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Archive for July, 2015

Cancer is the second leading cause of death in the World. According to the National Institute of Health, in United States only, around 1,658,370 new cases will be diagnosed and 589,430 people will die from cancer in 2015. While most conventional cancer treatments revolve around a mix of surgery, chemotherapy and radiation, some people question their efficacy — particularly chemotherapy. In these videos two naturopathic doctors make the argument that in many cases, chemo does more harm than good.

In the first video, Peter Glidden, BS, ND, brings up the relationship between cancer and monetary profit. Glidden, author of The MD Emperor Has No Clothes, cites a study published in the Journal of Clinical Oncology, which found that over a 12-year period, chemotherapy did not cure adult cancer 97 percent of the time. “Why is it still used? There’s one reason, and one reason only,” Glidden says in the video. “Money.”

He points out that while doctors don’t get direct kickbacks for prescribing most medications, chemo drugs are unique in that the doctors purchase them from the pharmaceutical company and then sell them to patients at a profit.

“Chemotherapeutic drugs are the only classification of drugs that the prescribing doctor gets a direct cut of,” Glidden says. “The only reason chemotherapy is used is because doctors make money from it — period. It doesn’t work 97 percent of the time. If Ford Motor Company made an automobile that exploded 97 percent of the time, would they still be in business?” he asks. “No.”

An Australian study looking at the contribution of cytotoxic chemotherapy to 5-year survival rates in adults with malignancies found that the “overall contribution of curative and adjuvant cytotoxic chemotherapy to 5-year survival in adults was estimated to be 2.3% in Australia and 2.1% in the USA.” In their conclusion, the researchers stated: “it is clear that cytotoxic chemotherapy only makes a minor contribution to cancer survival.”

He cites this issue as just one example of a so-called healthcare system that prioritizes profits over human wellness.

“This is the tip of the iceberg of the control that the pharmaceutical industry has on us,” says Glidden. “Medicine in the United States is a for-profit industry. Most people are unaware of this, and most people bow down to the altar of MD-directed high-tech medicine.”

In the second video, naturopathic doctor Leonard Coldwell shares a similar perspective, calling chemotherapy “the Agent Orange of the medical profession.”

“If you have a garden with flowers and bushes and trees and grass, and some weeds, you come with Agent Orange and kill it all off, and now it’s all dead, and you hope only the good stuff is coming back,” Coldwell says. “They bombard the entire system and then they say the cancer is in remission.”

He notes that statistics on the effectiveness of cancer cures refer to survival rates after five years. “You killed basically every bioelectrical and biochemical function in the body,” he says. “Since nothing works anymore, for three years, you have no cancer, you’re cured. You’re just dead in five years.”

Coldwell claims that radiation can cause similar harm. “It’s an assault with a deadly weapon,” he says. “When you radiate someone, it’s causing scars. A scar can never turn back into healthy tissue.”

The problem, he says, is the way doctors are trained. “No medical doctor ever learns about curing anything,” says Coldwell. “They learn about chemical intervention or surgery to suppress symptoms. They don’t go for the root cause.”

He points out that doctors have high rates of suicide as well as alcohol and drug abuse. “These poor guys figure out over time that they have no tools and that they are murdering, and [have] murdered, their patients,” Coldwell says. “You go into the medical profession, the first year, the first two years, you’re really excited, you’re really in it, you’re giving your all, until you find out no matter what you do the patient gets worse, or they cure themselves.”

“These poor doctors figure out they cannot help,” he says. “The medical profession is a religion.”

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0731cannibinoid01After a successful surgery to remove a cancer-ridden section of Jeff Moroso’s large intestine in the spring of 2013, the oncologist sat down with his patient to prepare him for what would come next: 12 rounds of punishing chemotherapy, once every two weeks for six months—standard practice for the treatment of colon cancer.

Moroso’s oncologist spent most of that appointment writing prescriptions for medications he said would minimize the debilitating side effects of chemotherapy. He gave Moroso scripts for ondansetron (Zofran) and prochlorperazine (Compazine) for nausea, and lorazepam (Ativan) for anxiety and insomnia. Because the nausea drugs are known to cause gastrointestinal problems and headaches, he also recommended three over-the-counter medications for constipation and one for diarrhea, as well as ibuprofen for pain. In total, he instructed Moroso to take more than a dozen prescription and nonprescription drugs and supplements.

Moroso says the first three rounds of treatment were more awful than he could have ever imagined. After chemotherapy, he felt so ill and weak that he could barely stand up, and it took him days to rebound. And the prescription drugs just made him feel worse. “I felt real sick, incapable of doing anything except for lying there and trying to hang on,” says Moroso, who is 70 and now cancer-free.

Moroso couldn’t afford to lose days of work while he was doing his chemo. He’d heard from friends and read in the paper that cannabis can help a patient through chemotherapy, so he got a letter from his oncologist that allowed him to obtain medical marijuana. (He chose coffee beans infused with 5 milligrams of cannabis, a low dose that he took when he felt he had to.) By the seventh round of chemotherapy, Moroso had dumped his prescription pills. “I would get blasted on the stuff and be happy as a clam, no problems,” he says.

A growing number of cancer patients and oncologists view the drug as a viable alternative for managing chemotherapy’s effects, as well as some of the physical and emotional health consequences of cancer, such as bone pain, anxiety and depression. State legislatures are following suit; medical cannabis is legal in 23 states and the District of Columbia, and more than a dozen other states allow some patients access to certain potency levels of the drug if a physician documents that it’s medically necessary, or if the sick person has exhausted other options. A large number of these patients have cancer, and many who gain access to medical marijuana report that it works.

“A day doesn’t go by where I don’t see a cancer patient who has nausea, vomiting, loss of appetite, pain, depression and insomnia,” says Dr. Donald Abrams, chief of hematology-oncology at San Francisco General Hospital and a professor of clinical medicine at the University of California, San Francisco. Marijuana, he says, “is the only anti-nausea medicine that increases appetite.”

It also helps patients sleep and elevates their mood—no easy feat when someone is facing a life-threatening illness. “I could write six different prescriptions, all of which may interact with each other or the chemotherapy that the patient has been prescribed. Or I could just recommend trying one medicine,” Abrams says.

A 2014 poll conducted by Medscape and WebMD found that more than three-quarters of U.S. physicians think cannabis provides real therapeutic benefits. And those working with cancer patients were the strongest supporters: 82 percent of oncologists agreed that cannabis should be offered as a treatment option.

Dr. Benjamin Kligler, associate professor of family and social medicine at Albert Einstein College of Medicine, says there has been enough research to prove that at a bare minimum cannabis won’t actually harm a person. In addition, “given what we’ve seen anecdotally in practice I think there’s no reason we shouldn’t see more integration of cannabis in the long run as a strategy,” he says. “We have this extremely safe, extremely useful medicine that could potentially benefits a huge population.”

Some years ago, Dr. Gil Bar-Sela, director of the integrated oncology and palliative care unit at the Rambam Health Care Campus in Haifa, Israel conducted two rounds of phone interviews with 131 cancer patients who used cannabis while in chemotherapy; just less than 4 percent of participants reported that they experienced a worsening of symptoms when they started using cannabis and the majority said it helped, according to the resulting paper published, in Evidence-Based Complementary and Alternative Medicine in 2013.

But self-reported data like this is limited when it comes to proving the clinical impact of cannabis. Patients may be biased in their opinions that cannabis is effective, may not accurately document their use of the drug, or may confuse the effects with those of the cancer treatment. In addition, symptoms such as pain are subjective and difficult for a physician to measure.

A paper published recently in JAMA analyzed the findings of 79 studies on cannabinoids for a variety of indications, including nausea and vomiting from chemotherapy, appetite stimulation for patients with HIV/AIDS, chronic pain and multiple sclerosis, among other conditions. This review, which accounted for 6,462 patients, found most who used cannabinoids reported improvements to symptoms compared with patients in placebo groups. However, the researchers say these improvements were not statistically significant. The analysis also indicated that cannabinoids had limited impact on symptoms of nausea and vomiting, and a number of patients reported adverse effects from the drug, including dizziness, disorientation, confusion and hallucinations.

Perhaps the biggest challenge in understanding marijuana stems from the fact that it is not a bespoke drug designed to act in a specific way on the body — it’s a complex plant that appears to provide a wealth of health benefits. The cannabis sativa plant contains more than 85 cannabinoids, a variety of chemical compounds that also exist in the body. Just as opioid pills activate the opioid receptors (and limit a person’s perception of pain), cannabinoids in marijuana activate the cannabinoid receptors, located throughout the body, including in the brain, liver and immune system.

To date, we really know about only two of these cannabinoids: tetrahydrocannabinol and cannabidiol. Research into THC and CBD has led to the development of drugs such as dronabinol (Marinol), a synthetic cannabinoid approved by the U.S. Food and Drug Administration for nausea and vomiting from chemotherapy and as an appetite stimulant, anti-nausea and anti-pain medication for AIDS patients. Nabiximols (Sativex), another cannabinoid drug, is THC and CBD that is derived from the plant and delivered as a mouth spray. It’s available in Europe and several other countries—but not yet FDA-approved—for multiple sclerosis patients to treat neurological pain and spasticity. One study on nabiximols for the treatment of cancer-related pain produced disappointing results. However, the GW Pharmaceutical Company, the maker of Sativex, is pushing through with further trials to evaluate the drug as a potential adjunctive therapy for opioids for pain management in patients with advanced cancer.

But how other cannabinoids work together is still much of mystery, says Dr. David Casarett, a professor of medicine at the University of Pennsylvania’s Perelman School of Medicine and the author of Stoned: A Doctor’s Case for Medical Marijuana. This means researchers aren’t entirely sure why the plant could help people manage symptoms like nausea and pain. “Marijuana is not as much of a science as it should be,” he says.

In large part, says Casarett, that’s because medical marijuana has proved to be most effective in palliative care, the medical specialty that focuses on managing symptoms of disease and improving a patient’s quality of life—and there is very little funding for palliative care in this country. “That’s changing slowly,” he says, “but it’s still much easier to get funding to test disease-modifying treatments than it is to develop and test palliative therapies, including cannabis.”

We are starting to get some idea of the palliative power of cannabis, Abrams says. “The reason we think we have this whole pathway of the receptors and the endocannabinoids is to get us to forget things, and particularly to get us to forget pain,” he says. In addition, cannabinoids relieve symptoms of nausea because that’s also a physiological reaction stemming from the central nervous system.

With the public perception of marijuana changing rapidly, barriers to studying the plant’s medicinal potential are beginning to fall. Earlier this spring, for example, the Obama administration announced it would remove some of the restrictions on medical marijuana research. In the meantime, though, it is clear that marijuana has a unique and important role to play in cancer care.

“People are realizing that even when patients do well in terms of survival, there’s a lot of suffering along the way that needs to be addressed,” says Casarett. “For many patients, [marijuana] is an opportunity to take control over their disease and symptom management when they can’t get the relief they need from the health care system.”

This article is one in a series from Newsweek ‘s 2015 Cancer issue, exploring challenges and innovations in cancer treatment and research. The complete issue is available online and at newsstands.

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