We Asked a Medical Oncologist What We Need to Know About Medicinal Marijuana

If you are about to start chemotherapy for cancer and have been paying attention to the political shift toward legalizing medicinal marijuana, there is a good chance that you may be wondering, “should I take some herbs and natural products to keep my immunity strong during chemotherapy?” If you live in a state like Colorado, you may be wondering whether or not to take marijuana instead of chemotherapy or how to include it in your treatment regimen.

The first question many people encounter is a simple one: does herbal medicine like marijuana really work? As in, do they treat symptoms related to cancer and treatments, or do they treat cancer itself? Well, we know that marijuana can help cancer-related pain, nausea, and poor appetite. At this time, we do not have any strong data from research in human beings to suggest it can directly force cancer into submission or eradicate it from the body entirely.

Generally speaking, in choosing whether to use herbs for cancer treatment or not, it is my humble opinion as a Hematologist, Medical Oncologist, and Fellow in the American College of Physicians that one pay attention to the following:

1. Review the existing data

Before deciding to utilize a natural product, it is helpful to review the supporting data with the physician or practitioner recommending it. Also make sure to discuss any possible side effects that are known. This will allow you to make the most informed decision possible regarding whether taking such a treatment is likely to help manage your cancer-related symptoms.

If you're not sure where to start looking for reliable data, the JAMA Network (Journal of the American Medical Association) is one I recommend getting acquainted with. MD Amy E. Thompson wrote this helpful article on Medical Marijuana in 2015, and these two research papers (Cannabinoids for Medical Use: A Systematic Review and Meta-analysis, and Medical Marijuana Use in Oncology: A Review) are great resources.

Just as our scientific understanding of herbal cancer treatments evolve, so do our laws. To stay on top of changes in local laws regarding the use of medicinal marijuana, you can consult the MarijuanaPolicyProject.com and ProCon.org.

2. Make sure you're looking at the right kind of data

An individual cancer case may have a different outcome with particular treatments simply because of its natural history. Any cancer can be naturally indolent in behavior and so may appear to have a great outcome with a particular treatment. Another cancer may be naturally aggressive and a patient may have a more difficult course regardless of what treatment is given.

In order to get an accurate signal regarding whether a medication actually works well for a given problem, one needs a large number of patients with similar features in a similar situation to make a helpful comparison between treatments. This is the basis for the randomized controlled trial design that is required for approval of most conventional cancer medications. Admittedly, trials are not always available for all cancer types, especially rare ones, but whenever available, it is better to go with better-studied treatments rather than anecdotal evidence.

3. Research how herbal medicine may affect other conventional medications

Remember that many chemotherapy drugs come from plants (some examples are taxol and vincristine). Plants do contain very powerful compounds, a testament to the long history of healing with such products. Consider that you may take penicillin for a strep throat. You may need x levels to treat strep throat, and 5x levels to have a serious side effect from penicillin.

With chemotherapy, very often the level needed to cause a serious side effect (5x level) is not very different from the level needed to treat the cancer (x level), meaning that there is much less wiggle room, described in medical terms as a "narrow therapeutic window." If there is any tendency of a natural/herbal product to increase levels of a chemotherapy drug in your body, you may be at higher risk of a potentially serious side effect from the combination.

News about the use of herbal medicine like medical marijuana is coming out every single day, and if you're in a position where this this news may have you considering introducing marijuana into your treatment regimen, you need to know what the facts are, which sources are reliable, and how to apply that information to yourself personally. Hopefully these resources will help you explore any interest you have in pursuing a herbal form of alternative cancer treatment and find out if it's right for you.

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Photo courtesy of Cuttersnap.