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Neurofibromatosis is a genetic disorder that causes neurofibromas, or tumors, to form on nerve tissue throughout the body. Studies have shown cannabis has anti-tumor effects and can help manage pain associated with the disorder.
Overview of Neurofibromatosis
Neurofibromatosis is a group of genetic disorders that cause tumors to form on nerve tissue. The tumors, which can develop anywhere in the nervous system, including the brain, spinal cord, and nerves, are typically benign. However, in some cases the tumors can become malignant. The disorder, typically diagnosed during childhood or early adulthood, can cause hearing loss, learning impairments, heart and blood vessel complications, vision loss and severe pain.
There are three types of neurofibromatosis, including neurofibromatosis 1, neurofibromatosis 2, and schwannomatosis. Neurofibromatosis 1 (NF1) is the most common and typically develops during childhood. Symptoms associated with NF1 include six or more light brown spots on the skin that measure more than 5 millimeters in diameter in children and more than 15 millimeters across in adolescents and adults, freckling in the armpit or groin, two or more growths on the iris of the eye, soft bumps on or under the skin, bone deformities like a curved spine and learning disabilities. Neurofibromatosis 2 (NF2) is much less common and can cause gradual hearing loss, ringing in the ears and poor balance. Schwannamatosis is rare and causes severely painful tumors to develop on cranial, spinal and peripheral nerves.
The mutated gene that causes neurofibromatosis is commonly inherited, but it can also result from spontaneous mutations.
There is no cure for neurofibromatosis, so treatment focuses on ongoing pain management and dealing with complications as they develop. In some cases, surgery may be necessary to remove large tumors or tumors that press on a nerve. Once tumors are removed, pain often subsides, but will recur once new tumors form.
Findings: Effects of Cannabis on Neurofibromatosis
Cannabis has been found to have anti-tumor efforts, which suggests it may be helpful in limiting the development and growth of tumors caused by neurofibromatosis. One study found that two children with neurofibromatosis had their tumors clearly regress during a three-year period where no conventional treatment was used but cannabis was consumed via inhalation (Foroughi, Hendson, Sargent & Steinbok, 2011). Cannabinoids found in cannabis have shown to be beneficial for inhibiting tumors by limiting the growth and even killed cancerous cells in animal trials (Hernan Perez de la Ossa, et al., 2013).
Cannabis may also be able to help those with neurofibromatosis manage pain. Even low doses of cannabis has demonstrated the ability to significantly lower pain, even showing it can help curtail pain that has proven refractory to other treatments (Wilsey, et al., 2013). Cannabis use has been found to be prevalent among the chronic pain population, with improvements in pain, sleep and mood being the most frequently reported reasons for use (Ware, et al., 2003). Cannabinoids interact with the endocannabinoid system’s CB1 and CB2 receptors to help regulate the release of neurotransmitter and central nervous system immune cells to manage pain levels (Woodhams, Sagar, Burston & Chapman, 2015).
States That Have Approved Medical Marijuana for Neurofibromatosis
Currently, only the state of Illinois has approved medical marijuana specifically for the treatment of neurofibromatosis. However, in Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment. In addition, a number of other states will consider allowing medical marijuana to be used for the treatment of neurofibromatosis with the recommendation from a physician. These states include: California (any debilitating illness where the medical use of marijuana has been recommended by a physician), Connecticut (other medical conditions may be approved by the Department of Consumer Protection), Massachusetts (other conditions as determined in writing by a qualifying patient’s physician), Nevada (other conditions subject to approval), Oregon (other conditions subject to approval), Rhode Island (other conditions subject to approval), and Washington (any “terminal or debilitating condition”).
Several states have approved medical marijuana specifically to treat “chronic pain,” a symptom commonly associated with neurofibromatosis. These states include: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New Mexico, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont and West Virginia. The states of Nevada, New Hampshire, North Dakota, Montana, Ohio and Vermont allow medical marijuana to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania, Washington and West Virginia have approved cannabis for the treatment of “intractable pain.”
Recent Studies on Cannabis’ Effect on Neurofibromatosis
- Foroughi, M., Hendson, G., Sargent, M.A., and Steinbok, P. (2011, April). Spontaneous regression of septum pellucidum/forniceal pilocytic astrocytomas–possible role of Cannabis inhalation. Child’s Nervous System, 27(4), 671-9. Retrieved from http://link.springer.com/article/10.1007%2Fs00381-011-1410-4.
- Hernán Pérez de la Ossa, D., Gil-Alegre, M.E., Ligresti, A., del Rosario Aberturas, M., Molpeceres, J., Torres, A.I., and Di Marzo, V. (2013). Preparation and characterisation of biodegradable microparticles filled with THC and their antitumor efficacy on cancer cell lines. Journal of Drug Targeting, early online, 1-9. Retrieved from http://www.tandfonline.com/doi/full/10.3109/1061186X.2013.809089?needAccess=true.
- Neurofibromatosis. (2013, January 3). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/neurofibromatosis/basics/definition/con-20027728.
- Neurofibromatosis Fact Sheet. (2015, July 27). National Institute of Neurological Disorders and Stroke. Retrieved from http://www.ninds.nih.gov/disorders/neurofibromatosis/detail_neurofibromatosis.htm.
- Ware, M.A., Doyle, C.R., Woods, R., Lynch, M.E., and Clark, A.J. (2003, March). Cannabis use for chronic non-cancer pain: results of a prospective survey. Pain, 102(1-2). Retrieved from http://journals.lww.com/pain/Abstract/2003/03000/Cannabis_use_for_chronic_non_cancer_pain__results.23.aspx.
- 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/.
- Woodhams, S.G., Sagar, D.R., Burston, J.J., and Chapman, V. (2015). The role of the endocannabinoid system in pain. Handbook of Experimental Pharmacology, 227, 119-43. Retrieved from http://link.springer.com/chapter/10.1007%2F978-3-662-46450-2_7.