Using cannabis in prostate cancer patients
In our hospital’s daily practice we notice the popular use of cannabis oil in prostate cancer (PCa) patients. As a nursing specialist for urology, I have even met patients who are so convinced of the curative benefits of cannabis oil in treating prostate cancer that they replace standard treatment with the use of cannabis oil.
These patients include those who have localised prostate cancer where active surveillance is followed, those with biochemical recurrence after treatment, and patients with metastatic PCa. I have always wondered whether cannabis oil could indeed be a cure for prostate cancer. Unfortunately, I do not see in practice the desired beneficial effect and the PSA values continue to rise. To find some answers, I did a search in scientific literature.
Cannabis, a very easy plant to grow, has been used for centuries for its medicinal properties. The oldest known document about cannabis use originates from the Chinese emperor Shen Nung in 2727 B.C. It suggested that cannabis has a neuron-protective effect. The Egyptians used cannabis to treat glaucoma and as an anti-inflammatory agent (inflammation of the eyes, fever). Cannabis was even used in obstetrics (mixed with honey) and the mixture was applied in the vagina to “cool” the uterus. In the Old Testament, there is also an account of God instructing Moses to make a holy anointing olive oil-based “Kaneh Bosm.”
Cannabis contains more than 400 chemical components 80 of which contain cannabinoid components and 200 non-cannabinoids components. For medical purposes, cannabinoid substances such as THC (Delta-9-tertrahydrocannabinol), CBD (cannabidiol) and non-cannabinoid substances such as terpenoids and flavonoids are relevant.
Medicinal cannabis must be distinguished from recreational cannabis which is used to achieve a psychotomimetic state of ‘high’. Cannabis strains used for recreational purposes contain a higher THC and lower CBD ratio than cannabis for medicinal use. Usually two cannabis plants are used: cannabis sativa which has a higher THC concentration and cannabis indica which has a higher CBD concentrate. The flavonoids are known for their antioxidant and anti-inflammatory effects. The terpenoids are resins (oil) with a strong odour.
In the 1990s, the endocannabinoid system (ESC) of the body was discovered by Raphael Mechoulam, an Israeli professor of medical chemistry. The endocannabinoid system, a central regulatory system, is the body’s largest receptor system and is important to maintain the homeostasis of the body.
Human beings produce their own cannabinoids (endocannabinoids) according to need and are not stored in the body. Like endorphins, the human body produces endocannabinoids in response to activities such as physical exercise (the high of runners might be due to endocannabinoids, not endorphins!).
Cannabinoid receptor type 1 (CB1) is mainly found in the brain, and also in the lungs, the reproductive organs, etc. Cannabinoid receptor type 2 (CB2) is usually located in the immune system and in the bones. THC mainly works on CB1 receptors, CBD on CB2 receptors.
In vitro studies with THC have shown that cannabinoids affect migration, angiogenesis and apoptosis (programmed cell death) of cancer cells, but each type of cancer appears to respond differently to the effect of exogenous cannabinoids. Many types of cancer cells have a higher concentration of CB1 and CB2 receptors.
Use of cannabis in cancer
– Pain: Cannabinoids have been used for centuries to lessen pain. Historical texts and old pharmacopoeia noted the use of cannabis for menstrual cramps, pain during childbirth, and headaches. Studies have shown that the cannabinoids have no effect on acute pain and post- operative pain. Two placebo-controlled studies with a cannabis extract showed modest benefits when using cannabinoids in addition to opioids and other adjuvant pain-killers in cancer patients with chronic pain. However, the effect of cannabinoids in chronic neuropathic pain was clearly demonstrated in 29 randomized studies.
– Nausea and vomiting: An initial study in 1975 showed a beneficial effect of THC on nausea induced by chemotherapy. Subsequently, two systematic reviews showed benefits of cannabinoids in nausea and vomiting due to chemotherapy, but most studies were observational or uncontrolled.
– Stimulation of appetite: Cannabinoids seem to have only a modest effect in cancer patients with cachexia. More promising results were seen in studies in the population without cancer.
– Pre-clinical studies (in vitro = cells in laboratory and in vivo = in mouse model) have shown the antiproliferative, anti-metastatic, anti-angiogenic and pro-apoptotic effects of cannabinoids in various malignancies (lung, glioma, thyroid, lymphoma, skin, pancreas, endometrium, breast and prostate). Even if an identified substance in vitro / in vivo appears to have a beneficial effect on a disease, it is important to realise that only one in 5,000-500,000 substances obtain a registration and becomes available to the patient (after 10-16 years of different study phases). Cannabis has never been clinically studied as a treatment for malignancy.
On the Internet, patients can get a lot of information about the curative effect of cannabis oil on prostate cancer but this information extrapolate the results of pre-clinical work to possible effects in people without any factual evidence. I often see patients in the doctor’s office showing me a website where it has been proven that cannabis oil can cure prostate cancer, which is obviously their own interpretation. In my view this can be a misleading message even though the website does not explicitly provide false information. The website [See figure below] shows information which is based on a study published in the British Journal of Cancer. This is correct, but the website “neglects” to mention that this is a publication of an in vitro study. The patient might not even know what an in vitro study is and is not aware that there are no studies on humans yet to prove this.
A challenge for the caregiver can be that the patient is convinced that we as healthcare practitioners work together with the pharmacists, and that we do not wish to carry out clinical trials (unfortunately, I hear that very often). We can hardly persuade patients that this is not true.
It is also important that we inform the patient about the possible interactions of cannabis oil with certain regular medications such as Coumarin (this blood thinner interacts with cannabis oil, leading to an increase of the INR and a greater risk of bleeding!). There are different types of cannabis oil available, such as CBD and THC oils with different concentrations which makes it difficult for patients to make a choice.
• There is no proof of cannabis oil as cure for prostate cancer;
• It is important not to be prejudiced or judgmental against patients who use cannabis oil;
• Listening to the patient’s view can be helpful since the patient often confides to the nurse rather than to their physicians;
• Avoid persuading patients not to use cannabis oil, but try to convince them of the need to follow a regular treatment combined with cannabis oil;
• Consider adverse interactions between cannabis oil and certain medications and inform your patient about these.
In our hospital we notice the popular use of cannabis oil in prostate cancer (PCa) patients, they even replace standard treatment with the use of cannabis oil.
Updated on June 15, 2020. Medical content reviewed by Dr. Joseph Rosado, MD, M.B.A, Chief Medical Officer
Cancer is one of the most talked-about diseases of our time. Science has dedicated itself to searching for a cure for as long as we’ve known about the disease. Our current treatments usually don’t guarantee a full cure and tend to put your body through a lot of stress.
It’s no wonder many cancer patients search for alternatives to the typical solutions doctors offer. While marijuana can’t completely replace your prostate cancer regimen, it can reduce your symptoms and possibly enhance your cancer treatment. Let’s examine how cannabis can aid you in the fight against prostate cancer.
Prostate Cancer Video Transcript:
The prostate is part of the male reproductive system. It is a small, round gland that is located in front of the rectum at the base of the bladder. Its primary function is to release fluid into the urethra during ejaculation. During ejaculation, sperm travels from the testicle through tubes called the vas deferens. The vas deferens run behind the bladder and enter into the prostate gland. During its journey, sperm combines with seminal fluids, other components of ejaculate, from three sources: the seminal vesicle, the prostate and the bulbourethral glands. The combined fluids called semen or ejaculate then travel the length of the urethra and out of the body via the penis. Prostate cancer develops as small nodules or bumps on the surface of the prostate which can be detected during rectal examination. There are many methods to treat prostate cancer. In most cases, the prostate does not need to be removed if the cancer is detected early. If prostate removal is necessary, the risk for erectile dysfunction increases because of the large number of nerves located near the prostate. Men over the age of 50 should have routine prostate cancer screenings as part of their regular health checkup; this includes digital rectal examination and serum PSA testing. Talk to your doctor about your individual risk for prostate cancer. Learn more below about how medical marijuana can help treat prostate cancer.
Marijuana and Prostate Cancer: Clinical Evidence
Some of the strongest, and most widely agreed-upon, clinical evidence regarding the use of medical marijuana is in the area of the treatment of cancer patients. Numerous clinical studies have shown the benefits offered by medical marijuana to cancer patients who are undergoing chemotherapy and/or radiation treatment.
Cannabidiol (CBD) is a compound found in medical marijuana. Clinical research has shown that CBD contains properties that relieve convulsion, inflammation, anxiety and nausea. It could even inhibit the growth of some cancer cells, including those that cause prostate cancer.
A chemotherapy patient needs to maintain a good diet to remain strong while the body fights off the cancer. Because chemotherapy can cause inflammation in the digestive tract, anything that helps reduce the inflammation will ultimately help the patient hold down food and remain healthy during the treatment.
Along with the anti-inflammatory benefits of medical marijuana, clinical studies have also repeatedly shown medical marijuana stimulates the appetite and reduces nausea, which can be critical for prostate cancer patients who are undergoing chemotherapy and/or radiation therapy.
Some studies have also found patients using medical marijuana suffer from less fatigue associated with radiation treatment, allowing the patient to live a more productive life while undergoing the treatment.
Finally, the relaxation benefits of medical marijuana have been shown to allow cancer patients to reduce stress levels, which, in turn, allows the body to better fight off the growth of the cancer cells.
Prostate Cancer & Medical Marijuana Research
Anandamide, a cannabinoid naturally created by our bodies, could work to kill and inhibit prostate cancer cells. Researchers investigated anandamide’s effect on isolated prostate cancer cells. To evaluate how much it impacted cancer cell levels and spread, they used a wide variety of evaluations, like staining and growth tests. The anandamide reduced receptors that communicate cell growth by activating the CB1 receptor. It also killed off a large number of cancer cells.
A review pointed out that cannabinoids could reduce some factors causing prostate cancer. Back in 1974, scientists found they lowered sperm production and testosterone levels in rats. In the early 1980s, researchers observed a decrease in substances like fructose and citric acid. The compounds examined in this study are all regulated by testosterone levels, and the results implied cannabis could reduce hormones that cause and exacerbate prostate cancer.
Another study examined the effects of non-THC cannabinoids on both isolated prostate cancer cells and prostate cancer cells in living beings. Researchers administered CBD and other compounds to test-tube cells and rats with tumors, and the cannabinoid worked incredibly well to kill the cells or reduce their spread. Also, an extract containing primarily CBD made some anticancer substances more effective.
How to Use Medical Marijuana for Prostate Cancer
We don’t have a simple answer for the question, “Which form of marijuana use will work best for my prostate cancer?” Only you and your doctor can decide the best route to take. However, we can give you some basic information about the many ways to use cannabis to give you the foundation you need to have this conversation with your oncologist.
The most frequently used methods of marijuana use include:
- Smoking — Inhaling marijuana lets you feel its benefits as soon as possible. However, smoking, the most popular way to inhale, is also one of the least healthy ways to consume cannabis. When you smoke weed, you breathe in toxins that are bad for your lungs.
- Vaping — While vaping still has some of the dangerous aspects of smoking, the toxins aren’t nearly as plentiful. So, if you need the immediacy of inhalation without as much respiratory damage, vaping could be a good choice for you.
- Topicals — The pain caused by prostate cancer mainly occurs in tissue too deep for topical treatments like lotions to reach. In fact, most topical treatments suit patients with localized pain in the muscles or joints. But patches administer medicine right into your blood slowly and gradually.
- Oils — When you hear testimonies about the healing powers of marijuana, you might hear a lot about CBD oil. Both CBD oil and Rick Simpson oil can be added to food for you to ingest.
- Pills and tinctures — Patients who prefer something like the medicine they get at a pharmacy can ask for a pill or tincture. While you take a weed pill like any other pill, tinctures go under your tongue.
- Edibles — Like patches, edibles have a less intense result that lasts longer. You might need to experiment with edibles more than you will with other methods, since the effects from edibles can be unreliable. If edibles end up working well for you, eat unhealthier options, like brownies, only occasionally.
If you’re unsure about using a different method, consult with an expert like your doctor or dispensary staff. The kind folks working at your dispensary receive training that gives them the expertise to recommend products based on their effects and medical benefits.
Side Effects Associated With Marijuana
Unlike mass-produced medicine you find in a pharmacy, marijuana doesn’t have black-and-white benefits and side effects. This is because patients and natural medicine practitioners define the side effects themselves. What helps one patient can be an inconvenience for another.
In other words, some of the common “side effects” of weed will actually help you out. Some side effects that benefit cancer patients include:
- Insomnia/energy boost — Some patients who use strains high in Sativa find that their medicine keeps them up at night. But, when used at the right time of day, you can use this side effect to your advantage. You can counteract the fatigue caused by cancer with energizing strains.
- Drowsiness/sleep aid — Inversely, Indica strains make some patients feel sleepy during the day. If you use one before bed, you can sleep deeper and easier.
- Hunger/increased appetite — Many people know about the “munchies” marijuana gives you. Some patients find the constant cravings inconvenient. However, if you have a lower appetite because of your cancer, feeling hungrier can let you eat the food you need.
On the other hand, some cannabis side effects will function for you as just that — side effects. Not to worry! Most of them have easy fixes.
- Short-term memory loss — Taking your medication right before you have to go to work or school can make you extra forgetful and affect your performance. If possible, change the time when you take your meds so you only have memory loss when off the clock.
- Giddiness — Marijuana can cause you to act goofy and interfere with your ability to get through the day. This is another situation where we recommend finding a different medication time.
- Dry mouth or thirst — If weed dehydrates you and makes your mouth feel like cotton, you have a simple solution. Drinking more water and chewing xylitol gum will help your mouth feel normal again.
- Red eyes — The red eyes resulting from cannabis use can embarrass some patients. If you feel this way, you can get rid of the redness using eye drops.
- Respiratory issues — As we discussed earlier, smoking and vaping can hurt your respiratory system. If you begin to feel the damage, use your medicine in a different manner.
- Uneasiness or anxiety — Some patients get paranoid when they use medical marijuana. If you feel extra-anxious after taking your medication, you should have a chat with your doctor about picking a different strain.
If you experience health problems you didn’t have before using cannabis medication, get in touch with your doctor right away. You could have an allergy you don’t know about, or you’re exacerbating another health issue that hasn’t been diagnosed.
How to Learn More About Cannabis and Prostate Cancer
The most important part of the medical marijuana experience is doing your research. As a one-stop source for your weed information, we offer numerous resources.
Getting started with the medical marijuana process requires basic knowledge about local resources and state laws. Read more about the cannabis laws in your state, the specially trained marijuana doctors in your area and the dispensaries supplying patients like you with quality medicine.
Once you have the basics down, you might want to dig deeper. For more condition pages like this guide, check out our list of conditions that qualify for medical marijuana. If you’d like to read about lesser-known topics surrounding cannabis and stay up to date, our blog features posts about recipes, legislature and more.
About Prostate Cancer
Cancer occurs when your body’s natural cell growth spirals out of control. The cells in the affected area begin to grow unchecked without dying off, crowding out healthy cells. When you have these extra cancer cells, your body has a harder time functioning.
Since cancers are named after the first location they manifest, prostate cancer is cancer that begins the gland found in men located right below the bladder. It produces part of the fluid contained in semen, and the urethra, or tube that urine travels through, goes through its center.
While prostate cancer begins in the prostate, if it gets to an advanced stage, it can spread to other parts of the body, causing symptoms in those areas. For instance, it can migrate to bone marrow, causing severe and chronic pain. Or, it can reach the spinal cord, interfering with mobility, bladder function and bowel movements.
Fortunately, prostate cancer has an incredibly low mortality rate and sometimes doesn’t even bother the person experiencing it. Many times, another health problem or old age will kill a patient before prostate cancer does. This is due to the fact that many cases of prostate cancer grow slowly.
Signs and Symptoms of Prostate Cancer
Patients with early prostate cancer typically don’t experience any symptoms. However, in more advanced stages, they can have symptoms like:
- Frequent urge to urinate
- Weak or slow urinary stream
- Erectile dysfunction
- Blood in the semen or urine
- Change in bladder or bowel functions
- Pain in areas where the cancer has spread
In addition to the symptoms associated with prostate cancer, prostate cancer patients deal with symptoms caused by any type of cancer. Cancer symptoms have the potential to severely impact daily functioning and quality of life. General cancer symptoms include:
- Chronic pain
- Rapid and unexplained weight loss
Prostate Cancer Facts and Statistics
- Ninety-nine percent of prostate cancers are adenocarcinomas, or cancers that form in the body’s gland cells.
- For men, prostate cancer is the third leading cause of cancer death.
- Despite that number, people with prostate cancer have a high survival rate. They have a 99 percent chance of surviving after five years, a 98 percent of surviving after 10 years and a 96 percent chance of surviving after 15 years.
- One in seven men will receive a prostate cancer diagnosis in his lifetime.
- Having a first-degree relative with prostate cancer more than doubles your risk of getting it yourself.
- People with African ancestry are more likely to get prostate cancer than people of other races.
Detecting and Diagnosing Prostate Cancer
Catching prostate cancer early is vital to ensuring higher survivability and a smoother recovery. However, since prostate cancer usually develops very slowly, getting further testing isn’t always the best decision. Sometimes the cancer won’t grow large enough to be a threat before a man dies from a different cause.
The current unreliability of prostate cancer screenings compounds the issue further. For example, imagine an older man in poor health gets a false-positive result and goes through a prostate biopsy. If the biopsy puts him through a lot of stress, the treatment could actually harm his health rather than improve it.
However, this doesn’t mean that you should completely avoid prostate cancer screening — it’s just a more complicated situation than you may think. To make an informed decision about getting checked, talk with your doctor.
Doctors use two methods for primary prostate cancer screening on undiagnosed patients. They can test for prostate-specific antigens in the patient’s blood. Or, they can conduct a digital rectal exam, in which the doctor feels the prostate gland for abnormalities.
If the initial tests suggest the presence of prostate cancer, the physician will conduct further testing. A transrectal ultrasound allows your doctor to examine your prostate without using invasive surgery. In a biopsy procedure, a urologist will take samples of your prostate to inspect for cancer cells.
Standard Treatments for Prostate Cancer
The kind of treatment you receive for your prostate cancer will depend on how far your cancer has progressed and the health conditions you have. Sometimes, you will just need to regularly check in with your doctor to track the progression of your cancer. In more advanced cases, you may have to go through surgery or other procedures tough on the body.
Two of the most well-known ways to treat cancer are chemotherapy and radiation therapy. While they’re two of the most effective treatment options we currently have, they can put your body under a lot of strain.
For prostate cancer patients who undergo chemotherapy and/or radiation therapy, the side effects of the therapy can be life-altering. Cancer cells divide rapidly, resulting in the spread of the disease throughout the body if not treated. Chemotherapy treats the patient with drugs that kill quickly dividing cells.
The idea behind chemotherapy is that the drug cocktail delivered will kill the cancer cells. Unfortunately, those same drugs do not differentiate between “good” cells and “bad” cells, resulting in the death of other rapidly dividing cells within the body as well. Along with killing the cancer cells, chemotherapy often kills cells within the digestive tract, bone marrow and hair follicles.
One of the most common side effects of chemotherapy is the inflammation of the digestive tract, leaving the patient unable to keep down food. Medical marijuana works to counteract this unwanted side effect by stimulating the appetite and reducing nausea and vomiting that often accompanies chemotherapy.
Radiation therapy, which is frequently used in conjunction with chemotherapy, uses strong beams of energy targeted at the cancer cells in an attempt to kill the lethal cells, or prevent them from dividing and multiplying. Radiation therapy, just like chemotherapy, can come with some extremely negative side effects, such as fatigue, nausea, sexual changes and diarrhea. Medical marijuana may be able to help counteract all these side effects, as well.
The drawbacks of typical cancer treatments are one of the reasons why we look into the benefits of consuming medical cannabis for prostate cancer. As we learn more about marijuana and prostate cancer, we can use this helpful drug to partially replace or supplement these treatments.
But marijuana’s cancer-fighting qualities don’t mean that you should completely dismiss your standard cancer regimen. The procedures we use are currently our best bet despite the risks, and not every patient has an adverse reaction to cancer therapies. Make sure to talk with your doctor before trying any alternative treatment methods yourself.
Using Medical Cannabis for Cancer Symptoms
Unlike many drugs on the pharmaceutical market, cannabis can relieve multiple symptoms at once with minor side effects. While it cannot help with problems related to the urethra, such as difficulty urinating, it serves as an excellent supplement to cancer treatment by reducing cancer symptoms and side effects from treatment. Here are the ways that medical marijuana can help you as a cancer patient:
- Cannabis reduces the pain caused by tumor pressure, chemotherapy, radiation therapy and surgical procedures. Most ofthe states that allow medical marijuana use approve chronic pain as a valid condition for the drug, and for good reason. Pain is one of the most researched and documented conditions successfully treated with medical cannabis.
- Marijuana stimulates your appetite and reduces nausea. While cancer causes both loss of appetite and weight loss, harsher treatments like chemotherapy cause nausea. Marijuana works as both an appetite stimulant and antiemetic, making it easier to get the nutrition you need.
- Certain strains of weed can give you an energy boost when cancer wears you out. Using a Sativa strain can clear your mind and kickstart your productivity.
- Or, if you need help sleeping due to cancer symptoms causing insomnia, Indica strains provide sedation and relaxation. You need to get as much rest as possible when you have a disease like cancer.
A potentially groundbreaking benefit of medical marijuana we’re still researching is its ability to kill cancer cells and keep them from spreading. While there’s not enough evidence to suggest cannabis can fully replace current treatments, the knowledge we have can teach us about the components of a successful cancer cure. Combined with its painkilling abilities, cannabis could work as the cancer medication hiding right under our noses.
See how medical marijuana could help relieve your prostate cancer symptoms. Find patient reviews on local doctors and information on treatment options.’ — just swap out the ailment name