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AROUND THE REGION
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Cannabis and Cancer

The discussion of cannabis and its use in and its derivatives (Off-Label of course) situation. Cannabis’ Mechoulam et al. discovered
cancer patients is a timely hot button These fundamental characteristics are at Schedule-1 status pre- the components of our
issue. the ROOT of the current conflict. How?? vents the proper research Endocannabinoid System.
First, we must specifically define what As physicians, our pharmacological “tool from being done. Over time, researchers were
Cannabis is: box” that we are trained on in Medical However, in the current able to figure out the mecha-
The Cannabis plant can represent any School/Residency/Fellowship is based on research “culture” of the nism by which cannabis acts
combination/ratio of Cannabinoids, FDA-Approved molecular isolates in fixed U.S., unless a company on malignant cells. To put it
Terpenes, and Flavonoids, administered doses at fixed frequencies. These isolated can get a patented isolated concisely, when Cannabinoids
via different delivery methods, the pur- compounds have gone through double- compound at the end of attach to the cannabinoid
pose of which is to exert a therapeutic blind controlled studies/clinical trials; the the research rainbow, it is BY MICHAEL J. receptors on the malignant
effect. end-result is availability at your local phar- just not worth it for them MCKENZIE, MD cell (CB1, CB2), it triggers a
• Cannabinoids are compounds like macy with prescription. to spend money on some- cascade of intercellular reac-
THC, CBD, CBG, CBN, et al. that interact Keep in mind the following: thing that they may not be tions, the end result being
with our Endocannabinoid System The Heterogeneity and Pleiotropy of able to get their money what is called apoptosis, or
• Terpenes are compounds like Cannabis precludes us from approaching back on. These companies make their programmed cell death (“cellular sui-
Myrcene, Limonene, et al. that interact it in the same manner as FDA-Approved money back when the compound being cide”). The healthy non-malignant cells,
with our Endocannabinoid System and molecular isolates that make up our cur- researched is Patented, FDA-Approved, on the other hand, do not undergo such a
give cannabis products their smell rent pharmacopeia. and sold at retail pharmacies. process, thereby sparing the healthy cell.
• Flavonoids are compounds like Isolates can be patented and sold as a When it comes to its use in patients with This is just the tip of the iceberg. There
Quercetin, Apigenin, et al. that interact fixed agent. For example, the drug various cancers, cannabis is used with 2 is so much more research that needs to be
with our Endocannabinoid System and Epidiolex is 99+% isolated plant-derived purposes: done in this area. While the concept is
give cannabis products their color CBD. No Terpenes, Flavonoids, or other 1. Alleviate the chemo-associated nau- there, the main challenge before us is how
The cumulative action of the above 3 Cannabinoids. However, the absence of sea and vomiting and increase appetite in to weaponize that in order to give patients
agents at the receptor sites of our these other important compounds limit those patients with malignancy-associated the best results while at the same time
Endocannabinoid System are what we the overall long-term efficacy of FDA- anorexia. minimizing harms. More to come.
refer to as the “entourage effect.” Approved/Cannabis-Derived medicines 2. Unlock the anti-tumor effects of
In order for us to understand the such as Epidiolex, Marinol (Synthesized Cannabinoids as a therapeutic adjunct to Dr. Michael J. McKenzie
Cannabis plant, we must first examine its THC in a sesame oil capsule), or Syndros Chemotherapy (Off-Label of course) is a Board Certified Family Physician,
two fundamental characteristics: (Synthesized THC in liquid form). The first time that the potential for anti- Diplomate of the American Academy of
Heterogeneity – There is no single enti- The fact of the matter is this. A 5000+ tumor effect was seen was in 1974 at the Cannabinoid Medicine, and Member of the
ty called Cannabis (refer to above defini- year-old plant with its level of heterogene- Medical College of Virginia. Lewis Lung Society of Cannabis Clinicians.
tion), hence there are multiple strains, ity/Pleiotropy cannot be patented like you Adenocarcinoma in mice was inhibited by
chemovars and cultivars which can be would a proprietary isolated compound. the oral administration of THC . While References:
1
used to target different pathologies (Off- Therefore, we must adjust the way we look researchers made that observation, they 1 Antineoplastic activity of Cannabinoids; A E
Label of course). at/approach Cannabis and appreciate its had no idea why it happened or what the Munson, L S Harris, M A Friedman, W L Dewey, R A
Pleiotropy – There are multiple properties in their proper context. mechanism was. It wasn’t until 16 years Carchman;; J Natl Cancer Inst; 1975 Sep;55(3):597-
602. DOI: 10.1093/jnci/55.3.597.
uses/applications for the Cannabis plant This brings us to our current catch-22 later in Israel where Dr. Raphael

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