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Neuroblastoma is the most common cancer found in infants under 1 year old. Studies have shown cannabis limits the growth of neuroblastomas and encourages cancer cell death.
Overview of Neuroblastoma
Neuroblastoma is a type of cancer that primarily affects infants and young children. The cancer starts in very early forms of nerve cells of the sympathetic nervous system of an embryo or fetus. Tumors develop when normal fetal neuroblasts fail to become mature nerve cells or adrenal medulla cells and instead continue to grow and divide.
While neuroblastomas can develop anywhere along the sympathetic nervous system, they primarily start in the adrenal glands, sympathetic nerve ganglia in the abdomen, and the sympathetic ganglia near the spine at the chest or neck. Most neuroblastomas are not inherited, and there are no environmental or lifestyle-related factors known to increase risk.
Neuroblastomas can vary greatly in how they behave. They can grow and spread quickly or grow slowly. Some cancer cells actually die without treatment and the tumors disappear. Most neuroblastomas spread to the lymph nodes before they’re detected. They can also spread to bones.
Children with neuroblastoma may find a large lump or swelling in the abdomen, chest, or neck. Tumors in the abdomen can reduce appetite and make a child feel full or have belly pain. In some cases, the tumor can press against blood and lymph vessels in the abdomen or pelvis, possibly stopping fluids from returning to the heart and causing swelling in the legs. When the tumor is located in the chest, it could press against the superior vena cava and limit blood flow, causing the face, neck, arms and upper chest to swell, or cause the child to become dizzy or develop a headache. When the tumor is in the neck, it could press on the throat or windpipe and affect breathing and swallowing.
Treating neuroblastoma is complex, and tactics vary depending on the stage of the cancer and the child’s age. The types of treatments can include chemotherapy, surgery, radiation therapy, stem cell transplant, and retinoid therapy.
Findings: Effects of Cannabis on Neuroblastoma
Recent evidence suggests that two major cannabis compounds, cannabidiol (CBD) and tetrahydrocannabinol (THC), have anti-cancer effects. A recent study that used culture and animal models found that CBD and THC were effective at helping mitigate the rapid multiplication of neuroblastoma. Both cannabinoids showed anti-tumor effects, while CBD was the most active of the two1.
In several animal models, CBD has shown to inhibit cancers located in the breast, lung, prostate, and colon5,8,10.
Cannabis has also shown to be beneficial for managing symptoms associated with cancer and its treatments. CBD has shown to effectively treat nausea, and prevent anticipatory nausea in patients undergoing chemotherapy7,11. THC has shown to reduce conditioned rejection and chemotherapy-induced nausea6. Cannabis has also been shown effective at lowering neuropathic pain that traditional treatment methods were unable to manage14. For patients with a loss of appetite and subsequent weight loss, THC stimulates appetite4,9.
States That Have Approved Medical Marijuana for Neuroblastoma
No states have approved medical marijuana specifically for the treatment of neuroblastoma. However, several states have approved medical marijuana for the treatment of cancer. Nearly all states with medical marijuana laws have approved cannabis specifically for the treatment of cancer. These states include: Alaska, Arkansas, Arizona, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, Washington, and West Virginia.
Although the state of Maryland hasn’t approved medical marijuana to treat cancer, it has approved it for the treatment of nausea and chronic pain, which are two symptoms commonly associated with cancer treatment.
In Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment.
Recent Studies on Cannabis’ Effect on Neuroblastoma
CBD impedes neuroblast growth, reduces the tumor’s viability and invasiveness and stimulates the death of cancer cells. THC also shown to impede neuroblast growth.
In vitro and in vivo efficacy of non-psychoactive cannabidiol in neuroblastoma.
Animal studies have shown that the cannabis-derived cannabinoid, CBD, inhibits the progression of many types of cancer (glioblastoma, breast, lung, prostate, colon).
The Antitumor Activity of Plant-Derived Non-Psychoactive Cannabinoids.
Fisher, T., Golan, H., Schiby, G., PriChen, S., Smoum, R., Moshe, I., Pesches-Yaloz, N., Castiel, A., Waldman, D., Gallily, R., Mechoulam, R., and Toren, A. (2016). In vitro and in vivo efficacy of non-psychoactive cannabidiol in neuroblastoma. Current Oncology, 23(Suppl 2), S15–S22. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4791143/.
Golan, H., Fisher, T., and Toren, A. (2017, February). The role of cannabinoids in the treatment of children with cancer. The Israel Medical Association Journal, 19, 89-94. Retrieved from https://www.ima.org.il/FilesUpload/IMAJ/0/228/114216.pdf.
How is neuroblastoma treated? (2016, January 22). American Cancer Society. Retrieved from http://www.cancer.org/cancer/neuroblastoma/detailedguide/neuroblastoma-treating-general-info.
Jatoi, A., Windschitl, H.E., Loprinzi, C.L., Sloan, J.A., Dakhil, S.R., Mailliard, J.A., Pundaleeka, S., Kardinal, C.G., Fitch, T.R., Krook, J.E., Novotny, P.J. and Christensen, B. (2002). Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a North Central Cancer Treatment Group study. Journal of Clinical Oncology, 20(2), 567-73. Retrieved from http://ascopubs.org/doi/full/10.1200/JCO.2002.20.2.567.
Ligresti, A., Moriello, A.S., Starowicz, K., Matias, I., Pisanti, S., De Petrocellis, L., Laezza, C., Portella, G., Bifulco, M., and Di Marzo, V. (2006, September). Antitumor activity of plant cannabinoids with emphasis on the effect of cannabidiol on human breast carcinoma. Journal of Pharacologogy and Experimental Therapeutics, 318(3), 1375-87. Retrieved from http://jpet.aspetjournals.org/content/318/3/1375.long.
Limebeer, C.L., and Parker, L.A. (1999, December 16). Delta-9-tetrahydrocannabinol interferes with the establishment and the expression of conditioned rejection reactions produced by cyclophosphamide: a rat model of nausea. Neuroreport, 10(19), 3769-72. Retrieved from http://journals.lww.com/neuroreport/pages/articleviewer.aspx?year=1999&issue=12160&article=00009&type=abstract.
Machado Rocha, F.C., Stefano, S.C., De Cassia Haiek, R., Rosa Oliveira, L.M., and Da Silveira, D.X. (2008, September). Therapeutic use of Cannabis sativa on chemotherapy-induced nausea and vomiting among cancer patients: systematic review and meta-analysis. European Journal of Cancer Care, 17(5), 431-43. Retrieved from http://onlinelibrary.wiley.com/wol1/doi/10.1111/j.1365-2354.2008.00917.x/full.
McAllister, S.D., Soroceanu, L., and Desprez, P.Y. (2015, June). The Antitumor Activity of Plant-Derived Non-Psychoactive Cannabinoids. Journal of Neuroimmune Pharmacology, 10(2), 255-67. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4470774/.
Nauck, F., Klaschik,E. (2004, June). Cannabinoids in the treatment of the cachexia-anorexia syndrome in palliative care patients. Schmerz, 18(3), 197-202. Retrieved from http://www.jpsmjournal.com/article/S0885-3924(05)00063-1/pdf.
Orellana-Serradell, O., Poblete, C.E., Sanchez, C., Castellon, E.A., Gallegos, I., Huidobro, C., Llanos, M.N., and Contreras, H.R. (2015, April). Proapoptotic effect of endocannabinoids in prostate cancer cells. Oncology Reports, 33(4), 1599-608. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4358087/.
Parker, L.A., Rock, E.M., and Limbeer, C.L. (2011, August). Regulation of nausea and vomiting by cannabinoids. British Journal of Pharmacology, 163(7), 1411-22. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3883513/.
Signs and symptoms of neuroblastoma. (2016, January 22). American Cancer Society. Retrieved from http://www.cancer.org/cancer/neuroblastoma/detailedguide/neuroblastoma-signs-and-symptoms.
What is neuroblastoma? (2016, January 22). American Cancer Society. Retrieved from http://www.cancer.org/cancer/neuroblastoma/detailedguide/neuroblastoma-what-is-neuroblastoma.
Wilsey, B., Marcotte, T., Deutsch, R., Gouaux, B., Sakai, S., and Donaghe, H. (2013, February). Low-dose vaporized cannabis significantly improves neuropathic pain. The Journal of Pain, 14(2), 136-48. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3566631/.