In a 2014 poll on WebMD, 82% of oncologists reported that they believe their patients should have safe access to cannabis. Despite majority support towards cannabis within the field of oncology, studies indicate that many cancer patients use the substance to treat their symptoms, without informing or consulting with their physicians.
In today’s world, chemotherapy and cannabis seem to go hand-in-hand—and for good reason. Cannabis can drastically alleviate symptoms caused by chemotherapy, such as nausea, weight loss from lack of appetite, anxiety, and many more. However, cannabis, like all medications, can interfere with chemotherapy drugs.
While we highly recommend the use of cannabis during chemotherapy, we must stress the importance of understanding how chemotherapy works and affects the body, as well as how cannabis interacts with the body, to treat chemo side effects safely and effectively.
Chemotherapy, in short, is the use of cytotoxic drugs to kill cancer cells. Cytotoxic drugs are considered toxic to all living cells, so when used during cancer treatment their goal is to kill cancer cells while mitigating the death of healthy cells. Oncologists often prescribe chemotherapy to get rid of cancer cells and keep them from coming back. In other scenarios, they may order the treatment to delay or slow the growth of cancer, which is often referred to as palliative chemotherapy.
The drugs used during chemotherapy work faster on cancer cells than normal cells because they grow and divide faster (this is also why people undergoing chemotherapy lose their hair—cytotoxic drugs target rapidly growing cells, like hair follicles). But, as stated above, it is impossible to isolate the effects of the medication to only kill cancer cells. As such, cytotoxic medications will cause damage to healthy, normal cells and produce the negative side effects attributed to chemotherapy.
The use of chemotherapy is conducted in a number of ways and at different times depending on the form of cancer:
- Physicians will either order chemotherapy before surgery or radiation therapy in an effort to shrink tumors. This method is referred to as neoadjuvant chemotherapy.
- When used after surgery or radiation therapy it is called adjuvant chemotherapy, and it works to destroy remaining cancer cells.
- For cancers of the blood or lymphatic system, including leukemia and lymphoma, chemotherapy is often the only course of treatment.
- Recurrent cancer is often treated with chemotherapy alone.
- Metastatic cancer, which is cancer that has spread to other parts of the body, is often treated with chemotherapy.
Chemotherapy is also distributed to the body in a variety of ways, usually dependent on the form of cancer. For instance, chemotherapy medications can be taken orally in the form of a tablet, intravenously, or administered locally into areas like the pleura, bladder, or spinal cavity.
Chemotherapy and Cannabis
When you’re undergoing chemotherapy, your body processes the medications through cytochrome P450 (CYP) enzymes in the liver. This is important to note because the same process occurs after one consumes cannabis orally, either through pills, sublinguals, or edibles.
Since the same enzymes metabolize the chemotherapy treatment and cannabis, there is a possibility for the two substances to interact negatively, meaning that using cannabis to mitigate chemotherapy symptoms may deter the chemotherapy drugs from working properly.
However, hope is not lost. Many oncologists have successfully used cannabis to help their patients cope with chemotherapy side effects safely and effectively. The key? The method of cannabis distribution.
Safely Using Cannabis for Chemotherapy
Let’s backtrack to a bit more talk of CYP enzymes and how the body processes both chemotherapy and cannabis. Research has indicated that drug interactions with CYP enzymes in the liver most often occur with oral and sublingual substances, like pills, edibles, and tinctures.
With that in mind, doctors have been able to use cannabis for chemotherapy side effects safely when they are able to bypass the liver. Many doctors who specialize in the use of cannabis for chemotherapy agree that the safest ways to administer cannabis to those undergoing chemotherapy is through:
- Inhalation methods like vaporizers, inhalers, or smoking—note that in our home state of Pennsylvania, smoking medical marijuana is illegal;
- Topical infusions, including local patches or creams; and,
- Intra-rectal or intra-vaginal routes with suppositories or ovules.
In an interview with Leafly, Dr. Rosado, a leading cannabis physician and lecturer who has successfully treated over 400 cancer patients, recommended inhalation—specifically vaporization—as the most effective delivery method. For him, it comes down to “a matter of absorption.” He states:
When you inhale cannabis, 100% of the medicine is absorbed within three to five
minutes through an exchange of gasses in the lungs. The cannabinoids bind directly to
red blood cells, making their way into the bloodstream immediately. Because of this,
patients get more bang for their buck with inhalation.
Dr. Rosado, who is also the author of “Hope and Healing: the Case for Cannabis,” suggests that using cannabis to mitigate chemo side effects is even safer if patients use the acid, or non-activated, form of cannabis, such as CBDA. New research has indicated that cannabinoids like CBDA do not metabolize the same way as non-acidic cannabinoids, making them less likely to negatively interact with the cytotoxic medications used to kill cancer cells.
The Bottom Line
Put simply, cannabis is often a godsend for those undergoing chemotherapy. The majority of oncologists practicing today recommend the use of cannabis to treat chemo side effects, as long as it is used safely, and a plethora of positive anecdotal evidence from cancer patients is readily available all over the internet.
For instance, take Cheyann Shaw’s article for Healthline where she documents her experience with medical marijuana during chemotherapy. In it, she writes, “I’m a firm believer that medical cannabis helped me win my fight against cancer. THC and CBD helped not only with nausea, but with the side effects I was experiencing from chemo and the insomnia that I dealt with on the nights after my treatments.”
*Please note that Cheyann’s course of treatment included oral forms of cannabis consumption, which we do not recommend during chemotherapy, as discussed above.
If you are currently undergoing chemotherapy and are experiencing its negative side effects, speak to your physician or oncologist about the use of medical marijuana. It may just be the answer to your prayers.