Cancer Monthly 2006
May 25, 2006
The FDA is getting the reputation of letting drug company representatives make decisions for the country (see Financial conflict of interest disclosure and voting patterns at Food and Drug Administration Drug Advisory Committee meetings), approving dangerous drugs (see Frontline interview with Sidney Wolfe, MD), and not performing follow-up on approved drugs (see FDA says firms still lagging on follow-up drug studies). Now, add to this list the fact that the FDA throws science out the window and makes decisions that have no basis in reality. This bureaucracy recently stated that smoked marijuana has no currently accepted or proven medical use in the United States... This statement was made apparently without any research and demonstrates that the needs of cancer patients play little if any role in the decisions of this disgraceful organization.
In 1999, the governments own prestigious Institute of Medicine looked at this issue and published a report titled: Marijuana and Medicine: Assessing the Science Base. Their conclusions included, The accumulated data indicate a potential therapeutic value for cannabinoid drugs, particularly for symptoms such as pain relief, control of nausea and vomiting, and appetite stimulation. The therapeutic effects of cannabinoids are best established for THC, which is generally one of the two most abundant of the cannabinoids in marijuanaThe combination of cannabinoid drug effects (anxiety reduction, appetite stimulation, nausea reduction, and pain relief) suggests that cannabinoids would be moderately well suited for particular conditions, such as chemotherapy-induced nausea and vomiting and AIDS wasting.
In fact, there are literally hundreds of articles that appear in the peer reviewed medical and scientific literature that discuss marijuanas effects in pain relief, control of nausea and vomiting, and appetite stimulation. Just last month an article in the Journal of Ethnopharmacology concluded that, Cannabinoids present an interesting therapeutic potential as antiemetics, appetite stimulants in debilitating diseases (cancer and AIDS), analgesics, and in the treatment of multiple sclerosis, spinal cord injuries, Tourette's syndrome, epilepsy and glaucoma.
Beyond ameliorating the side-effects of chemotherapy, research also suggests that marijuana may play a role in killing cancer cells. Recent journal articles have discussed how the chemicals in marijuana (i.e. delta9-THC) suppress or inhibit the growth of a variety of cancer cells invitro including breast cancers cells, brain cancer (glioblastoma cells), and leukemia cells. See for example:
Breast Cancer Cannabinoids and cancer
Leukemia Targeting cannabinoid receptors to treat leukemia: role of cross-talk between extrinsic and intrinsic pathways in Delta9-tetrahydrocannabinol (THC)-induced apoptosis of Jurkat cells.
In fact, the knowledge that cannabinoids suppress Lewis lung carcinoma cell growth has been known for 30 years.
The FDAs illogical position not only ignores peer reviewed medical research, but also disregards nearly 5,000 years of history. Cannabis has been used for medicinal purposes for over 4,800 years. Surviving texts from China, Greece and Persia confirm that its psychoactive properties were recognized, and the ancient doctors used it for a variety of illnesses and ailments. These included a whole host of gastrointestinal disorders, insomnia, headaches and as a pain reliever, frequently used in childbirth. In fact, cannabis was listed in the United States Pharmacopeia from 1850 until 1942. (For more background see Medical cannabis.)
The legal situation is now as confused as the political one. There is a split between the US federal and state governments over medical marijuana policy. On June 6, 2005, the Supreme Court, in Gonzales v. Raich, ruled in a 6-3 decision that Congress has the right to outlaw medicinal marijuana, thus subjecting all patients to federal prosecution even in states where the treatment is legalized. Not all Feds agree. In 1988, Francis L. Young, an administrative law judge with the Drug Enforcement Agency, declared that, Marijuana, in its natural form, is one of the safest therapeutically active substances known to man. By any measure of rational analysis marijuana can be safely used within a supervised routine of medical care. See In The Matter of Marijuana Rescheduling Petition Of Docket No. 86-22, September 6, 1988, pp. 58-59. Currently, there are eleven states with medical marijuana laws on the books: Alaska, California, Colorado, Hawaii, Maine, Montana, Nevada, Oregon, Rhode Island, Vermont, and Washington.
Obviously smoking marijuana is not risk-free especially to respiratory organs and tissue. However, compared to the risks of a typical chemotherapy agent such as cytoxan which includes: urinary bladder, myeloproliferative, or lymphoproliferative malignancies, potential sterility, urinary system hemorrhagic cystitis, hematuria, cardiac toxicity, anaphylactic reactions, significant suppression of immune responses, and sometimes fatal, infections; the risks of marijuana pale in comparison. And for cancer patients with advanced cancers who want to improve the quality of their life, a risk versus benefit analysis weighs heavily on the benefit side. Unfortunately, the FDAs unsupportable position will only slow down the progress in researching the applications and efficacy of this plant in cancer.