As a tireless advocate who believes patients should have access to cannabis to treat a myriad of ailments — from PTSD to epilepsy to cancer-related symptoms — Dr. Donald Abrams believes safe access to cannabis (a natural medicine) is a fundamental human right. Clearly, the federal government has a moral duty and obligation to end the hypocrisy — end prohibition and remove cannabis from the DEA’s Schedule 1.
Despite the fact that to date, more than half of the states in the country have legalized medical cannabis, and a voluminous amount of research on PubMed (a resource from the National Institute of Health), validates cannabis medicinal value, the federal government continues the “War on Drugs” and prohibits the therapeutic use of cannabis.
Worse, the government refuses to acknowledge that cannabis has any medicinal value whatsoever and classifies cannabis as a Schedule 1 drug. According to the federal government, Schedule 1 drugs have a high potential for abuse and addiction while offering no medical value — both claims have been disproven in the medical and scientific communities, and even by federally funded research groups and advocacy organizations such as the National Cancer Institute.
When it comes to cancer, given that 39.6% of Americans will be diagnosed with cancer at some point in their lives and an overwhelming majority of Americans believe medical marijuana should be legal, the federal government should make it a top priority to ease restrictions and allow safe access to cannabis for those who can benefit.
However, the media and cannabis advocates also have an ethical responsibility to represent accurately the scientifically proven and validated benefits of cannabis without overstating the benefits or mischaracterizing research.
Within the area of cannabis and cancer research, there exists significant misinformation and disinformation. What we do know is that the benefits of cannabis to alleviate both cancer-related symptoms and cancer treatment side-effects are well-documented — both anecdotally and through peer-reviewed studies and clinical research.
However, as far as curing cancer, most of the information that exists is purely anecdotal or based on preclinical research conducted in a lab, not on humans. While this is not to say cannabis research will not lead to a cure for cancer — it may. What it does say, is that "clinical research" — research done on humans — needs to be done to determine if cannabis may be used efficaciously as a curative cancer treatment or, at least, to reduce the risk of acquiring cancer.
Recently, I had the opportunity to interview cannabis advocate Dr. Donald Abrams, an integrative medicine specialist at the UCSF Osher Center for Integrative Medicine at Mount Zion in San Francisco, and one of the leading oncologists and cancer researchers in the world. Dr. Abrams has more than three decades experience conducting research and treating cancer patients. Through our interview, Dr. Abrams attempts to set the record straight on cannabis and cancer.
"Cure" is a huge word in oncology. It usually implies that the patient has survived five years without evidence of their cancer. We are able to cure more cancers today than we were when I began my career as an oncologist. That has been through advances in diagnosis and treatment with conventional therapies.
As an integrative oncologist, I work to incorporate complementary therapies with conventional treatment to alleviate symptoms as well as to perhaps improve overall outcome. Cannabis is often a supplement that I recommend as it is so effective in treating symptoms related to both cancer and its treatment.
Over the past 33 years of being an oncologist in San Francisco, I would guess that a large proportion of the patients I have treated have used cannabis. If cannabis cured cancer, I would have expected that I would have a lot more survivors.
How do you explain the research out there that supports the belief cannabis can cure cancer?
The first suggestion that cannabinoids – a class of active ingredients in cannabis – could impact cancer cells came from research published from our National Cancer Institute in 1974. Scientists reported that delta-9-tetrahydrocannabinol, delta-8-tetrahydrocannabinol and cannabidiol could suppress Lewis lung carcinoma cells in the test tube as well as in mice implanted with the tumors. These were very exciting findings but no further research was conducted.
More recently, European investigators in Spain and Italy have been looking at the many mechanisms by which cannabinoids might suppress growth and spread of cancer cells and lead to their programmed cell death. Pretty much all of this work has been in test tubes or animal models.
There really has been no research done in humans with cancer. The only human study to date, conducted by my friend Manuel Guzman in Madrid, looked at patients with recurrent glioblastoma multiforme (GBM), the most aggressive form of brain tumor. Dr. Guzman’s lab had studied the effect of cannabinoids on metabolism. Brain cells are the most metabolically active cells of the body so they studied them in tissue culture.
They wondered if they could work faster if they studied brain tumor cells. So they set up a culture of glioma cells and added cannabinoids and everything died. They tried again and the same thing happened.
They thought maybe something was wrong with the cannabinoids, but when they added them to normal brain, everything lived. The cannabinoid 1 receptor (CB1) is the most densely populated receptor in the human brain. So it would make some sense that brain tumors may be impacted by cannabinoids in culture.
In the experiment in humans, THC was dripped by a catheter into the recurrent tumors of a handful of patients with recurrent GBM. The results were not impressive in my mind. And that is pretty much the evidence of cannabis as an anti-cancer agent in humans.
What I’m saying, clearly, is that there is not enough research for all the claims that are out there. Can we do more research? Of course, but as you know, it is quite difficult to study Schedule 1 substances [the federal government classifies drugs it considers having a high potential for abuse and no known medical use] for their clinical effectiveness. So that has been a deterrent.
Even if one could do such research, no one would allow a patient with cancer that has treatment to be randomly assigned to receive cannabis or a placebo — as that would not be ethical. At best, one might allow cannabis versus the standard treatment. As so many of our standard treatments work, though, the sample size — the number of patients one would need to treat to get the answer — would have to be quite large. Finding patients and finding funding to do such a study with a plant that cannot be patented presents significant challenges!
I do not like the word prevention in cancer either because one can reduce the risk of cancer, but not likely prevent it. These are really two different issues. Cannabis is an antioxidant and an anti-inflammatory agent — both good for reducing cancer risk. In the test tube, cannabis also has proven anti-cancer activities which may be more potent against small populations of rogue cancer cells than against a fully established tumor. So I would be more enthusiastic thinking about cannabis as reducing the risk of cancer rather than curing it outright.
Cannabis is an antioxidant and an anti-inflammatory agent — both good for reducing cancer risk.
Although the drug warriors are constantly seeking evidence that cannabis increases the risk of cancer, there is no really convincing evidence that it does, while some data suggests it may reduce the risk of some malignancies.
Much of the anecdotal evidence we hear or read about cannabis as having curative properties relate to “cannabis oil.” What is your opinion on “cannabis oils?”
Most of my comments before relate to inhaled cannabis as it has been most widely used until recently. One could argue that inhalation does not allow for the blood to achieve adequate levels to exert anti-cancer effects and that the more potent oils that are currently touted as the answer are better delivery systems for patients trying to impact existing cancer.
Despite internet testimonials, there is no real data from controlled clinical trials. Recall that the only legal source of cannabis to research in the US is from the National Institute on Drug Abuse (NIDA). I am aware that my friend Mahmoud Elsohly, who grows cannabis for NIDA, has a cannabis extract that could be studies. Again, the question becomes how to design and fund a cannabis versus cancer study?
Two things that distress me as an oncologist are worth mentioning:
First, I note that many of the people who are very vocal about how cannabis oil cured their cancers seem to forget that they also received conventional therapies. If people really have used only cannabis oil and can truly document that they have cured their cancer — other than a skin cancer — they need to submit that data to the National Cancer Institute’s Office on Cancer Complementary and Alternative Therapy’s Best Case Scenario website. That way the evidence can be documented. A number of groups are also trying to collect observational data from patients using cannabis products for cancer treatment, again to build the evidence base.
Second, what really upsets me the most, though, is when I see a patient with a potentially curable malignancy who is using cannabis oil instead of conventional therapy. In some situations, the window of opportunity for potential cure may close when their cancer progresses on cannabis alone. That makes me very sad.
[Unsubstantiated claims of cancer as a cure] worry me for the reasons I stated earlier and because I fear it will make those doctors who are on the fence about cannabis as medicine throw out the baby with the bathwater. Cannabis is truly an amazing medicine for many cancer and treatment-related side effects — nausea, vomiting, loss of appetite, pain, depression, anxiety, insomnia.
The claims that this or that cannabis preparation “cures cancer” puts it in the same domain as shark’s cartilage and Laetrile for many health professionals who may otherwise be interested in utilizing it as a medicine. And that is unfortunate. Cannabis is truly an amazing medicine for many cancer and treatment-related side effects — nausea, vomiting, loss of appetite, pain, depression, anxiety, insomnia.