usually in the form of an edible extract or tea. Smoking marijuana for medicinal purposes is mainly recent.
Emperor Shen Nung, also known as Chen Nung (circa 2700 B.C), according to Chinese legend, discovered marijuana’s healing properties. A compendium of drug recipes compiled in 1 A.D shows cannabis as an ideogram of plants drying in a shed. This text recommends cannabis for more than 100 illnesses, including malaria, absentmindedness, rheumatism, and gout.
After a few centuries, a Chinese medical text (1578 A.D) showed that cannabis could treat vomiting, parasitic infections, and bleeding. Currently, the Chinese use marijuana as a folklore remedy for diarrhea, dysentery as well as to stimulate the appetite.
For thousands of years, Indians have associated cannabis with magic, religion, and healing. Up to today, practitioners of traditional Ayurvedic medicine still prescribe cannabis. They use cannabis to promote appetite, sleep, and digestion and to relieve pain. Cannabis is also considered an intoxicant and aphrodisiac. However, ancient Greek and Roman physicians cautioned their people that using cannabis excessively could diminish their sexual performance. Despite this drawback, some doctors recommended cannabis as a treatment for various illnesses, including earaches.
Cannabis’s dual nature, beneficial medicine versus harmful intoxicant, has been a subject of debate for centuries. As early as the fifteenth century, Muslim theologians were torn between whether hashish (a potent drug made from marijuana resin) should be treated like alcohol, which is forbidden by the Quran. The scholars solved the dilemma by distinguishing between the use of hashish as an intoxicant punishable by brutal whipping, and its use as a medicine which is permitted.
Muslims invented techniques to manufacture paper from hemp fibers and introduced it to Europe in the twelfth century. There is, however, little evidence that Europeans used cannabis as medicine in medieval Europe. Arab traders passed the knowledge of hemp’s medicinal value to Africa during medieval times. People in Africa allegedly used cannabis to treat a variety of illnesses such as snake bites, labor pains, dysentery, and malaria.
It was not until the 1840s that cannabis got introduced to western medicine. While working in the British East Indies Company, W.B O’Shaughnessy learned of its medicinal benefits and introduced it to western medicine. They promoted cannabis for being sedative, anti-inflammatory, analgesic anticonvulsant, and antispasmodic. Queen Victoria’s dysmenorrhea was allegedly treated using cannabis.
The United States Treasury Department introduced the Marijuana Tax Act of 1937. The Act’s primary opponents were the physicians and was masterminded by Harry Anslinger, who was the director of the Federal Bureau of Narcotics from its inception in 1931 until 1962. Harry Anslinger testified in congress that marijuana is the most violence-causing drug in the history of humankind. However, the Marijuana Tax Act imposed a levy of one dollar an ounce for medicinal use and one hundred dollars for recreational use, which at that time was a prohibitive cost. Cannabis was removed from the U.S Pharmacopoeia in 1942 on the claims that it was a harmful and addictive drug. The Controlled Substances Act in 1970 classified marijuana as a Schedule I drug with no medical use.
Physicians reported that they had successfully used cannabis to treat gonorrhea, pain, chronic cough, and other conditions at the first American conference on the clinical use of cannabis, which was held by the Ohio Medical Society. With the rising demand for cannabis-based medications, pharmaceutical firms attempted to produce reliable and potent drugs from marijuana. By the 1930s, several companies in the U.S were selling standardized extracts of marijuana for use as an antispasmodic, an analgesic, and sedative. Grimault & Company sold marijuana cigarettes as a remedy for asthma. After the Marijuana Tax Act of 1937, most pharmaceutical companies stopped producing marijuana-based drugs.
The use of medicinal cannabis continues to grow and evolve, as proven by the increasing number of states in the U.S permitting cannabis for therapeutic use. Researchers are conducting more studies, and evidence supporting the health benefits of cannabis is increasing. More people are turning to cannabis to treat and manage nausea associated with cancer and HIV/AIDS treatments, insomnia, pain relief, anxiety, and several other conditions.
*The Protective Role of The Endocannabinoid System Against Cancer
Neurons, cannabinoid receptors, and endocannabinoids make up the endocannabinoid system (ECS). The ECS work is to maintain homeostasis in an organism. Endocannabinoids bind and activate one or more cannabinoid receptor subtypes, thereby producing properties similar to cannabis. ECS exists in the body even without using cannabis and regulates physiological and cognitive processes such as fertility and reproduction, sleep, mood, memory, and appetite. It may also play a significant role in the regulation of tumor generation and advancement.
There are two main endocannabinoids known so far; anandamide and 2-arachidonoyglyerol. These endocannabinoids ensure that internal body functions run smoothly. There are receptors found throughout the body to which the endocannabinoids bind. There are two key endocannabinoid receptors; CB1 receptors, which are typically found in the central nervous system, and CB2 receptors are primarily found in the peripheral nervous system, particularly immune cells.
Endocannabinoids and phytocannabinoids inhibit cancers in several ways. The most common method is programmed cell death, also known as induction of apoptosis. All cells in the body destroy themselves in the body when they are too old or when they are damaged. Cancer cells, however, grow abnormally and do not kill themselves. Cannabinoids restore the ability of cancer cells to undergo apoptosis, therefore, killing them. Cannabinoids can as well slow cancer cells reproduction through modulation of biological processes. Cannabinoids prevent tumors from forming their blood vessels and stop the spread of cancer within local tissues and other tissues.
Research has proven that endocannabinoids kill many types of cancer cells. The first endocannabinoid to be discovered was anandamide and is majorly responsible for the ECS’s anti-cancer activity.
A 2003 study reported that anandamide induced cell death in prostate cancer cell lines. Cancer cell lines are a collection of cells consisting of the same genetic makeup. Anandamide stopped the spread of cancer cells and induced the cancer cell lines’ death by activating CB1 receptors on the cancer cells’ surface.
Cannabinoids mostly kill cancer cells through apoptosis, but there are instances where they initiate necrosis alternatively. Necrosis can result from an injury and is characterized by the cell membrane rupturing and spilling the cell contents into the extracellular area, leading to inflammation and death of adjacent cells. Most standard chemotherapeutic agents kill cancer through necrosis. It is better to kill cells through apoptosis than through necrosis as apoptosis is more deliberate and keeps the adjacent cells safe. Several studies have indicated that cannabinoids cause apoptotic cell death.
According to a 2011 study, anandamide and two other endocannabinoid-like compounds, palmitoylethanolamide and oleoylethanolamide, reduced neuroblastoma cells’ viability. Cell viability is used to measure the health of the cell. There are a number of indicators of cell viability, including adenosine triphosphate (ATP), which is the chief unit of energy in cells and degenerates quickly during apoptosis or necrosis. When there are high levels of ATP, the cell is more viable. In situations where measuring ATP is not possible, other ways can be used, such as membrane leakage evaluation and mitochondrial assessment. It is used to measure mitochondrial enzymes’ activity and their ability to convert a specific chemical dye into soluble crystals.
The endocannabinoid system has been shown to have therapeutic effects in alleviating symptoms such as chemotherapy-induced neuropathic pain and bone cancer pain, appetite loss, nausea, and vomiting.
The endocannabinoid system suppresses tumors in different cancer types. Breast cancer mainly affects women, but men have around a 1% chance of getting it. A study conducted in Italy in 1998 showed that anandamide stopped the proliferation of breast cancer cell lines. The endocannabinoid had no pro-apoptotic effects but reduced the number of cancer cells. Most forms of breast cancer fuel their growth by producing hormones such as prolactin. Prolactin has several functions, including the production of milk. Many breast cancer cell lines produce significant amounts of prolactin, which activates prolactin receptors and increases proliferation. Anandamide reduces prolactin receptor synthesis and preventing prolactin action.
Researchers also tried mixing anandamide with cannabidiol, a plant-based cannabinoid. The combination slightly increased the cell death rates in lymphoma and leukemia cells compared with cells only treated with anandamide. In a 2011 study, anandamide strongly suppressed colorectal cancer cells’ spread through receptor-independent interaction with lipid rafts. The effects on anandamide on the cancer cells were dependent on dose and increased expression of the pro-apoptotic enzyme caspase-3. An earlier study had shown that increasing anandamide levels reduced the development of precancerous colon lesions.
Endocannabinoids and phytocannabinoid have similar properties, and Phytocannabinoids can also inhibit and kill cancer cells. Cannabinoids can cross the blood-brain barrier and kill many types of brain cancer cells. CBD exerts a lot of cytotoxic effects on brain cancer cells. In another study, THC reduced tumor growth and the number of tumors in breast cancer. It also induced apoptosis, stopped angiogenesis, reduced proliferative potential, and decreased lung metastases.
CHAPTER 2: CANNABIS AND CANCER
*Antiemetic effect
*Malnutrition and Weight Loss
*Not A Magic Bullet
CHAPTER 3: MEDICAL MARIJUANA AND CHEMOTHERAPY
*What Is Chemotherapy?
*Chemotherapy Side Effects
*Effect of medical marijuana on chemotherapy side effects
CHAPTER 4: SYMPTOM MANAGEMENT
*Neuropathy
*Anxiety, depression, and sleep
*Analgesia
CHAPTER 5: ANTI-CANCER POTENTIAL
*Cannabinoids
*Terpenes
*Flavonoids
CHAPTER 6: CANCERS THAT CANNABIS HAVE TREATED
*Brain Cancer
*Breast Cancer
*Cervical Cancer
*Skin Cancer
*Lung cancer
*Other
CHAPTER 7: HOW CANNABIS IS ADMINISTRATED
*Smoking
*Vaporizers
*Ingestion
*Capsules
*Topical Application
CHAPTER 8: CANNABIS DOSING GUIDELINES
*How to Begin
*General Dosing
CHAPTER 9: CANNABIS PHARMACEUTICALS
*Controlled Substances Scheduling
*Novel Cannabinoid Medications
*Medical Marijuana Use
CHAPTER 10: CANNABINOID CHEMISTRY
*Cannabinoids and The Cell
*Cannabinoids and The Immune System
*Cannabinoids and The Nervous System
CHAPTER 11: CAUTIONS IN USING CANNABIS
*Lung Problems
*Neuropsychiatric
*Other
CHAPTER 12: POTENTIAL RISKS
*Safety and Side Effects
*Guidelines for Providers
CHAPTER 13: LEGAL ISSUES
*From Medicine to Illicit Drug
*A Medical Necessity?
*Research and Regulation
CHAPTER 14: MARIJUANA’S MEDICAL FUTURE
*The IOM Recommendations
*Other Reports on Marijuana as Medicine
*Looking to the Future
CHAPTER 15: SUMMARY
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Elizabeth