Doctor's tip: How to use cannabis during chemotherapy
In popular culture, the terms "cannabis "and" cancer treatment " often go together. This idea is supported by modern scientific research, a growing body of evidence supports the use of cannabis for the treatment of cancer and related symptoms such as pain, nausea and loss of appetite.
Unfortunately, the lack of cannabis education for doctors and the legal status of cannabis make many oncologists reluctant to recommend cannabis to their patients. For this reason, patients often consume cannabis without informing their doctor.
According to an 2018 survey of cancer patients, one in eight patients reported using cannabis to treat symptoms of cancer. cancer. In the same study, only 15% of patients agreed with the statement "Cannabis interferes with other drugs".
This is a dangerous misconception. According to Dr. Joseph Rosado, physician, speaker and author of Hope and Healing: Cannabis interacts with every drug that is treated by the liver, including all chemotherapy drugs. He should know that to date, Dr. Rosado has treated nearly 400 cancer patients with cannabis-based drugs.
Learn more about cannabis and drug interactions in chemotherapy
How does cannabis interact with chemotherapy drugs?
When cannabinoids such as THC and CBD are consumed orally, they interact with other drugs that are treated with the enzymes of the body. cytochrome P450 (CYP) in the liver. Interaction results in elevation, fall or rise, and drop in concentrations of the other drug. Our body uses CYP enzymes to metabolize 60% of drugs on the market today, including all chemotherapy drugs and several anti-epileptic, cardiac and antifungal drugs (drugs that end up as "azole").
Chemotherapy drugs are cytotoxicwhich means they are toxic to all living cells. The goal of chemotherapy is to kill as many cancer cells as possible while minimizing the death of healthy cells. Because of the CYP interaction, patients who use a cannabis drug in combination with chemotherapy are at risk of having a different concentration of toxic chemicals in their blood than expected, which makes cannabis and chemotherapy a potentially dangerous combination.
Can chemotherapy patients use cannabis?
The good news, according to Dr. Rosado, is that cannabis can be safely used in combination with chemotherapy. Interactions in the liver can be easily avoided by changing the way you administer your cannabis drug.
Interactions of CYP enzymes in the liver occur mainly orally (tablets, foods and tinctures) and sublingual. "The liver can be bypassed if the mode of administration is changed, for example by inhalation (vaping, smoking, inhalers), by topical patches and creams or intrarectally or intravaginally (suppositories, ova)", explains Dr Rosado.
Among these methods, Dr. Rosado recommends inhalation. "It's an absorption issue," he said. "When you inhale cannabis, 100% of the drug is absorbed in three to five minutes by a gas exchange in the lungs. Cannabinoids bind directly to red blood cells and are immediately found in the blood. Because of this, patients get more for their money with inhalation. "
According to Dr. Rosado, inhalation is even safer when patients use the acidic (non-activated) form of cannabinoids such as CBDA, which do not appear to be metabolized in the same way as nonacidic cannabinoids. To ensure that the cannabinoids are not activated, Dr. Rosado recommends that patients spray cannabis flowers at 131 ° F (55 ° C) or less.
He also recommends spraying rather than smoking. Smoking cannabis has negative effects that make it a bad choice for medicinal use.
What about patients who can not inhale cannabis?
Dr. Rosado says patients should never take oral or sublingual cannabis during chemotherapy treatments. To avoid dangerous interactions, do not consume edible cannabis in 1,5 2 hours after treatment. In addition, he recommends that patients never use edible products when they are treated for liver cancer. Liver cancer significantly reduces the ability of the liver to metabolize cannabis, not to mention the toxicity caused by chemotherapy.
If a patient is unable to inhale cannabis, Dr. Rosado recommends a low-temperature tea made from cannabis buds.
Follow this recipe to make a tea medicinal cannabis:
- Bring the water to a boil and remove from the heating element.
- Wait until the water stops boiling. The water boils at 100 ° C. The temperature of the water should be below 105 ° C when you add the buds, so that the cannabinoids are not activated.
- Place the cannabis buds in the hot water, cover the pan and let infuse for 20 minutes. You can also brew tea in a French press.
- Filter the buds and your tea is ready to drink.
Whichever method you use to take cannabis for medical purposes, always disclose self-medication to your oncologist. Some cancers require closer monitoring of cannabis use. For example, THC may affect estrogen levels (the jury is still under consideration). For this reason, doctors are paying more attention to estrogen levels in patients with hormone-producing cancers (such as ovarian, breast, prostate and testicular cancers) who use cannabis.