National Marijuana Day on April 20th comes at a pivotal moment for pot lovers as more and more states are legalizing the once forbidden drug– and marijuana use is normalized like never before.
Some states like New Jersey and New York are taking more time to pass marijuana laws, while others with fewer issues and restrictions are moving forward more quickly to legalize. But many doctors and researchers are deeply concerned that we have not taken seriously enough research about marijuana’s effects on cancer risk and during cancer treatment.
According to some lung cancer doctors, marijuana smoking can cause aggressive lung cancer.
“As someone in the front lines who sees this every day, I’ve seen lung cancer caused by marijuana that is incredibly aggressive,” says Dr. Raja Flores, Chairman, Department of Thoracic Surgery at Mount Sinai Health System. “And just because we don’t have the numbers yet, because we haven’t been recording this data, doesn’t mean that marijuana is safe.”
The risk involved in this case comes largely from smoking the plant– lighting and inhaling the substance makes it carcinogenic.
SurvivorNet’s extensive review of the medical literature finds no high-quality scientific research establishing a direct link between smoking–or vaping–marijuana and an increased risk of developing lung cancer. This is largely due to the fact that smoking pot was illegal for so long and therefore not easy to study in a long term way. The lack of rigorous scientific data has been quickly embraced by the booming cannabis industry, which is starting to be called “big marijuana.”
But that doesn’t mean that smoking marijuana isn’t associated with cancer; it just means we don’t know yet.
The dilemma is reminiscent of the 1960s, when cigarette smoking was extremely popular, yet we didn’t have the necessary research to tell us whether it was unhealthy. Some doctors have wondered whether we really want to take that same risk with marijuana smoking, and have to redo all the efforts we made to reduce cigarette smoking.
“Just as cigarettes come with health risk warnings, the risks of marijuana smoke need to be defined for users to allow them to make an informed decision about smoking pot,” adds Dr. Friedberg, Head of the Division of Thoracic Surgery at the University of Maryland School of Medicine.
Doctors are calling for more research on the topic, and for firmer scientific ground to stand on when talking about smoking marijuana and cancer risk. “Given the expanding legalization of marijuana, and the anticipated wave of increased use, there is clearly a need to study the cancer risks of marijuana with the same rigor that has been devoted to tobacco smoke,” says Dr. Joseph Friedberg. “Both types of smoke contain some of the same carcinogens, so the widely held belief that tobacco smoke causes cancer and marijuana smoke does not is inherently flawed.”
At the same time, a lot of our doctors recognize the potential benefits of cannabis as a part of integrative therapy for pain relief. Marijuana is not a cure for cancer, but it can help with some of the side effects if patients consult with their doctors to make sure it doesn’t interfere with traditional treatments.
“Integrative therapy is when patients come to see me when they want to add alternative or complementary therapies to their conventional treatments,” says Dr. Junella Chin, an integrative cannabis specialist.
In a recent Instagram post, Canci claimed that, “The presence of ceramide [a chemical in marijuana] leaves no possibility of cancer cell survival.”
But Dr. Chin describes marijuana as more of a way to help with the pain and discomfort that can result from certain parts of cancer treatment.
“When patients come to me, and they have cancer and they have pain, usually, they’ve tried conventional medicine first. Their oncologogists have already prescribed the traditional pain medication. And it just doesn’t seem to work,” says Dr. Chin.
“As humans, we all have a natural cannabis system that our body makes– endocannabinoid system– natural cannabis molecules,” Dr. Chin continues. “And when we are in chronic pain states, or, in our case, a cancer patient, these endocannabinoid molecules are deficient.”
For example, sometimes she treats patients who are experiencing pain due to chemotherapy. “A chemotherapy patient usually comes to see me if they have nausea, if they have decreased appetite, if they have pain, if they have insomnia, and if they’re depressed,” she says.
“Medical cannabis if you think about it, it’s the only botanical medicine, it’s the only plant-based medicine that can help nausea, increase appetite, decrease pain, and elevate mood,” Dr. Chin continues. “So I could in essence write four or five different prescription medications which a lot of physicians do, a lot of oncologists do, or we can try having the patient take one plant-based medicine first.”
When we’re talking about cannabis for relief during cancer treatment, it’s important to know that each patient is different based on their age, size, and medical history, and based on the other treatments they’ve undergone or are undergoing.
At Dr. Chin’s office, assessing the individual patient is the first step. “When a patient comes sees me through a referral through their oncologist or from a friend, word of mouth, the first step is to look at their medical records, do a full history and physical exam. You’re still assessing the patient as a regular physician’s visit,” says Dr. Chin.
“Then we talk about different medications that they’re on that might’ve worked, different medications that they’re on that might not have worked. Their lifestyle. Whether they’re still working, whether they’re at home, and we can recommend,” Dr. Chin continues. “We look at the patient’s medication list. We look at the patient’s lifestyle, and we decide and recommend a medical cannabis formulation that will work well for them.”
But the potentially adverse effects of marijuana, especially burning and smoking it, remain. And lung cancer doctors aren’t the only doctors who have some fears about marijuana and cancer– for some cancers, alternative therapies can come in the way of ongoing conventional treatments, causing them not to work or to work less effectively.
“I have no problem with patients getting marijuana from a reputable, licensed source as long as patients are open with their physician about what they’re taking, and making sure it doesn’t interact with any clinical trial drug that they’re taking or any standard therapy,” says Dr. Elizabeth Comen, Medical Oncologist at Memorial Sloan Kettering Cancer Center.
“My first concern is that patients are safe, that they’re not doing anything that will harm their current treatment, and they’re not doing anything that will increase their risk of a future cancer down the line,” says Dr. Comen.
If you are thinking about using marijuana, during cancer treatment or otherwise, it’s really important to talk to your doctor so that you can weight the risks and benefits before use.