Cancer Archives - Page 2 of 2

25/Oct/2016

THC and CBD the ABC’s of Medical Marijuana

The perspective of a Naturopathic Doctor

As a practicing Naturopathic Doctor, I have understandably been occupying a front row seat in what has become one of today’s hot topic health issues; the use of medical marijuana. I have seen a trend recently in my patients; they’re dropping the conventional pain medications and experimenting with the unquestionably still taboo, cannabis. Two things seem to be driving this phenomenon: traditional pain medications aren’t doing the trick anymore and there is a curiosity about this promising although misunderstood plant.

Professionally, I too have been very curious about the medical applications of marijuana. For years patients would confide in me and share their experiences with using different preparations of cannabis. One of the usual preparations is “hemp oil”, which can contain a significant amount of a cannabinoid called CBD. Hemp oil may have been dismissed as folk remedy; however, with the recent surge in medical marijuana use prompting an educated examination of a potential effective therapy. I can now appreciate that hemp oil is a way to reap the benefits of cannabis without getting intoxicated.

There are thousands of articles on the web that explain in depth what the different components of marijuana are and how they differ in pharmacology and therapeutic applications. The point of this article is not to give a thesis but rather present a concise easy to grasp understanding of what those components do in the body and why cannabis in one form or another should be considered as a first choice medicine.

Before presenting the different types and components of marijuana, I would like to give this article some context and legitimacy by introducing myself, and my medical background. I am a Naturopathic Doctor and have been in private practice for just over 7 years in Toronto Canada. Over the past 4 years my practice has focused on the treatment of pain, debilitating neurological conditions and cancer. This really sets the stage as the first few regulated cannabis medications in Canada, namely Nabilone and Sativex, were approved for neuropathic pain, spasticity and nausea associated with cancer treatment and multiple sclerosis; both of which I see more consistently than the average naturopathic doctor. Naturally I started having patients that had experience with these medications or who were experimenting with unregulated forms of cannabis.

A watershed moment in my practice occurred when I began treating a 10-year-old girl that had suffered a stroke. I thought she would benefit from cannabis but at the same time was hesitant about subjecting her to the hallucinogenic properties of THC. Fortuitously around that very same time I viewed a CNN Sanjay Gupta report about a low THC / high CBD strain of marijuana called “charlottes web”. Treatment with this strain had been helping a young girl with a rare debilitating condition associated with frequent seizures. My young patient didn’t have seizures but had chronic high muscle tone as is also seen during seizures. The report also mentioned how CBD is not hallucinogenic. I was certainly intrigued as to the potential efficacy of this treatment and devoted both time and resources in understanding medical cannabis and CBD. As a result of this study and promising results, I now recommend CBD regularly in my practice. Now let’s take a step back and understand what CBD is and what does it do.

Although there are thousands of potentially therapeutic compounds in cannabis, research has really focused on two: THC and CBD. Depending on the sex and strain of the cannabis some will be higher or lower in one compound than the other.

THC is what gets you high. It acts on cannabinoid receptors in the body and brain with the result of inducing the perception altering experience that marijuana is known for. Along with the “high”, research has pointed out that there are definite pain lowering and mood enhancing properties of THC. However; there are some concerns with THC as it may impact learning in the developing brain, may trigger a psychotic episode in individuals predisposed to schizophrenia and impacts the users ability to carry out daily living tasks such as operating machinery and driving.

CBD, on the other hand, is a non-psychoactive component of cannabis that can comprise up to 40% of the active cannabinoids in marijuana. Although large doses of CBD in my experience can induce an intense feeling of relaxation there are no perception altering effects from even the highest doses of CBD. Research into this curious compound has pointed out that rather than binding to cannabinoid receptors in the body, as does THC, CBD for the most part blocks activity at these receptors and exerts most of its effect at a receptor called 5-HT1a. The 5-HT1a-receptor is linked to serotonin activity.

The overall effect of CBD in the complicated milieu of the human body is that it is anti-inflammatory, mood enhancing, offers protection for the nervous system, promotes relaxation, anti-spasmodic and negates some of the unwanted side-effects of THC consumption. CBD has even been shown to prolong the beneficial effects of THC by increasing the body’s amount of cannabinoid receptors. Furthermore, there has yet to be any evidence for negative side effects or toxicity even at very high doses of CBD per day. CBD research is currently exploring promising therapeutic effect in epilepsy, dementia, migraine and cancer. So all in all it’s a pretty impressive compound.

Now you may be wondering; “how do I get CBD?” – do I need a prescription and is it legal? Technically in Canada any derivative of Marijuana including THC and CBD is classified as a schedule 2-drug and can only be legally obtained with a prescription from a medical doctor. Personally I find it frustrating that Naturopathic Doctors, who receive 4 years of training in botanical medicine, are restricted from prescribing marijuana (a botanical last time I checked) whereas the responsibility falls on medical doctors who typically have no training in prescribing botanical preparations. Fortunately hemp, which is part of the cannabis family, is high in CBD, low in THC and in some cases legal (The legality of the extraction depends on factors such as THC levels and what part of the plant is used).

There are now many companies which specialize in CBD preparations derived from hemp and do not require a prescription from a medical doctor. Unfortunately the CBD on the market continues to be a bit pricey per milligram ($1/10mg) since a therapeutic dose often starts at around 40mg all the way up to 200mg per day. Hopefully in the future we will start to see some higher potency, cheaper preparations of CBD.

As a Naturopathic Doctor, I offer the following personal and professional perspective to both botanical medicines as a whole and specifically CBD. Medicines derived from whole botanicals are a complex collection of thousands of compounds. Often we really only have an understanding of a few of those compounds and that is what disorients many practitioners, especially medical doctors. However, I believe we should appreciate the complexity of botanical medicines precisely because our own physiology is just as complex. Pharmaceutical preparations are very specific in their composition and action in the body. Our bodies are not built that way and that is why we often see side effects with pharmaceutical preparations.

Certainly I do not claim that there are no side effects with botanical medicines, but it is a fact that there are far fewer. Pharmaceutical medicines have a definite time and place in specific treatment but we should not be frightened to use botanical medicines because it is their complexity that often make them safer for prolonged use proving for a more balanced therapeutic effect.

During my relatively short period of recommending CBD, I have seen the benefits in: Pain, Sleep, Focus and Rigidity. I work with a great deal of patients who have suffered from neurological injuries (Spinal cord injury, brain injury, stroke) and neurological disease (Multiple Sclerosis, Transverse Myelitis, Chronic Regional Pain Syndrome, Migraine, Fibromyalgia). I have witnessed more than half of these clients taper down or completely come off of several pain medications including addictive opioid medications and manage their symptoms more effectively with a combination of THC and CBD.

I have a number of patients who after several years of insomnia return to a normal sleep pattern with a therapeutic program that includes CBD. Many of my clients with high tone and muscle rigidity experience a relaxation response within minutes of taking CBD. In fact patients will often take a dose of CBD during a treatment session and will see the effects immediately. I have several patients tell me that since starting CBD their thinking has been clearer. I even have one patient who has told me that her vision is clearer, which makes sense in the context of inflammation of the optic nerve often experienced in multiple sclerosis.

As a Naturopathic Doctor it is my job to be on top of the latest research and treatment-options within the realm of nutraceuticals, complimentary therapies and herbal medicines. CBD is an exciting new treatment option with an excellent safety profile, promising results and that fits in well with my patient population. I am proud to an advocate for medical marijuana and have made a commitment to continue to update my patients and peers as to my clinical experience with CBD.

DoctorShawn

02/Mar/2016

There are few fruits more enticing than the jewel-like arils (seed casings) of pomegranate. Adding to the allure of pomegranate are its incredibly versatile culinary applications and its amazingly powerful medicinal properties.

The fruit we know as Pomegranate comes from the deciduous shrub Punica Granatrum. The Pomegranate is native to Iran, The Himalayas and Northern India. An ancient fruit mentioned as early as Iron-Age Greek Mythology; pomegranate is now cultivated in many warm and dry climates around the world. In the northern hemisphere the fruit is typically in season from September to February. There are many culinary uses for pomegranate. The sweet and sour juice has long been a popular drink in Persian and Indian cuisine and has recently become familiar to consumers in Canada and the United States. The cocktail mixer, Grenadine, is a syrup made from sweetened and thickened pomegranate juice. Pomegranate can also be used to create delicious sauces. For instance, in the traditional Iranian recipe, Fesenjan, a thick sauce is made from pomegranate juice and ground walnuts. Pomegranate arils are also great to eat on their own. After opening up the pomegranate, try separating the arils from the pulp in a bowl of water. The pulp will float while the arils sink to the bottom of the bowl.

Pomegranate is an important traditional remedy in many ancient systems of medicine. In Ayurvedic medicine the rind of the fruit is used against diarrhea, dysentery and intestinal parasites. It is now known that the rind contains ellagitannins that are anti-parasitic, anti-inflammatory and astringent (helping to stop diarrhea). The medicinal applications of pomegranate that ancient medical systems have known about for centuries through empirical evidence is now being validated through scientific investigation.

Recently a multitude of studies has surfaced outlining pomegranates therapeutic application in areas such as: cancer therapy, cosmetics, rheumatology and cardiology. The following is a summary of some of the most recent research on pomegranates application in these medical topics.

In 2009 the journal “Nutrition and Cancer” published a review on cancer chemoprevention by pomegranate. In the review the authors outline recent research showing that pomegranate polyphenol extracts selectively inhibit the growth of breast, colon and lung cancer cells in culture. The review also demonstrated that in pre-clinical animal studies, oral consumption of pomegranate extract inhibited the growth of lung, skin, colon and prostate tumors. As far as human trials go, an initial phase 2 clinical trial of pomegranate juice consumption in patients with prostate cancer reported significant prolongation of prostate specific antigen (PSA) doubling time. This means that the pathological growth and disruption of normal functioning prostate tissue was likely decreased. PSA doubling time can be a useful tool in the screening and monitoring of prostate pathology in men, but has to be interpreted in the correct context and by a trained health care professional.

An excellent article was recently published on the topic of PSA in the November 2010 issue of Naturopathic Doctors News and Review (ndnr). Research would suggest that pomegranate has potential application in the field of natural cosmetics. A study in the “International Journal of Dermatology” demonstrated that a polyphenol extract of the rind fruit and seed of pomegranate protected skin cells against UV-B radiation induced skin damage and increased the synthesis of collagen. Collagen is a connective tissue closely related to cartilage; the shock absorbing cushion found in joints. Interestingly, a recent study in the journal of “Arthritis Research and Therapy”demonstrated that pomegranate extract has the ability to inhibit chemical messengers involved in the breakdown of cartilage, as well as decreasing inflammation often seen in osteoarthritic joints.

Since ancient times, Pomegranate has been known as a tonic for the cardiovascular system. I often prescribe a glass of pomegranate juice per day as adjunctive treatment for high blood pressure. The rich red color of pomegranate juice suggests that it is high in polyphenol rich antioxidants. There is great concern in patients at risk for cardiovascular disease for the development of atheroscelrotic plaques. In summary, atheroscleortic plaques develop when lipoprotein (fat transporting protein) becomes oxidized by free radicals and are subsequently attacked by the immune system. The combination of oxidized lipoproteins and immune cells create pimple-like outgrowths in the artery wall, blocking blood flow. LDL-cholesterol (often referred to as bad cholesterol) is not bad in of itself, it is the action of free radical damage on LDL-cholesterol that makes for trouble. Antioxidant-like molecules produced by the body such as PON1 and PON2 protect against atherosclerotic development. A study in the England journal “Biofactors” demonstrated that the polyphenols in pomegranate juice increase the production of PON1 and PON2 therefore helping to decrease the risk of forming atherosclerotic plaques. These studies suggest that molecules called polyphenols found in pomegranate juice, rind and seed have multiple benefits on health. It is our luck that pomegranate arils and juice are delicious and can be easily incorporated into the diet. Unfortunately it is impossible to know exactly how rich the polyphenol content is in the pomegranate or pomegranate juice you buy. However, a good rule of thumb to ensure that you get a good dose of polyphenols is to pick fresh, brightly colored, organic if possible; pomegranates. When buying juice, make sure that it is 100% pure pomegranate juice. A great website on how to pick and prepare pomegranate is www.pomegranatefruit.org

DoctorShawn

10/Sep/2015

Apple is the fruit from the tree Malus Domestica, a member of the rose family (Rosaceae) which also includes Peaches. The apple tree originated in western asia and was brought to north america in the 17th century.

Thousands of years of cultivation has lead to many varieties of apples differing in texture and taste. I personally enjoy Russet for its sophistication of flavor and Honey Crisp for its crispy sweetness. The wide variety of apples make them a great fruit to enjoy on their own or to prepare into other foods. Apples are now in season, making it a great time to go to a local orchard and experience the taste of a freshly picked apple.

The proverb “an apple a day keeps the doctor away” dates back to 19th century Whales. There are many healthy compounds found in apples, such as: antioxidants, fiber, vitamins and minerals. Recent research has focused on investigating the health benefits of the polyphenols found in apple peel.

A study published in the Journal of Pharmacology in July of 2010 demonstrated that an apple peel polyphenol extract (APPE) protected colorectal cells against the cytotoxic effects associated with consumption of the anti-inflammatory drug indometacin. APPE was shown to have free-radical scavenging ability, preventing mitochondrial (the energy production center of the cell) oxidative damage induced by indometacin.

A study in the Journal of Agricultural Food Chemistry in June 2010 revealed that APPE may have a role to play in the treatment and prevention of H. pylori infection. The study concluded that doses of 150 and 300 mg/kg/day of APPE showed an inhibitory effect on H. Pylori attachment to the stomach lining. Furthermore, APPE also showed an anti-inflammatory effect on H. Pylori associated gastritis.

The same journal contained a study published in May 2010 demonstrating the liver protective effects of apple polyphenols. The study concluded that apple polyphenols had significant effect against acute liver damage induced in mice. The authors speculate that the effect may be due to the free radical scavenging, inhibition of fat oxidation and increased antioxidant activity of apple polyphenols.

In the same month, the same journal published a study demonstrating that apple juice containing apple polyphenols can actually inhibit the activity of toxins produced by staphylococcus. A toxin which effects the intestine known as “staphylococcal enterotoxin A” is a common culprit of gastroenteritis. The apple polyphenols studied here were shown to bind to the enterotoxin rendering it biologically inactive.

In Naturopathic medicine, as with all health care models, safety is never taken for granted; even when dealing with relatively natural substances. It is necessary to seek out, if possible, studies demonstrating the safety profile of a medicinal substance. The Journal of Oleo Science published a study this year evaluating the safety of excessive intake and efficacy of long-term intake of beverages containing apple polyphenols. Subjects were either given a normal dose (340g/day) of apple polyphenols for 12 weeks or three times the normal dose (1020g/day) of apple polyphenols for 4 weeks. There were no adverse reactions noted in either trial. The study also found that the consumption of the apple polyphenols led to a significant reduction in visceral fat area of subjects who were above normal range at baseline, with no change in visceral fat area in subjects in normal range at baseline.

As I have mentioned in previous articles, I especially like studies that evaluate consumption of the whole food over time. The European Journal of Cancer Prevention published a study in January of 2010 that evaluated the effect of regular consumption of apples on colorectal cancer risk in populations with low intake of fruits and vegetables (i.e. most north american populations). The study revealed that while there was more than a 30% reduction in cancer risk with just one apple a day, risk was reduced to around 50% with intake of more than one apple per day. The authors speculate that the beneficial effect may result from the rich content of flavonoid and other polyphenols, which can inhibit cancer onset and cell proliferation.

It seems the old proverb is true, so enjoy your apple, or better yet, more than one apple a day and remember to always have the peel too.

DoctorShawn

17/Aug/2015

The tomato is one of the most commonly cultivated and consumed foods in North America. The tomato is a member of the nightshade family, including potato and eggplant. Some individuals may have an allergy or sensitivity to this family of foods, which is something that can be tested for through your Naturopathic Doctor or allergist.

There are many varieties of tomatoes, including Beefsteak, Plum, Cherry and Heirloom. No matter what variety, all tomatoes contain a multitude of beneficial vitamins, minerals and molecular compounds. One such compound is lycopene. Lycopene is a carotenoid found in tomatoes, carrots, watermelons and papayas, and gives these fruits their red-orange colour. This pigment acts as a powerful antioxidant, protecting the fruit from free-radical damage [free radicals are electron hungry ions that cause damage to other molecules by stealing their electrons]. Free radicals are formed in multiple ways including stress and prolonged sun exposure. Lycopene has a similar effect in our bodies as it does in the fruit, helping to quench free radicals in our blood and tissues. Some studies have found lycopene to be 100 times more potent than vitamin E as an antioxidant. Interestingly, one study found that eating tomatoes consistently for 10-12 weeks before sun exposure, provided individuals with increased protection against sunburn.

Besides lycopene, tomatoes contain a multitude of other beneficial compounds. Tomato skins contain a compound called naringenin chalcone, which has anti-allergy properties, helping to stabilize histamine releasing cells. A randomized, double-blind, placebo controlled trial (RCT) done on 33 individuals with seasonal allergies used tomato extract (from tomato peels and seeds) or placebo for 8 weeks in order to determine if tomato extract can alleviate some of the symptoms of seasonal allergies. The study found that sneezing, runny nose and blocked nose were all decreased in the tomato extract group while the placebo group had no significant change. Furthermore quality of life was reported to be increased in the group that took tomato extract.

Tomatoes have also been shown to be very beneficial for preventing cardiovascular disease. One of the ways tomatoes do this is by inhibiting blood clotting in individuals prone to inflammation. An RCT done in 2006 by the American Journal of Nutrition demonstrated that in blood samples given by healthy individuals 3 hours after consuming a tomato extract, platelet aggregation was significantly reduced. Furthermore in individuals with high levels of plasma homocysteine and C-reactive protein (laboratory markers of inflammation) inhibition of platelet aggregation was most pronounced. The authors concluded that tomato extract may have a role in the primary prevention of cardiovascular disease by reducing platelet activation, which could contribute to a reduction in thrombotic events.

Tomatoes have a very important role to play in the treatment and prevention of several types of cancer. A clinical trial in 2002 investigated the effects of lycopene supplementation in individuals with prostate cancer. Twenty-six men with prostate cancer were randomly assigned to receive a tomato extract containing 30 mg of lycopene or nothing, 3 weeks before prostatectomy. After 3 weeks the prostatic tissue was evaluated. The results demonstrated that in the group taking the tomato extract, the tumours were smaller and less diffuse. Prostate specific antigen levels (a laboratory marker for prostate cancer) were lower in the intervention group compared to the control group.

DoctorShawn

04/Aug/2015

Ginger (Zingiber officinale) has been used as a culinary spice and as medicine for centuries. In Ayurvedic medicine ginger is known as “The Universal Medicine” and forms the basis of countless traditional treatments. In terms of everyday use, ginger is known to prepare the body for digestion and assimilation of nutrients as well as to warm the body during cool winter months. In the last decade, research into the properties of ginger has revealed anti-inflammatory, anti-tumor, anti-nausea and gastrointestinal protective properties.

In relation to ginger’s gastroprotective properties, an aqueous extract of ginger has been shown to prevent stress induced and alcohol induced gastrointestinal ulcers. Ginger was also shown to prevent the growth of harmful H-pylori bacteria.

The anti-nausea properties of ginger have long been known, and ginger can often be found in medications for nausea and vomiting. A recent study in the journal of gynecological oncology demonstrated that randomized control trials have proven that ginger is an effective agent in alleviating post-chemotherapy nausea.

Extensive study into the anti-tumor properties of ginger has been accomplished in the last decade. One study determined that a ginger extract reduces expression of NF-KappaBeta and TumorNecrosisFactor-alpha (compounds which cause inflammation in the body and are up-regulated in cancer) in rats with liver cancer. Another study revealed that [6]-gingerol (one of the compounds that makes ginger pungent) suppresses hepatoma (liver tumor) cell proliferation by inducing cell cycle arrest (stopping cancer cell growth) and apoptosis induction (causing cancer cells to self-destruct). A study looking into the benefits of ginger in ovarian cancer revealed that 6-shogaol (another pungent compound in ginger) inhibited NF-kB (inflammatory compound) as well as diminished secretion of VEGF and IL-8 (compounds secreted by cancer cells to tell the body to form new blood vessels to feed the cancer cells).

DoctorShawn

22/Jul/2015

Broccoli is a member of the mustard/cabbage family known as the Brassicacea. Members of this family contain a multitude of compounds that have been and are currently being studied for their health promoting and chronic disease mitigating properties. These compounds include: Diindolymethane (DIM), Sulforaphane, Isothiocyanates and Glucoraphanin. Aside from these specialized compounds, broccoli is also a good source of vitamin C, K, A and fibre.

When investigating nutritional therapy, the most relevant clinical trials are usually those done on a population of people whom are actually consuming significant quantities of the food in question.

A study done in 2008 investigating broccoli’s role in protection against prostate cancer followed a group of men who were either given 400g of broccoli or 400g of peas per week as a dietary addition for 12 months. Samples of prostatic tissue were analyzed before and after the intervention. The results indicated that the group receiving broccoli displayed significant beneficial effects with regard to signalling pathways involved in prostate cancer growth and generalized inflammation. The effects were especially significant in men possessing a gene involved in detoxification “GSTM1” which represents approximately 50% of the population. There were no significant changes in the pea group. Analysis revealed that Sulforaphane was responsible for many of the beneficial effects of broccoli consumption.

In 2003 an epidemiological study was done in Shanghai, China, which investigated the correlation between the development of breast cancer in women and consumption of Brassicacea. The participants levels of Brassicacea consumption were measured by urine output of Isothiocyanates, (compounds in Brassicacea vegetables which help induce phase 2 detoxification). Results indicated a significant reduction in breast cancer in women with high urine levels of Isothiocyanates, therefore a high level of Brassicacea consumption.

An interesting study done in 2001 examined the protective role of Brassicacea on heterocyclic aromatic amine (HAA) metabolism. HAA’s are compounds produced in grilled foods (those yummy charred lines and smoky flavours you get when BBQ’ing your favourite foods. Although tasty, HAA’s are associated with an increased risk of several types of cancer, especially colon cancer. By measuring urinary excretion of certain metabolites from HAA’s investigators were able to conclude that metabolism of HAA’s is enhanced after eating a diet rich in Brassicacea vegetables.

As testament to the power of broccoli and other Brassicacea in health promotion, chemotherapy agents (such as C-DIM’s) have been synthesized using the naturally occurring compounds in this group of vegetables.

It is important to note that prolonged heat exposure will damage the beneficial compounds in broccoli, especially Sulforaphane. Studies suggest that in order to preserve these disease fighting compounds, low heat (such as used in steaming) and short term heat exposure (less than 10 minutes) are key points to remember when preparing Broccoli. Naturally, you can eat it raw too.

Newer Posts

Why CBD is my new favourite medicine

Pomegranate for health

An Apple A Day

Tomato; the summertime superfood

Ginger the Universal Medicine

Broccoli Beating Cancer

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