August “Weed to the Wise: Cannabis and Cancer”

Welcome to the August edition of the curated PLAYBOOK for emerging medical cannabis news for seniors! This month we are focusing on Cannabis and Cancer. According to the World Health Organization, cancer refers to more than 200 different diseases that all present challenges to oncology treatments. It is agreed that we need new treatments for patients who have no effective therapy, and in those who respond to treatment we need therapies with less toxicity. Cannabis (both as CBD and medical marijuana) is currently a common alternative therapy for helping patients survive the side effects of chemotherapy (which is well documented), but emerging research is focusing on the anti-tumor properties of THC. This month’s playbook will also mention the rather mysterious confounding factors in medical research with mice as well as emerging legal challenges for senior living facilities when elders use medical cannabis. Before you fly off, pause for a nightingale’s song!

EMERGING MEDICAL CANNABIS RESEARCH

WHAT’S NEW?

1. Sanchez, Cristina. Phytocannabinoids as an Anti-tumor Tool. O’Shaughnessy’s, Winter 2018-19. This is a rather technical medical research report written by a team of biochemists. In 1998, THC was documented as causing cell death of glioblastoma cells in a petri dish. THC binds to CB1 and CB2 and switches off the regulator cells of glioblastomas, breast tumors, and others. The question was asked, “Is pure THC extract more or less effective than whole plant compounds?” The team found that compounds that include terpenes were most effective against cancer tumors (which is called “The Enterourage Effect”). Cannabis in both forms was tested against three types of breast cancer and two types of prostate cancer, and the team found that “all breast cancer subtypes are sensitive to cannabinoid anti proliferation action…However there was a synergistic response combining both THC and whole plant compound with tamoxifen and an unexpected decrease in cell viability.” The message is that the whole plant compound is more effective in both cell cultures and in test animals for anti-tumor activity.
2. Brooks, Lisa. Medical Marijuana. 2018, Publications International, Ltd. p. 109.  “When undergoing treatment, patients can be given up to a dozen different drugs that can have their own side-effects, which adds up to a frustrating and often ineffective, cocktail of pills. Grateful cancer patients have found that simply using cannabis–one single drug–can help quell their symptoms so well that they don’t need a myriad of pills to function.” This is largely because cannabis/CBD has a proven impact on pain, anxiety, insomnia, and depression which are all variables during treatment.
3. Cannabis Extracts as Anti-Tumor Agents. The Laboratory of Cancer Biology and Cannabinoid Research, Israel Institute of Technology, Haifa, Israel. Jun 25, 2019. “Our findings showed that pure (-)-Δ9–trans-tetrahydrocannabinol (Δ9-THC) did not produce the same effects on these cell lines as the whole Cannabis extracts. Furthermore, Cannabis extracts with similar amounts of Δ9-THC produced significantly different effects on the survival of specific cancer cells. In addition, we demonstrated that specific Cannabis extracts may selectively and differentially affect cancer cells and differing cancer cell lines from the same organ origin. We also found that cannabimimetic receptors were differentially expressed among various cancer cell lines and suggest that this receptor diversity may contribute to the heterogeneous effects produced by the differing Cannabis extracts on each cell line. Our overall findings indicate that the effect of a Cannabis extract on a specific cancer cell line relies on the extract’s composition as well as on certain characteristics of the targeted cells.” At this point, none of this cannabis research is randomized, double blind, peer reviewed, or legal in the U.S. In other words, we have a long way to go! This is what happens when we use a reductionist approach to research by measuring and going increasingly smaller in focus. The whole plant has been used for healing for thousands of years, yet we put cancer cells in a test tube and separate the cannabinoids into extracts and then wonder why the results aren’t definitive! It’s a far cry from singing to the plant and the plant singing back to tell us if it can help. But it leads us to understand that at some point, researchers will put cells from our biopsy into a test tube and run it against a profile of different cannabinoids to determine which strain, terpenes, or cannabinoids will help the oncologist’s treatment plan. See https://dmeiri.net.technion.ac.il/research/cancer1/
4. For previous articles referring to lymphoma, lung cancer, CBD with glioma, etc. see https://grass4geezers.com/category/research/cancer/page/2/

APPRECIATING NATURE
THE GREAT CONVERSATION

List of research articles (with abstracts) by Jeff Mogil, PhD.  Because most animal studies with cannabis are done with mice, Mogil’s research can be curious, enlightening, or disturbing–what connections are we oblivious to in this animal research? Topics include the Rat Grimace Scale for quantifying the subjective experience of pain; body odor of male researchers impacting pain-inhibition in mice; the role of empathy–pain sensitivity in mice produced solely by exposure to their cagemates, but not to strangers. (When will humans become sensitive to the ocean of consciousness that connects us all??)

The Biology of Wonder: Aliveness, Feeling, and the Metamorphosis of Science.  Andreas Weber. 2016.

“The nightingale’s song is not the emotional expression of a musical individual but of the conditions of existence.  It does not refer to personal challenges but to the drama of being alive.  Its themes are the tides of the organism, the rising and ebbing of the life force, the flourishing in springtime and the end, which always comes too quickly.”

Song. Hartley Coleridge.

“Tis sweet to hear the merry lark,
That bids a blithe good-morrow;
But sweeter to hark, in the twinkling dark,
To the soothing song of sorrow.
Oh nightingale! What doth she ail?
And is she sad or jolly?
For ne’er on earth was sound of mirth
So like to melancholy.”

LIVING WELL
EMERGING LEGAL ISSUES IN SENIOR LIVING FACILITIES

1. Cannabis in Nursing Homes. Dr. David Casarett, Chief of Palliative Care at Duke University Medical Center, and his colleague Dr. Joshua Briscoe recently wrote an article about medical marijuana for older adults in the Journal of the American Geriatrics Society. Casarett and Briscoe support legalizing medical use, and hope for a reclassification of cannabis so it can be fully studied without federal interference. “You might not like it,” Cassarett told The New York Times. “You might not believe in it. But your patients are using this stuff.” Briscoe added, “We’re always searching for a better medication that can treat pain and a host of other symptoms without burdensome side effects, and cannabis is promising.”
2. Palm Beach Nursing Home to Begin Cannabis Study. As mentioned in last month’s Playbook, MorseLife Health System will be the only senior living provider in Florida to offer cannabinoid-based therapies for its clients in a variety of care settings as an alternative to pharmaceuticals. This is a pilot program authorized by the State and likely the only one in the U.S. at this time.
3. Smarter Pot Policies for Senior Living. “Don’t be afraid to tackle this issue,” said Gabriela Sanchez, a shareholder and co-chair with the senior living and long-term care team at Seattle-based law firm Lane Powell PC. “Whether you’re going to allow marijuana or not, medicinal or recreational, it’s really important that you have robust policies that talk about how you’re going to manage it in your communities.” You’ll find a list of legal policy suggestions in this article, some of which are rather humorous (e.g., having insurance for accidents with wheel chairs and walkers when high, etc.).

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