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Neuroblastoma is the most common cancer found in infants under 1 year old. Studies have shown cannabinoids derived from cannabis may limit the growth of neuroblastomas and encourage 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
Evidence suggests that the major cannabinoids found in cannabis, including tetrahydrocannabinol (THC) have anti-cancer effects and inhibit the progression of cancer. In culture and animal models, cannabinoids have shown they have the capabilities of limiting the growth and even killing cancerous cells1,2,5,9,15.
Studies indicate that these anti-cancer effects of cannabinoids are related to their interaction with the endocannabinoid system’s cannabinoid receptors3,7.
These anti-cancer properties of cannabinoids have shown to apply to neuroblastoma cells. One study found that cannabinoids helped combat neuroblastoma by inhibiting the cells’ metabolism and viability10.
Cannabis has also shown to be beneficial for managing symptoms associated with cancer and its treatments, some as nausea caused by chemotherapy14. THC has shown to reduce conditioned rejection and chemotherapy-induced nausea17.
Cannabis has also been shown effective at lowering neuropathic pain that traditional treatment methods were unable to manage4,21. For patients with a loss of appetite and subsequent weight loss, THC stimulates appetite12,17.
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
- Blázquez, C., Casanova, M.L., Planas, A., Gómez Del Pulgar, T., Villanueva, C., Fernández-Aceñero, M.J., Aragonés, J., Huffman, J.W., Jorcano, J.L., Guzmán, M. (2003, March). Inhibition of tumor angiogenesis by cannabinoids. FASEB Journal, 17(3), 529-31. Retrieved from http://www.fasebj.org/content/early/2003/03/02/fj.02-0795fje.long.
- Blazquez, C., Gonzalez-Feria, L., Alvarez, L., Haro, A., Casanova, M.L., and Guzman, M. (2004, August 15). Cannabinoids inhibit the vascular endothelial growth factor pathway in gliomas. Cancer Research, 64(16), 5617-23. Retrieved from http://cancerres.aacrjournals.org/content/64/16/5617.long.
- Blázquez, C., Carracedo, A., Barrado, L., Real, P.J., Fernández-Lun, J.L., Velasco, G., Malumbres, M., and Guzmán, M. (2006, December) Cannabinoid receptors as novel targets for the treatment of melanoma. FASEB Journal, 20(14), 2633-5. Retrieved from http://www.fasebj.org/content/20/14/2633.long.
- Brisbois, T.D., de Kock, I.H., Watanabe, S.M., Mirhosseini, M., Lamoureux, D.C., Chasen, M., MacDonald, N., Baracos, V.E., and Wismer, W.V. (2011, February 22). Delta-9-tetrahydrocannabinol may palliate altered chemosensory perception in cancer patients: results of a randomized-double-blind, placebo-controlled pilot trial. Annals of Oncology, 22, 2086-2093. Retrieved from https://academic.oup.com/annonc/article/22/9/2086/211788/Delta-9-tetrahydrocannabinol-may-palliate-altered.
- Caffarel, M. M., Andradas, C., Mira, E., Pérez-Gómez, E., Cerutti, C., Moreno-Bueno, G., Flores, J.M., Garcia-Real, I., Palacios, J., Manes, S., Guzman, M., and Sánchez, C. (2010). Cannabinoids reduce ErbB2-driven breast cancer progression through Akt inhibition. Molecular Cancer, 9, 196. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2917429/.
- Casanova, M.L., Blázquez, C., Martínez-Palacio, J., Villanueva, C., Fernández-Aceñero, M.J., Huffman, J.W., Jorcano, J.L., and Guzmán, M. (2003). Inhibition of skin tumor growth and angiogenesis in vivo by activation of cannabinoid receptors. Journal of Clinical Investigation, 111(1), 43–50. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC151833/.
- Cudaback, E., Marrs, W., Moeller, T., and Stella, N. (2010). The Expression Level of CB1 and CB2 Receptors Determines Their Efficacy at Inducing Apoptosis in Astrocytomas. PLoS ONE, 5(1), e8702. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2806825/.
- Galve-Roperh, I., Sanchez, C., Cortes, M.L., Gomez del Pulgar, T., Izquiero, M., and Guzman, M. (2000, March). Anti-tumoral action of cannabinoids: Involvement of sustained ceramide accumulation and extracellular signal-regulated kinase activation. Nature Medicine, 6(3), 313-9. Retrieved from http://www.nature.com/nm/journal/v6/n3/full/nm0300_313.html.
- Guzmán, M., Duarte, M.J., Blázquez, C., Ravina, J., Rosa, M.C., Galve-Roperh, I., Sanchez, C., Velasco, G., and González-Feria, L. (2006). A pilot clinical study of Δ9-tetrahydrocannabinol in patients with recurrent glioblastoma multiforme. British Journal of Cancer, 95(2), 197–203. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2360617/.
- Hamtiaux, L., Hansoulle, L., Dauguet, N., Muccioli, G.G., Gallez, B., and Lambert, D.M. (2011). Increasing Antiproliferative Properties of Endocannabinoids in N1E-115 Neuroblastoma Cells through Inhibition of Their Metabolism. PLoS ONE, 6(10), e26823. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3203169/.
- 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.
- 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., Chan, C., Taft, R.J., Luu, T., Abood, M.E., Moore, D.H., Aldape, K., and Yount, G. (2005, August). Cannabinoids selectively inhibit proliferation and induce death of cultured human glioblastoma multiforme cells. Journal of Neuro-oncology, 74(1), 31-40. Retrieved from http://link.springer.com/article/10.1007%2Fs11060-004-5950-2.
- 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/.
- Sallan, S.E., Zinberg, N.E., and Frei, E. (1975, October 16). Antiemetic Effect of Delta-9-Tetrahydrocannabinol in Patients Receiving Cancer Chemotherapy. The New England Journal of Medicine, 293(16), 795-7. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJM197510162931603.
- Salazar, M., Carracedo, A., Salanueva, Í.J., Hernández-Tiedra, S., Lorente, M., Egia, A., Vazquez, P., Blazquez, C., Torres, S., Garcia, S., Nowak, J., Fimia, G.M., Piacentini, M., Cecconi, F., Pandolfi, P.P., Gonzalez-Feria, L., Iovanna, J.L., Guzman, M., Boya, P., and Velasco, G. (2009). Cannabinoid action induces autophagy-mediated cell death through stimulation of ER stress in human glioma cells. The Journal of Clinical Investigation, 119(5), 1359–1372. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2673842/.
- 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/.