There is currently 1 CBD treatment approved by the U.S. Food and Drug Administration (FDA) called Epidiolex, which is used to treat a rare and severe form of epilepsy in children. There are not currently any FDA-approved CBD medications for treating cancer or side effects of cancer treatments.
CBD is 1 of the hundreds of chemicals found in the flowering cannabis plant. CBD does not have the psychoactive, or mind-altering, effects of another chemical found in cannabis called tetrahydrocannabinol (THC). THC is the chemical that causes people to experience a “high.” CBD, on the other hand, is being used by some to help ease pain, anxiety, and sleep issues.
What is CBD?
There have been some studies that show that CBD, alone or together with THC, may relieve pain, insomnia, or anxiety, but these studies were not specific to people with cancer. While no studies to date have shown that CBD eases these side effects specifically in people with cancer or people receiving cancer treatment, some people with cancer have reported benefits in taking CBD, such as helping with nausea, vomiting, depression, and other side effects. According to ASCO guidelines, your doctor may consider prescribing cannabinoids for chronic pain management if you live in a state where it is legal. However, ASCO guidelines state that there is not enough evidence to support the use of cannabinoids for preventing nausea and vomiting in people with cancer receiving radiation therapy or chemotherapy.
Cannabidiol, also known as CBD, is one of many chemicals found in the cannabis plant. It has been touted in some online forums as an alternative treatment, and even a cure, for many illnesses, including cancer. And, some people with cancer say that CBD has helped them as a complementary therapy in managing their symptoms and side effects from standard cancer treatment.
Can CBD help people with cancer?
CBD comes from cannabis plants called hemp that are specifically grown with high levels of CBD and low levels of THC. Cannabis plants grown with high levels of THC are usually called marijuana. CBD comes from oil that is extracted from the cannabis plant. That oil can then be ingested as a liquid, a capsule, a gummy, or inhaled through vaping. It can also be added as an ingredient in such products as lotions and skin patches.
Danish researchers conducted a review of 22 clinical trials conducted over a 19-year span on the use of cannabis and CBD in adults. They concluded that, while CBD may have “therapeutic effects” on some social and psychiatric disorders, the studies showed “substantial risks of bias” and had varying “methodological weaknesses.”
“In its absence, it doesn’t mean something isn’t of value, but it’s much harder to advise its use in patients,” Dr. Markman says. “There’s no regulation. The research just isn’t there yet. The fundamental problem has been, and remains, that you’re talking about a class of drugs that’s been woefully under-researched, and the reason is because it’s illegal under federal law. It’s an incredible situation where you have proclamations by people about how great it is, but we also know about the placebo effect, which is a very important consideration. There have also been multiple studies that have shown potential for harm to the central nervous system and cognition. And there’s an incredible economic incentive to consider.”
The FDA acknowledges the “significant public interest in cannabis and cannabis-derived compounds,” but maintains there are “many unanswered questions about the science, safety, and quality” of CBD products. The agency is engaged in “ongoing efforts” to answer these questions, according to its website.
Cancer and CBD
While some anecdotal evidence has been publicly shared about CBD’s benefits for cancer patients, the scientific research is lacking. The situation causes a conundrum for doctors who treat cancer patients, says Maurie Markman, MD, President of Medicine & Science at Cancer Treatment Centers of America ® (CTCA).
Available only by prescription, Epidiolex contains a highly purified form of CBD, the FDA says. Safety risks include possible liver damage and the potential for adverse reactions when the drug is taken with other medications—potential hazards that the FDA requires be disclosed on its label.
CBD comes in many forms—creams, capsules, edibles, tinctures and oils, including a vaping oil. Unlike another key ingredient in the cannabis plant, tetrahydrocannabinol, or THC, CBD does not cause users to feel high. CBD may be found in grocery stores, marijuana dispensaries, gas stations, pharmacies and health food stores. It can be smoked, vaped, drunk or eaten.
CBD, as well as medical marijuana, must be studied in the same way all other FDA-approved drugs are, by conducting randomized trials, its effects on various age groups and populations, and comparisons to already approved drugs, Dr. Markman says. To date, he says, no studies have met the agency’s criteria or standards to win FDA approval, which Dr. Markman calls “the gold standard.” In order to do so, experts must determine that a drug’s benefits “outweigh the known risks for the intended use,” he says.
CBD is thought to work by targeting cannabinoid receptors (CB1 and CB2) found mainly in the brain and other areas of the body. These receptors are part of the endocannabinoid signaling system, which—while its role is not completely understood— is believed to help regulate various mental functions, including cognition, sleep, pain and mood. CBD may also help regulate the production of cortisol, a hormone that helps the body deal with stress.