Saturday, September 26, 2015

Marijuana, Cancer, and Conflicting Messages Within the Government

There is a very public discontinuity between the federal ban of marijuana and the many states which have decriminalized it in one form or another.  This is about something else, though.  A friend posted an article highlighting the irrationality of the Drug Enforcement Agency declaring cannabis to be without any known medical benefit while the National Cancer Institute includes information on its website recognizing benefits attributed to cannabis.  Here is the article:

"National Cancer Institute Quietly Confirms Cannabis Can Cure Cancer"

It's a pretty sensational headline, so I followed it.  What I found was worth making a blog post about.  The short version is that the article is predictably misleading, but there is an element of truth it it.  Remarkably, this truth is somewhat encouraging.

Some quick context: the DEA rates drugs in "schedules" based on their potential for abuse versus their potential for benefit.  Marijuana has long been a schedule 1 drug, which means that the DEA considers cannabis to be 1) addictive, 2) dangerous, and 3) without any medical benefit.  All three are strongly disputed by advocates, but the third point is the one challenged by this article.

The article claims that "The unpublicized studies that prove cannabis’s medical merits are referenced within the NCI (National Cancer Institute)."  It then lists some brief summaries of studies which have indicated that various cannabinoids -- chemicals which give marijuana its effects -- can inhibit the growth of tumors.  

Though I'm a strong advocate of marijuana legalization, I must take the article to task for summarizing these studies without actually citing any of them.  I also think that this article makes a common mistake in accepting the result of a given study as proof of a scientific fact.  In truth, every scientist will tell you that even their own work can only be viewed as a single piece of evidence which can create consensus when taken with many, many studies.  Single studies by themselves are not to be taken as conclusive confirmation.

My first big question, though, was whether it was true that the National Cancer Institute was openly contradicting the DEA.  The NCI is an agency within the National Institute of Health which funds cancer research and provides guidelines for doctors and researchers on behalf of the US government.   Here are some links on their website providing information on treating cancer with pot:

Cannabis and Cannabinoids–for health professionals (PDQ®)

Cannabis and Cannabinoids–for patients (PDQ®)

Firstly, way to explain your acronyms, NCI.  PDQ stands for "Physician Data Query".  I found some information about why it's a registered trademark by the way, but that doesn't seem relevant at the moment.  These PDQ®s are the NCI's resources for physicians and patients looking for reliable information put together by the NCI.  So does the NCI recognize cannabis as a valid treatment?  Not really.  It is listed as a "Complementary or Alternative medicine", and a disclaimer is attached insisting that its inclusion is NOT a formal policy statement.  Still, it IS there.  The reason why is that -- to the credit of the NCI -- they have an independent board of scientists which reviews medical literature and provides its assessment of treatments not currently embraced by the mainstream, regardless of the opinions of the NCI or the United States government.  Below is an excerpt from another page written specifically for people wondering what I was wondering (link):

Reviewers and Updates
This summary is reviewed regularly and updated as necessary by the PDQ Cancer Complementary and Alternative Medicine Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).
Board members review recently published articles each month to determine whether an article should: 
- be discussed at a meeting, 
- be cited with text, or 
- replace or update an existing article that is already cited. 
Changes to the summaries are made through a consensus process in which Board members evaluate the strength of the evidence in the published articles and determine how the article should be included in the summary.
The lead reviewers for Cannabis and Cannabinoids are: 
Donald I. Abrams, MD (UCSF Osher Center for Integrative Medicine) 
Nagi B. Kumar, PhD, RD, FADA (Fellow of the American Dietetic Association) 
Any comments or questions about the summary content should be submitted to Cancer.gov through the NCI website's Email Us. Do not contact the individual Board Members with questions or comments about the summaries. Board members will not respond to individual inquiries.

The last thing I was wondering is whether the NCI recognized cannabinoids as having tumor inhibiting potential.  Frankly, I have never seen substantive evidence that marijuana can directly help fight cancer.  I've seen compelling evidence that it can be used to relieve some side-effects of chemotherapy, as well as evidence that it can assist in regulating mood as well as some other fascinating possibilities in treating forms of epilepsy or glaucoma.  I'm not saying marijuana DOESN'T cure cancer, just that every time I hear someone say "Marijuana cures cancer!" they seem to be shouting and I feel a desire to distance my advocacy from theirs.  In any case. Marijuana undeniably has medical applications and the NCI recognizes this fact even if they do not directly advocate for the expansion of its use in mainstream treatments.  To me, that still sounds like progress.

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