Cannabis and Neuroblastoma: Can Weed Help Treat Neuroblastoma?

Neuroblastoma is a cancer that typically starts in the adrenal glands and is characterized by tumors that develop in immature nerve tissue called neuroblasts. In some cases, these tumors clear up without any treatment, while others may require surgery, chemotherapy, or other cancer therapies.

Although neuroblastoma is a rare condition that most often occurs in children under the age of five, it is the most common type of cancer found in infants. According to The American Cancer Society, every year, there are around 700-800 new cases of neuroblastoma in the US.

What Causes Neuroblastoma?

Neuroblasts are immature nerve tissue that eventually mature into functioning nerve cells, but sometimes, a genetic mutation causes them to grow out of control. If these masses of cells don’t mature, they form a tumor. Experts aren’t sure what causes the initial genetic mutation.

Risk factors for neuroblastoma include:

• Age: individuals under the age of 10 are the most likely to develop neuroblastomas
• Family history is only a predictor of neuroblastoma in 1% to 2% of cases
• Being born with a congenital abnormality can increase the chances of neuroblastoma

Signs & Symptoms of Neuroblastoma

If your child has neuroblastoma, they  may experience one or more of the following symptoms:

• A bump in the neck, abdomen, chest, or pelvis
• In infants, multiple lumps under the skin that may look blue or purple
• Changes in eyes, including bulging eyeballs, dark circles, drooping eyelids, or changes in pupil size
• Diarrhea or constipation
• Bloating, stomach pain, or loss of appetite
• Fatigue, cough, and fever
• Anemia, which may cause pale skin
• Breathing difficulties
• Affected mobility, including weakness or paralysis
• High blood pressure 
• Horner’s syndrome
• Pain felt in bones, legs, or back
• Lack of coordination
• Abnormal eye movement that cannot be controlled

Symptoms of neuroblastoma can range in severity and usually differ depending on the disease stage and the location of the tumor. Two different staging methods categorize Neuroblastoma.

The International Neuroblastoma Risk Group Staging System (INRGSS) is used before any treatment begins and uses imaging tests to determine how much of the tumor can be removed with surgery. The stages of INRGSS are:

1. L1: The tumor is only on one side of the body and has not spread.
2. L2: The tumor may have grown, but it has not spread.
3. M: The tumor has spread to other parts of the body.
4. MS: In children under 18 months old, the tumor has spread to the skin, liver, and/or bone marrow.

The International Neuroblastoma Staging System (INSS) is not used in all cases because it can only be utilized after surgery has occurred. The stages of INSS range from stage 1 through stage 4, with the higher numbers indicating that the cancer has started to spread to other parts of the body.

Treatment for neuroblastoma can vary widely. Doctors determine the best course of treatment by categorizing each child into one of three risk groups: Low-risk, intermediate-risk, and high-risk. Children with a low-risk designation live more than five years 95% of the time, while only half of those who are high-risk may live past five years.

Can Cannabis Help Alleviate Symptoms of Neuroblastoma?

Researchers have been studying the effect of cannabinoids on cancer cells, as well as on the side effects of chemotherapy, for decades.¹ Many studies have also demonstrated that cannabinoid compounds like THC may help relieve the side effects experienced when undergoing chemotherapy.²

• A recent study from 2018 that was done on cell lines found that CBD-dominant hemp extract had more neuroprotective effects than pure CBD and that non-decarboxylated hemp CBD extract (CBDA) also demonstrated neuroprotective effects for certain cell lines associated with neuroblastomas.¹

• In 2016, researchers studied the effects of THC and CBD on neuroblastoma cell cultures and tumors in mice. In both cases, THC and CBD suppressed the growth of neuroblastoma, with CBD proving to be the most effective. They concluded that injected CBD has promise as a future therapy, and more study is warranted to determine how it may be best used against neuroblastoma.³ 

• In a 2019 in vitro study, researchers investigated, for the first time, how CBD induces cell death in neuroblastoma cells. Their results suggested that it may be regulated by molecules found in the cells and bloodstream called microRNA.⁴

• Multiple studies have shown that cannabinoids like delta-9 THC have helped relieve side effects of chemotherapy, like nausea and vomiting.¹ In fact, the FDA has three approved synthetic delta-9 THC pharmaceuticals for the treatment of chemotherapy-induced nausea and vomiting: Cesamet, Syndros, and Marinol.

While researchers have conducted a number of preclinical trials on cannabis and neuroblastomas, there is a significant need for more clinical research to corroborate these results in humans and determine the best course of treatment. 

Many cancer patients are already using cannabis to relieve their symptoms, even though clinical guidance needs further evidence to support it. Studies show that cannabis may improve the quality of life of some of these patients, although it doesn’t always improve symptoms.

Cancer is a qualifying condition for medical cannabis in many states that provide access to it, but this doesn’t mean that it is appropriate in every case. Neuroblastoma affects children and is extremely rare in adults. Individuals should consult with their oncologist to determine the best course of action if they want to introduce cannabis into their treatment routine.

Legality and Doctor’s Recommendation

To determine if your state considers neuroblastoma to be a qualifying condition for medical cannabis, check out our Laws & Regulations section for the medical cannabis rules for your state.

If you find that your state recognizes neuroblastoma or its symptoms as a qualifying medical condition, you can seek a doctor’s recommendation to get your medical cannabis card in your state.

How NuggMD Can Help

NuggMD is the nation's leading medical marijuana technology platform, serving patients in more than half the states in the U.S. We’ve connected over 2,000,000 patients with their new medical marijuana doctors face-to-face via our state-of-the-art telemedicine platform. 

We believe that every human being has the right to explore the benefits of medical cannabis and are fully committed to helping each patient explore all of their options in their journey to wellness. For further information on whether you qualify for medical cannabis, select your state.

Frequently Asked Questions About Cannabis & Neuroblastoma

Is cannabis okay for cancer patients?

Some people with cancer use medical cannabis, and it is a qualifying condition for medical cannabis in states that provide legal access to medical cannabis. While cannabis has not been approved to treat cancer or its symptoms, synthetic delta-9 THC has been approved by the FDA for over 30 years in drugs like Marinol, Cesamet, and Syndros to treat the side effects of chemotherapy, like nausea and vomiting.

Can you use cannabis with chemotherapy?

Cannabinoids like delta-9 THC may improve certain chemo-related side effects, like nausea and vomiting.¹ If you are being treated with chemotherapy, make sure to consult with your healthcare provider before using cannabis to check for any possible drug interactions. 

Is cannabis used as a treatment for neuroblastoma?

While cellular and animal studies have found that cannabis appears to suppress the growth (and in some cases causes cell death) of neuroblastoma cells, researchers must confirm these results through human clinical trials.^3,4 Currently, medical cannabis is not approved by the FDA as a treatment for any form of cancer. Patients are advised to stick with their doctor's recommendation for treatment for the best outcome.

Resources

1. Pellati F, Borgonetti V, Brighenti V, Biagi M, Benvenuti S, Corsi L. Cannabis sativa L. and Nonpsychoactive Cannabinoids: Their Chemistry and Role against Oxidative Stress, Inflammation, and Cancer. BioMed Research International. 2018;2018:1-15. doi:https://doi.org/10.1155/2018/1691428
2. National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice. Therapeutic Effects of Cannabis and Cannabinoids In: The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. National Academies Press (US); 2017. https://www.ncbi.nlm.nih.gov/books/NBK425748/
3. Fisher T, Golan H, Schiby G, PriChen S, Smoum R, Moshe I, Peshes-Yaloz N, Castiel A, Waldman D, Gallily R, et al. In Vitro and In Vivo Efficacy of Non-Psychoactive Cannabidiol in Neuroblastoma. Current Oncology. 2016; 23(s1):15-22. https://doi.org/10.3747/co.23.2893
4. Alharris E, Singh NP, Nagarkatti PS, Nagarkatti M. Role of miRNA in the regulation of cannabidiol-mediated apoptosis in neuroblastoma cells. Oncotarget. 2019;10(1):45-59. Published 2019 Jan 1. doi:10.18632/oncotarget.26534

The information in this article and any included images or charts are for educational purposes only. This information is neither a substitute for, nor does it replace, professional legal advice or medical advice, diagnosis, or treatment. If you have any concerns or questions about laws, regulations, or your health, you should always consult with an attorney, physician or other licensed professional.