National Cancer Institute at the National Institutes of Health
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Have any preclinical (laboratory or animal) studies been conducted using Cannabis or cannabinoids?
Preclinical studies of cannabinoids have investigated the following activities:Antitumor activity
- Studies in mice and rats have shown that cannabinoids may inhibit tumor growth by causing cell death, blocking cell growth, and blocking the development of blood vessels needed by tumors to grow. Laboratory and animal studies have shown that cannabinoids may be able to kill cancer cells while protecting normal cells.
- A study in mice showed that cannabinoids may protect against inflammation of the colon and may have potential in reducing the risk of colon cancer, and possibly in its treatment.
- A laboratory study of delta-9-THC in hepatocellular carcinoma (liver cancer) cells showed that it damaged or killed the cancer cells. The same study of delta-9-THC in mouse models of liver cancer showed that it had antitumor effects. Delta-9-THC has been shown to cause these effects by acting on molecules that may also be found in non-small cell lung cancer cells and breast cancer cells.
- A laboratory study of cannabidiol in estrogen receptor positive and estrogen receptor negative breast cancer cells showed that it caused cancer cell death while having little effect on normal breast cells.
- A laboratory study of cannabidiol in human glioma cells showed that when given along with chemotherapy, cannabidiol may make chemotherapy more effective and increase cancer cell death without harming normal cells.Stimulating appetite
- Many animal studies have shown that delta-9-THC and other cannabinoids stimulate appetite and can increase food intake.Pain relief
Have any clinical trials (research studies with people) of Cannabis or cannabinoid use by cancer patients been conducted?
- Cannabinoid receptors (molecules that bind cannabinoids) have been studied in the brain, spinal cord, and nerve endings throughout the body to understand their roles in pain relief.
- Cannabinoids have been studied for anti-inflammatory effects that may play a role in pain relief.No clinical trials of Cannabis as a treatment for cancer in humans have been found in the CAM on PubMed database maintained by the National Institutes of Health.Cannabis and cannabinoids have been studied in clinical trials for ways to manage side effects of cancer and cancer therapies, including the following:Nausea and vomiting
- Delta-9-THC taken by mouth: Two cannabinoid drugs approved in the United States are available under the names dronabinol and nabilone. Both dronabinol and nabilone are approved by the Food and Drug Administration (FDA) for the treatment of chemotherapy-related nausea and vomiting in patients who have not responded to standard therapy. Many clinical trials have shown that both dronabinol and nabilone worked as well as or better than some of the weaker FDA-approved drugs to relieve nausea and vomiting. Newer drugs given for chemotherapy-related nausea have not been directly compared with Cannabis or cannabinoids in cancer patients.
- Inhaled Cannabis: Three small trials have studied inhaled Cannabis for the treatment of chemotherapy-related nausea and vomiting. Various study methods and chemotherapy agents were used with mixed results. There is not enough information to interpret these findings.Stimulating appetite
- Delta-9-THC taken by mouth: A clinical trial compared delta-9-THC (dronabinol) and a standard drug (megestrol) in patients with advanced cancer and loss of appetite. Results showed that delta-9-THC was not as effective in increasing appetite or weight gain in advanced cancer patients compared with standard therapy. However, a clinical trial of patients with HIV/AIDS and weight loss found that those who took delta-9-THC had increased appetite and stopped losing weight compared with patients who took a placebo.
- Inhaled Cannabis: There are no published studies of the effect of inhaled Cannabis on cancer patients with loss of appetite. Studies of healthy people who inhaled Cannabis showed that they consumed more calories, especially high-fat and sweet snacks.Pain relief
- Combining cannabinoids with opioids: In a small study of 21 patients with chronic pain, vaporized Cannabis was added to slow-release oxycodone or morphine and given for five days. Results showed that combining vaporized Cannabis with morphine relieved pain better than morphine alone, while combining vaporized Cannabis with oxycodone did not produce significantly greater pain relief. These findings should be tested in further studies.
- Delta-9-THC taken by mouth: Two small clinical trials of oral delta-9-THC showed that it relieved cancer pain. In the first study, patients had good pain relief as well as relief of nausea and vomiting and better appetite. A second study showed that delta-9-THC could be given in doses that gave pain relief comparable to codeine. Higher doses of delta-9-THC were found to be more sedating than codeine. An observational study of nabilone also showed that it relieved cancer pain along with nausea, anxiety, and distress when compared with no treatment. Neither dronabinol nor nabilone is approved by the FDA for pain management.
- Whole Cannabis plant extract medicine: A study of a whole-plant extract of Cannabis that contained specific amounts of cannabinoids, which was sprayed under the tongue, found it was effective in patients with advanced cancer whose pain was not relieved by strong opioids alone. This treatment was studied using different doses in a randomized, placebo-controlled clinical trial of cancer patients with chronic pain not controlled by opioids. Patients who received the lower doses of cannabinoid spray showed markedly better pain control and less sleep loss compared with patients who received a placebo. Adverse side effects depended on the dose received. Only patients in the high-dose group had adverse side effects that made the treatment less beneficial than the placebo. Some patients using the cannabinoid spray were followed in a long-term study. Results showed that, for some patients, control of their cancer-related pain continued without needing higher doses of spray or higher doses of their other pain medicines.
- Inhaled Cannabis: Various clinical trials have shown benefits of inhaled Cannabis compared with placebo in relieving neuropathic pain. These include a study of inhaled Cannabis in patients with HIV -related peripheral neuropathy. Results found better pain control in the Cannabis group than in the placebo group. Another study involved patients with various kinds of chronic pain that was not relieved by other pain medicines. Results showed that those treated with either low-dose or medium-dose inhaled Cannabis had improved pain relief at both doses compared to patients treated with a placebo. Side effects of the inhaled Cannabis were minor. To date, no clinical trials have studied cannabinoids in the treatment of chemotherapy-related neuropathy in patients with cancer.Anxiety and sleep
- Inhaled Cannabis: A small case series found that patients who inhaled marijuana had improved mood, improved sense of well-being, and less anxiety.
- Whole Cannabis plant extract spray: A trial of a whole-plant extract of Cannabis that contained specific amounts of cannabinoids, which was sprayed under the tongue, found that patients had improved sleep quality.
Can we please pull our heads out of our butts and legalize Medical Cannabis now?