Like most people who value individual freedom from government regulation, I approve of the worldwide movement towards legalising cannabis, both for medical and recreational use. Hell, I favour legalising all drugs, for several excellent reasons which do not involve the claim that drug use does no harm.
However, with individual freedom comes individual responsibility. There are many things you can do legally that will harm you, or even kill you. An example played itself out in the pages of Daily Maverick. The late IFP MP, Mario Oriani-Ambrosini, was diagnosed with stage four lung cancer in April 2013. Unsurprisingly for an advanced, metastasised case of cancer, doctors gave him little hope of survival. In November of the same year, however, he penned a heartfelt article, railing against the medical establishment over its alleged failure with respect to cancer. He wrote: “Predictions and prognosis notwithstanding, I am still alive and working, my cancer has not spread, and it appears to have stopped growing.”
He attributed this to his decision to forgo conventional treatments and instead treat himself on the advice of “a group of scientifically-minded friends, none of whom are physicians”. Based on the hypothesis of an Italian doctor, who had the distinction of having been struck off the medical roll, he treated himself with bicarbonate of soda, which supposedly kills the fungus that supposedly causes cancer.
Pity that his article could not include the information that despite his belief that his alternative treatment was effective, he died on August 16, 2014, at the age of 53. Granted, he was going to die anyway, and desperate people can be forgiven for clutching at straws, but his supermarket cancer remedy certainly did not help.
As sad as this is, the real problem I had with his article was that it spread dangerous misinformation to gullible or desperate readers. Who knows how many people read it, believed his story, and died because they took bicarbonate of soda instead of proven medical treatment?
Internationally, the late Steve Jobs was another case in point. After being diagnosed in 2003 with pancreatic cancer, he opted to forgo treatment in favour of a “fruitarian” diet for nine months, before finally having surgery. He died seven years later when his cancer recurred. Several doctors claimed that failing to treat the cancer as early as possible probably shortened his life significantly.
Even highly intelligent people succumb to desperation when facing a dreaded diagnosis. It is not pleasant to hear that you have a disease without a certain cure, or that you have a 50% chance of dying in the next five years. When the prognosis is even worse, as it can be with certain types of cancer or with late diagnoses, it is hardly surprising that people lose faith in conventional medicine, or are prepared to try anything, however outlandish. When the odds are against you, your only hope is to get really lucky.
To promote research into alternative treatments is admirable. After all, a great deal of “alternative medicine” has been the subject of research, and when proven to work, joined the ranks of “medicine”. To make it legal for doctors to prescribe alternative therapies as a last resort, as Oriani-Ambrosini did when he tabled the Medical Innovation Bill in Parliament six months before his death, is reasonable. His Bill also proposed to legalise “growing, processing, distributing, using, prescribing, advertising or otherwise dealing with or promoting cannabinoids” for treatment purposes, as well as commercial and industrial uses, which also has my full support.
However, to go further and claim that unproven treatments actually work is dangerous and irresponsible. Several South African sellers of cannabis oil do exactly that. “Cannabis cures cancer,” declares the Cannabis Oil SA website, registered to Canna-Health of Johannesburg, Kwazulu-Natal (sic). “Four Ways Cannabis Kills Cancer,” reads an article on the Medical Cannabis Dispensary website, which is aimed at South Africans but is owned by a blind proxy in the US.
Such claims are highly overstated. Usually, they are supported by testimonials which are entirely worthless as medical evidence because they involve unspecified confounding factors (including conventional cancer treatment) and the subjective, uneducated perceptions of patients. If anyone tries to sell you any treatment on the basis of anecdotal evidence, that means they cannot produce scientific, statistical proof that the treatment actually works. Random chance, experimenter bias and the placebo effect are enough to produce anecdotal evidence. Anyone can do it.
Many of the claims made by cannabis oil sellers involve treating not cancer itself, but the symptoms of cancer or side-effects of cancer treatment, such as nausea, loss of appetite, pain and insomnia. There is some evidence of its effectiveness in clinical trials, and although there are also other, better tested medications for this purpose, it is not unreasonable to consider using cannabis oil for symptomatic relief. Sleeping and eating better are in themselves good things, when you’re in ill health.
The biggest headlines about cannabis and cancer, however, are based on a very small set of laboratory and animal studies, which suggest that in some cases, for some cancers, the active ingredients might inhibit cancer cell growth, cause cancer cell death, reduce tumours, or block the growth of blood vessels needed to supply a tumour. These are all pre-clinical studies, and no published clinical trials have confirmed these effects in any cases in humans. Clinical trials are essential not only to be able to determine in which cases, if any, cannabis might be used to combat cancer in humans, but also to determine the appriopriate dosage and treatment regimen, and discover dangerous side-effects or contra-indications.
However, to make the leap from “possibly somewhat effective for some cancers in a few early studies in petri dishes or mice” to “cannabis cures cancer” is a dangerous lie.
Cancer is the most widely studied disease in the world. There are mountains of studies, many of which involve initially promising compounds that show some effect in laboratories, or in animal studies. The vast majority never make it to medical dispensaries, because they are not effective in humans, or prove to be too dangerous to prescribe. Most of the rest end up having very limited use.
Contrary to the mantra of natural health practitioners, cannabis also causes side-effects, which in some people could be serious, or could be dangerous in combination with other medications. These include tachycardia, low blood pressure, muscle relaxation, dizziness, depression, paranoia, and, of course, hallucinations. Clinical trials are needed to determine when these risks are acceptable, and when not.
At best, cannabis is a promising experimental drug that might prove to be effective in future, perhaps in combination with surgery, radiation treatment, or other drugs. Even if it does work, claiming that it is okay to treat cancer with cannabis oil made by people who are not chemists and prescribed by people who are not doctors is like saying it’s okay to grow your own opium and make your own heroin to treat pain, instead of relying on doctors to prescribe professionally produced morphine. It should be legal, because hey, it’s your body, but it is highly inadvisable.
More responsible merchants of cannabis supplies, such as BTL South African Cannabis News and Supplies, are far more guarded about their claims: “Cannabis Oil is by no means a silver bullet cure for all ailments. Although it undoubtedly has a multitude of health applications across the board, identifying and applying the unique essential elements is new frontier (sic) that’s only beginning to get to grips with itself. So be realistic in your expectations. As it stands in SA, you need to keep in mind that results may vary.”
That site also warns that cannabis oil cons run rampant, and there is no reliable way to distinguish a well-meaning hippie with a few backyard dagga plants, primitive equipment and little knowledge, from responsible vendors who produce high-quality products and have some experience with treating patients. “[I]t is the wild west out there. The place is packed with charlatans running rampant.”
Sadly, such charlatans cause a great deal of suffering and death. I personally know of several people who chose to forgo cancer treatment in favour of cannabis oil or other “natural remedies”. Their reasons are understandable – wanting to escape invasive or disfiguring surgery, avoid the unpleasant side-effects of chemo- or radiotherapy, or simply being there for their children. When the cancer almost inevitably got worse, they ended up regretting their decision, just as Steve Jobs did with his fruitarian diet. And by that stage, it is often too late.
Others had medical treatment as well as cannabis oil, and go around claiming that it was the cannabis that cured them. At least they’ll live.
Oriani-Ambrosini claimed that pharmaceutical companies aren’t interested in bicarbonate of soda or cannabis oil because they cannot be patented. Not only is this false, since they certainly can be patented in specific forms for specific uses, but that same supposedly greedy industry also sells aspirin, penicillin, quinine, and paracetamol, which are dirt cheap and unpatented. Besides, if nobody was interested in cannabis oil, it wouldn’t be a fast-growing, multibillion dollar industry. The argument that nobody can afford clinical trials in an industry that size is also spurious.
Another false narrative pits alternative remedies against conventional medicine, on the grounds that the latter are sold by profit-seeking corporations. This is even more absurd, since people who sell alternative remedies are just as much in it for the money, and the only difference between alternative medicine and conventional medicine is the existence of reliable, repeatable, double-blind, placebo-controlled clinical evidence that proves that it can work. The chemicals in cannabis are simply untested drugs, flogged by unqualified people.
Cannabis should be legal, and its medicinal properties are worth investigating. Selling cannabis oil should also be legal. But people who get swindled into believing that cannabis oil is a harmless drug that can cure cancer should be warned that they are gambling their lives on an unproven hypothesis.
I know they’re desperate, and sometimes there is no hope, but that doesn’t make their wishful thinking any more valid. By all means, try using it to relieve some of your symptoms, especially if you have terminal cancer. But consult your medical doctor about it, instead of trusting your local drug dealer. And don’t ever believe that it can replace conventional treatment.
Selling unproven drugs as a cure for cancer actually kills people. While supporting cannabis legalisation and research, let’s not condone charlatans who take advantage of desperately ill people. DM