{"id":7577,"date":"2017-07-13T14:44:51","date_gmt":"2017-07-13T14:44:51","guid":{"rendered":"http:\/\/www.denverpost.com\/?p=2709466"},"modified":"2017-07-13T14:44:51","modified_gmt":"2017-07-13T14:44:51","slug":"help-and-hope-could-cannabis-possibly-help-fight-cancer","status":"publish","type":"post","link":"https:\/\/cannitrol.com\/blog\/help-and-hope-could-cannabis-possibly-help-fight-cancer\/","title":{"rendered":"Help, and hope: Could cannabis possibly help fight cancer?"},"content":{"rendered":"<div id=\"wp_fb_like_button\" style=\"margin:5px 0 5px 5px;float:right;height:100px;\"><script src=\"http:\/\/connect.facebook.net\/en_US\/all.js#xfbml=1\"><\/script><fb:like href=\"https:\/\/cannitrol.com\/blog\/help-and-hope-could-cannabis-possibly-help-fight-cancer\/\" send=\"true\" layout=\"standard\" width=\"450\" show_faces=\"false\" font=\"arial\" action=\"like\" colorscheme=\"light\"><\/fb:like><\/div><div class=\"media_block\"><\/div>\n<p><em><a href=\"http:\/\/www.denverpost.com\/2017\/05\/16\/help-and-hope-a-cancer-journal\/\">One of an occasional series about cancer, from a patient\u2019s perspective.<\/a><\/em><\/p>\n<p>John Kofel was devastated when a biopsy last October showed he had metastatic prostate cancer. Having had a daughter diagnosed with breast cancer in her 30s, he knew firsthand the nightmare cancer can become.<\/p>\n<p>After Kofel made a follow-up visit to an oncologist, his mood changed from shock to anger, not that he had cancer, but at his doctor.<\/p>\n<p>\u201cHe was very discouraging, in general,\u201d Kofel recalled. \u201c \u2018You might have 31 months to live.\u2019 \u2026 Leaving, I was clearly dazed. I thought, \u2018I\u2019m a dead man.\u2019 \u201d<\/p>\n<p>He also knew that doctor wasn\u2019t for him. (Memo to all cancer patients: If you learn nothing else from this ongoing journal, make sure you have doctors fighting for you.)<\/p>\n<aside class=\"related right\" \/>\n<p>Kofel soon after sought a second opinion and was referred to Dr. Edward (Ted) Eigner, of Urology Associates, who changed his life.<\/p>\n<p>\u201cIt was like night and day,\u201d Kofel said. \u201cHe said, \u2018Yes, you have metastatic cancer, but it\u2019s a very solvable, meaning controllable, issue. \u2026 It\u2019s very treatable.\u2019 \u201d<\/p>\n<p>The bioposy of his prostate, after all, showed only four of 12 samples positive for cancer, with a spread to the pelvic bone and one femur. With newfound optimism, Kofel became obsessed about researching a game plan to fight the cancer. He revamped his diet, including what he drank (now exclusively alkaline water), and began taking a list of supplements that fills an 8- by 11-inch notebook page \u2014 single spaced. And, in December, he began ingesting oils derived from marijuana plants.<\/p>\n<figure id=\"attachment_2712345\" class=\"wp-caption alignright size-article_inline_half\"><img class=\" lazyautosizes lazyload\" src=\"https:\/\/cannitrol.com\/blog\/\/wp-content\/uploads\/2017\/07\/help-and-hope-could-cannabis-possibly-help-fight-cancer\" alt=\"These are bottles of CBD, in ...\" width=\"2784\" \/><figcaption class=\"wp-caption-text\">\n<p>Helen H. Richardson, The Denver Post<\/p>\n<p>These are bottles of CBD, in front, and THC oils that John Kofel takes daily at his home on June 19, 2017 in Aurora. Kofel who has prostate cancer uses CBD and THC oils daily, morning and evening to help him fight the cancer. He also takes a long list of supplements.<\/figcaption><\/figure>\n<p>\u201cI\u2019m trying to leave no stone unturned, attacking it from all sides,\u201d Kofel said.<\/p>\n<p>The cannabis oils he uses contain concentrated amounts of two plant compounds: tetrahydrocannabinol (THC), the psychoactive component of marijuana that gets you high, and cannabidiol (CBD), a non-intoxicating substance that has <a href=\"http:\/\/www.thecannabist.co\/tag\/special-report-cbd-tbd\/\">gained fame for its purported medicinal benefits<\/a>.<\/p>\n<p>\u201cThe combination of both (CBD and THC) causes apoptosis; cannabis tends to go to cancer cells weakened due to chemotherapy and causes them to kill themselves,\u201d Kofel said.<\/p>\n<p>Well, maybe.<\/p>\n<figure id=\"attachment_2713029\" class=\"wp-caption alignleft size-article_inline_third\"><img class=\" lazyautosizes lazyload\" src=\"https:\/\/cannitrol.com\/blog\/\/wp-content\/uploads\/2017\/07\/help-and-hope-could-cannabis-possibly-help-fight-cancer-1\" alt=\"Cindy O'Bryant, PharmD, BCOP - Associate ...\" width=\"206\" \/><figcaption class=\"wp-caption-text\">\n<p>Provided by Cindy O&#8217;Bryant<\/p>\n<p>Cindy O\u2019Bryant, PharmD, BCOP.<\/figcaption><\/figure>\n<p>\u201cThere is data to suggest cannabis can kill cancer cells in the lab,\u201d said Cindy O\u2019Bryant, a professor at the University of Colorado Skaggs School of Pharmacy. \u201cIt appears to affect cancer cells and not normal cells, unlike chemotherapy does, but this is happening in a dish, in the lab, not the human body. Getting it in people to see if it has an effect, therein lies the problem.\u201d<\/p>\n<p>The truth is, <a href=\"http:\/\/www.thecannabist.co\/2017\/01\/12\/marijuana-research-review-united-states-health-benefits-risks-future\/71204\/\">as much as is known about cannabis and its effects<\/a> on the human body, little is known regarding its safety and effectiveness in fighting cancer.<\/p>\n<p>* * *<\/p>\n<aside class=\"related right\">\n<figure id=\"attachment_2713030\" class=\"wp-caption aligncenter size-article_inline\"><img class=\" lazyautosizes lazyload\" src=\"https:\/\/cannitrol.com\/blog\/\/wp-content\/uploads\/2017\/07\/help-and-hope-could-cannabis-possibly-help-fight-cancer-2\" alt=\"Daniel W. Bowles, MD - Investigator, ...\" width=\"226\" \/><figcaption class=\"wp-caption-text\">\n<p>Provided by Daniel Bowles<\/p>\n<p>Daniel W. Bowles, MD.\u00a0<\/figcaption><\/figure>\n<p><em>Following are excerpts from an interview with Dr. Daniel Bowles, who has been studying cannabis for several years. Bowles is an investigator at the University of Colorado Cancer Center.<\/em><\/p>\n<p><strong>Q. Where is the research in terms of whether cannabis causes cancer?<\/strong><br \/><em><br \/><strong>A.<\/strong> \u201cThe data regarding cannabis use as a risk factor for cancer development is mixed. The strongest data suggesting a link is from a large study from Sweden which demonstrated that heavy marijuana smokers at a young age were at a higher risk of lung cancer later in life. There are also some suggestions that it might increase the risk of testicular cancer. It has been more difficult to show that marijuana smoking increases the risks of other cancers. There is exceedingly little information about cancer risk and other forms of cannabis ingestions (vaporized, edibles, etc.).\u201d<br \/><\/em><em><br \/><strong> Q. Where is the research in terms of whether cannabis or cannabis-related products can control cancer symptoms?<\/strong><br \/><\/em><em><br \/><strong>A.<\/strong> \u201cWhen we think of levels of evidence for a treatment, the strongest version is a randomized controlled trial (RCT). There are a few RCTs that demonstrate that smoked cannabis is more effective than a placebo at treating certain pain conditions, especially neuropathic pain. An agent called nabiximols that combines THC and another cannabinoid demonstrated some effectiveness in addition to opiates in cancer patients.<br \/><\/em><em><br \/>\u201cRegarding appetite, there was an RCT comparing a cannabis extract with two other medications used to treat anorexia, and it was less effective than those other two.\u201d<br \/><\/em><em><br \/><strong>Q. How much knowledge do oncologists have to be able to answer questions from patients about cannabis and cancer?<\/strong><br \/><\/em><em><br \/><strong>A.<\/strong> \u201cIt\u2019s fairly mixed. Some oncologists are quite knowledgeable, and others are not and feel very uncomfortable.\u201d<br \/><\/em><em><br \/><strong>Q. If there isn\u2019t any proof that cannabis products help fight cancer, why are so many patients using them?<\/strong><br \/><\/em><em><br \/><strong>A.<\/strong> \u201cMany patients are hopeful that it\u2019s an alternative to supplement their routine care. In my mind, I think people view it as similar to trying vitamins or herbals for other conditions where there is a similar lack of data.<br \/><\/em><em><br \/>\u201cThe biggest issue here is what patients are doing in the real world with smoked products, edibles, extracts and other preparations is largely unstudied.\u201d<br \/><\/em><em><br \/><strong>Q. With the federal government\u2019s view of marijuana, how difficult is it to do research, such as clinical trials, to really know what is going on?<\/strong><br \/><\/em><em><br \/><strong>A.<\/strong> \u201cIt\u2019s very difficult to do research in this field for several reasons. First, the marijuana approved for research provided by the (National Institutes of Health) NIH <a href=\"http:\/\/www.thecannabist.co\/2017\/07\/05\/dea-marijuana-monopoly-research-mississippi-nida\/83118\/\">is not very similar to the marijuana people can buy in a dispensary<\/a>, so it\u2019s difficult to tell whether studies using this marijuana <a href=\"http:\/\/www.thecannabist.co\/2017\/03\/13\/government-research-marijuana-quality\/75461\/\">reflect real world usage<\/a>. Second, the laws regarding drugs in school settings make it difficult to perform research at universities. Lastly, I\u2019m not sure there is a large amount of community support for these studies, as people can currently go use marijuana without any supporting data.<br \/><\/em><em><br \/>\u201cI do think we\u2019re making some headway. The state of Colorado <a href=\"http:\/\/www.thecannabist.co\/tag\/colorado-research-grants\/\">funded several grants<\/a> to evaluate marijuana\u2019s role in several diseases. There is more going on in the pharmaceutical end, too. For instance, a study was just <a href=\"http:\/\/www.thecannabist.co\/2017\/05\/25\/cannabidiol-cbd-oil-epilepsy-medical-study\/80258\/\">published in the New England Journal of Medicine<\/a> evaluating the effectiveness of cannabidiol (CBD) for treating refractory seizures in a condition called Dravet syndrome.<br \/><\/em><em><br \/>\u201cIn my mind, if we\u2019re going to treat cannabis and cannabinoids like medications, we need to study them like medications. \u2026The best way to study this going forward is with pharmaceutical-grade products with known dosing and schedules.\u201d<br \/><\/em><\/p>\n<\/aside>\n<p>Drive west toward Denver when exiting the University of Colorado Cancer Center in Aurora, and you\u2019ll soon pass a marijuana dispensary, Altitude, on your right. \u00a0A dozen or so more dispensaries dot Colfax Avenue before you reach downtown.<\/p>\n<p>In a state where marijuana has become omnipresent, perhaps it\u2019s not a surprise that 53 of 185 cancer patients who filled out a recent survey at the CU Cancer Center said they use some type of marijuana product. That\u2019s 28.6 percent, almost double the rate of marijuana usage of those 18 years or older in Colorado (17 percent), according to CU. The voluntary, anonymous survey, conducted by O\u2019Bryant, showed the vast majority of the patients (81 percent) who use marijuana are doing so to treat side effects of their cancer treatment, such as fatigue, loss of appetite, irregular sleep and pain. \u00a0Around 19 percent say they are using marijuana to treat the cancer itself.<\/p>\n<p>Interest in the issue is clearly on the rise.<\/p>\n<p>\u201cWe\u2019re getting more and more questions about it as regulatory issues become more relaxed,\u201d O\u2019Bryant said. \u201cNot necessarily older patients who are asking, but sons and daughters are asking about it.<\/p>\n<p>\u201cPatients view it as a natural product, so it\u2019s safe, but we really don\u2019t know how it interacts with other drugs.\u201d<\/p>\n<p>She would like to know, as would many of her colleagues, but with the federal government having classified cannabis as a Schedule I drug in the Controlled Substances Act, research hospitals such as CU are stymied.<\/p>\n<p>\u201cOur neurology department has been a big supporter (of research),\u201d O\u2019Bryant said. \u201cWe would like to do more research in current cancer patients. But there are a lot of hoops to jump through. To work with the FDA, to bring a drug to market, we have to take on liability. \u2026 We get federal funds, so there\u2019s always trepidation research funding could be negatively affected.\u201d<\/p>\n<p>* * *<\/p>\n<p>One of the most frustrating aspects of having cancer is the uncertainty: the uncertainty of what will happen next, yes, but also the uncertainty of which drug sequencing or treatment option offers the best hope. Often it\u2019s simply a gut call, a best guess. You can now add \u201cCould cannabis possibly help?\u201d to the list.<\/p>\n<p>Confusion about cannabis and cancer is deepened by a lack of scientific evidence, despite wild, anecdotal claims of its curative powers found on the internet.<\/p>\n<p>For now, Kofel, who lives in Aurora, will keep doing what he\u2019s doing. Twice a day, he takes CBD and THC oils orally via a dropper. He gets the oils, which are bottled as a tincture, from a local provider.<\/p>\n<p>\u201cDo your homework; get good stuff from reliable people,\u201d said Kofel, 72, who has a medical marijuana card.<\/p>\n<p>Upon his diagnosis last fall, he was immediately put on Lupron, a drug used to reduce the production of testosterone, which feeds prostate cancer, and lower a man\u2019s prostate-specific antigen (PSA). He soon after underwent chemotherapy (docetaxel), six rounds. His PSA has dropped from 82 to 0.22. (PSA is a protein produced by the prostate; any number above 4.0 is cause for concern.)<\/p>\n<p>\u201cMy doctor told me, \u2018Whatever you\u2019re doing, it\u2019s working,\u2019 \u201d he said.<\/p>\n<figure id=\"attachment_2712343\" class=\"wp-caption aligncenter size-article_inline\"><img class=\" lazyautosizes lazyload\" src=\"https:\/\/cannitrol.com\/blog\/\/wp-content\/uploads\/2017\/07\/help-and-hope-could-cannabis-possibly-help-fight-cancer-3\" alt=\"John Kofel uses an eye dropper ...\" width=\"4176\" \/><figcaption class=\"wp-caption-text\">\n<p>Helen H. Richardson, The Denver Post<\/p>\n<p>John Kofel uses an eyedropper to take small amounts of THC oil as part of a daily regime of THC and CBD oils at his home on June 19, 2017 in Aurora. Kofel has prostate cancer and uses CBD and THC oils daily, morning and evening, to help fight the disease. He also has a ton of supplements he takes daily to fight cancer as well.<\/figcaption><\/figure>\n<p>He\u2019s planning to start radiation Monday to deliver what he hopes is a final, knockout blow.<\/p>\n<p>\u201cNo one is using the word cure,\u201d Kofel said. \u201cBut my mind-set is I can cure this.\u201d<\/p>\n<p><em>Scott Monserud: 303-954-1578, smonserud@denverpost.com or @monserud<\/em><\/p>\n<aside class=\"related right\">\n<p>Results released last month of a clinical trial of nearly 2,000 prostate cancer patients showed that adding abiraterone acetate (Zytiga) to a standard initial treatment for high-risk, advanced prostate cancer not only prolonged life but lowered the chance of relapse by 70 percent.<\/p>\n<p><strong>My take<\/strong>: It\u2019s huge, positive news for patients with metastatic prostate cancer. Finding the right sequencing of drugs remains a key to making metastatic prostate cancer a chronic disease and not a death sentence, along with advancing immunotherapy research. There is currently only one immunotherapy, Provenge, approved by the FDA to treat prostate cancer. Men older than 50: Get your PSA tested yearly.<\/p>\n<p><strong>My treatment:<\/strong> No changes; I remain on Lupron<\/p>\n<p><em>If you have a question you\u2019d like answered, please send it to me.<\/em><\/p>\n<\/aside>\n<h3>Recommended reading<\/h3>\n<p><strong>Web site<\/strong>: <a href=\"http:\/\/www.curetoday.com\">curetoday.com<\/a><\/p>\n<p><strong>Book<\/strong>: <a href=\"https:\/\/www.amazon.com\/Being-Mortal-Medicine-What-Matters\/dp\/0805095152\">Being Mortal: Medicine and What Matters in the End, by Atul Gawande<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"media_block\"><\/div>\n<p>John Kofel was devastated when a biopsy last September showed he had metastatic prostate cancer. Having had a daughter diagnosed with breast cancer in her 30s, he knew firsthand the nightmare cancer can become. <\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[460,7205,6892,6813,77,9,5019,1,3,7206,61,1736],"tags":[3034,7207,6893,6818,2655,5022,7208],"_links":{"self":[{"href":"https:\/\/cannitrol.com\/blog\/wp-json\/wp\/v2\/posts\/7577"}],"collection":[{"href":"https:\/\/cannitrol.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cannitrol.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cannitrol.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cannitrol.com\/blog\/wp-json\/wp\/v2\/comments?post=7577"}],"version-history":[{"count":0,"href":"https:\/\/cannitrol.com\/blog\/wp-json\/wp\/v2\/posts\/7577\/revisions"}],"wp:attachment":[{"href":"https:\/\/cannitrol.com\/blog\/wp-json\/wp\/v2\/media?parent=7577"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cannitrol.com\/blog\/wp-json\/wp\/v2\/categories?post=7577"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cannitrol.com\/blog\/wp-json\/wp\/v2\/tags?post=7577"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}