Cannabidiol [CBD] - Epidiolex - Advanced Prostate...

Advanced Prostate Cancer

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Cannabidiol [CBD] - Epidiolex

pjoshea13 profile image
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A number of men have expressed interest in CBD (cannabidiol) for PCa. It is currently available throughout the U.S., but who knows how much CBD is in the products, or how long before they are banned (if Jeff Sessions gets his way)? The FDA has now approved a purified product, Epidiolex, for "seizures associated with two rare and severe forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome" [1].

"Analysts expect Epidiolex to cost $2,500 to $5,000 a month" (NY Times) [2].

-Patrick

[1] fda.gov/NewsEvents/Newsroom...

[2] nytimes.com/2016/03/15/busi...

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cesanon profile image
cesanon

Patrick

1. There is another synthetic cannabinoid called "Marinol" that has been around so long that it now has a generic. Offhand I don't know what it costs, but it isn't a lot.

2. "Epidiolex" is almost certainly a single one of over 100 known cannabinoids. FDA requirements make it too expensive to test multi-ingredient pharmaceuticals with FDA compliant clinical trials. If you are testing 2 ingredients, costs increase by about 4 fold. If you are testing a combination of 4 ingredients, costs increase about 16 fold.

3. Don't forget Myers observation was that cannabinoid use by his patients seemed to increase the growth of prostate cancer, and there is a rational scientific explaination why this could be so.

pjoshea13 profile image
pjoshea13 in reply to cesanon

Marinol is synthetic THC.

The PCa literature concerning cannabinoids is very interesting, but I have no strong feelings on the subject. There was a review paper last year:

ncbi.nlm.nih.gov/pmc/articl...

"Cannabinoids and prostate cancer

"In terms of urological malignancies, the highest amount of focus in the role of cannabinoids has been on prostate cancer. Various different biological mechinisms have been explored to explain the possiblity of the beneficial effect of cannabinoids of prostate. First, Orellana-Serradell et al postulated that by activation of apoptotic mechanisms, endocannabinoids could halt the growth of prostate cancer cells.13 In their study, they used a commercial cell line and primary cultures derived from prostate cancer demonstarating the expression of CB1 and CB2 in those cell lines, which was more prominent in later stages of the disease. They also proved that treatment with endocannabinoids produced a dose-dependent cell growth inhibitory effect on all the different prostate cancer culture cells. Based on these results, they suggested that endocannabinoids may be a beneficial option for the treatment of prostate cancer that has become non-responsive to common therapies. Another study suggested that the anticancer activity of cannabinoids was linked to induction of phosphatases.14 They demonstrated cannabinoids induced mRNA expression of several phosphatases in prostate cancer cells and this was consistent with induction of phosphatases by other phyto-chemical anticancer drugs.

"Olea-Herrero et al investigated the effect of the cannabinoid R(+)methanandamide in androgen-resistant prostate cancer cells and found a dose-dependent increase in the secretion of the cytokine IL-6.15 Their study suggested that CB2 agonists may offer a novel approach in the treatment of prostate cancer by decreasing cancer epithelial cell proliferation. Chung et al used formalin-fixed, paraffin-embedded tissue samples from patients who were diagnosed with prostate cancer at a trans-urethral resection and probed whether the level of cannabinoid 1 receptor immunoreactivity (CB1IR) in prostate cancer tissues is associated with disease severity and outcome.16 Ultimately, they found that high CB1IR immunoreactivity is associated with a more severe form of the disease at diagnosis and a poorer outcome. Lastly, Thors et al studied the expression of the endocannabinoid-metabolizing enzyme fatty acid amide hydrolase from patients diagnosed with prostate cancer.17 In this study, the tumour epithelial fatty acid amide hydrolase was found to be associated with prostate cancer severity and outcome at mid-range, but not high CB1IR scores.

"In summary, elucidating the exact intracellular pathways of the effect of cannabinoids on prostate cancer cells is still an area of active research that could have significant ramifications for treatment options in the future, especially for castrate-resisitant prostate cancers. Once plausible biological mechanisms are discovered, the next would step would be to move on to clinical trials to investigate whether or not there is any clinical utility for such treatment options.

-Patrick

cesanon profile image
cesanon in reply to pjoshea13

1. "Marinol is synthetic THC" Yes. At this point, there is no reason to distinguish between or among the effects of different cannabinoids.

All any credible researcher can do is test them one at a time, before testing them in various combinations.

2. Whatever they were using in the study you cite, or the studies that were reviewed in that article, you can be highly confident, that it was unlike the cocktail of cannabinoids Myers patients were using to self-medicate.

And that it was unlike the various cocktails of cannabinoids that are otherwise available to most of us for self-medication purposes.

3. Those self-medicating cannabinoid cocktails also contain hundreds of terpenes that are themselves almost certainly bioactive. To what effect, who knows.

arete1105 profile image
arete1105

If you look at this chart from SClabs.com, you can see the various benefits from the different cannabinoids. THC does have some benefit, but most of the time the non-THC cannabinoids cover those same benefits. The cancer benefit comes from the non-THC cannabinoids.

Non THC oil/paste is legal and available nationwide and is cheap. You don't need the government to get involved with their "pharm" products.

ITCandy profile image
ITCandy in reply to arete1105

Incredibly useful information.

Thanks for posting.

pjoshea13 profile image
pjoshea13 in reply to arete1105

"Non THC oil/paste is legal and available nationwide"?

In a statement from FDA Commissioner Gottlieb yesterday, he expressed concern over the "illegal marketing of unapproved CBD-containing products":

nutraingredients-usa.com/Ar...

My understanding is that the FDA had previously claimed that it was for the DEA to act. i.e. they denied having jurisdiction over an illegal substance. However, now that the FDA has approved a CBD drug, it may act against otc CBD products. It was very aggressive against red yeast rice producers when Lovastatin was approved. In that instance, they were unsuccessful. However, RYR products cannot mention Lovastatin.

CBD products, on the other hand, are specifically designed to deliver CBD, & unlike RYR, there is no long history of use.

-Patrick

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