Gord, Proust and Glioblastoma

The real voyage of discovery consists not in seeking new lands but seeing with new eyes.
— Proust, one of Gord's favourites

The news of Gord Downie's glioblastoma diagnosis has touched many of us.

As it happened, I learned the bad news as I was recovering from a concussion, and researching all sorts of things that might help my brain. As I poked around the internet's nether-regions, I stumbled upon a fact that surprised me. Did you know marijuana (or cannabis) has been approved by the FDA specifically for the treatment of glioblastoma? Click below and scroll through a couple screen grabs I took:

This was shocking to me. The research isn't about improving appetite, which is what we usually think of when marijuana and cancer are discussed. Instead, it describes marijuana as a "potent inhibitor of metastatic cancer."

Marijuana being used as a treatment for brain cancer, approved by the FDA? In all the ink spilled over the impending legalization of cannabis in this country, this story had never come up. I had seen lots of photos of hooligans smoking big spliffs, warnings about damage to young brains, fear about stoned drivers and alarm about marijuana provoking schizophrenia. But marijuana as a brain cancer treatment? I had never heard of it. So, I was curious.

The first thing you need to know is that cannabidiol is marijuana. While THC (tetrahydrocannabinol) is the most famous of marijuana's cannabinoids (it's the one that gets you high), cannabidiol (CBD) has become more and more famous as its medical properties are researched more. 

All medical suppliers of marijuana now have high-CBD strains that don't get you high.

 Tilray are the first licensed medical cannabis producer in North America to be GMP certified in accordance with the European Medicines Agency’s good manufacturing practice (GMP) standards

Tilray are the first licensed medical cannabis producer in North America to be GMP certified in accordance with the European Medicines Agency’s good manufacturing practice (GMP) standards

In the article above, Dr. Sean McAllister, a cancer researcher, states he has been "studying cannabinoids as potent inhibitors of metastatic cancer cells for the past decade." Using my newly acquired investigative skills, I entered 'cannabinoid glioblastoma' into the google scholar search engine. Not only did I find some of Dr. McAllister's work, I found a whole bunch of research involving cannabinoids and glioblastoma. I made a gallery of 26 of these studies you can click and scroll through:

This gallery must be considered partial. Still, these studies clearly show that CBD is of interest to these researchers for its ability to "inhibit glioma cell invasion" and it's "antitumor effects." Presumably, it is research like this that prompted the FDA's approval. You may be wondering though, as I did, why are all these scientists studying marijuana and this very specific form of cancer? It seemed odd to me. When I entered 'cannabinoids cancer' into google scholar, I learned people have been studying the effects of cannabinoids on cancer cells for years. Click below to scroll through a gallery of 35 of these studies:

My gallery is partial, obviously, but it is clear that a lot of study has been done. Most of these studies are done by chemists, testing these specific compounds and cannabinoid receptors, but different types of studies have been done, like this large-scale survey (84, 000 respondents) which found that bladder cancer rates were lower in cannabis users.

Anyway, it is clear that glioblastoma research grew out of all of this research on other cancers. But why are these researchers studying cannabinoids as a cancer treatment? 

It turns out there has been a tremendous amount of research since the discovery of the endocannabinoid system in the early '90s. In the same way the study of the opium poppy led to the discovery of opiate receptors and the endorphin system (which led to many different treatments for many disparate ailments), the study of cannabis has led to the discovery of the endocannabinoid system. It is not every day a new biological system gets isolated, so researchers from all over the world have been excited to explore it.

By the way, the endo in endocannabinoid refers to endogenous, which means something the body produces. Here's how Health Canada describes this system:

The endocannabinoid system is an ancient, evolutionarily conserved, and ubiquitous lipid signaling system found in all vertebrates, and which appears to have important regulatory functions throughout the human body.

 It's hard to summarize ubiquity, but, for example, one of the ways humans produce cannabinoids is through exercise:

According to this CBC interview there have been more than 33,000 tests on cannabinoids and the endocannabinoid system.  Click below to scroll through a gallery of a fraction of them. I have limited myself to 40 to try to show the scope of cannabinoid research, and I also tried to pick straight forward titles.  Depending on what device you are looking at this on, you may only be able to read the titles. If you want to investigate any of them further, they are easy to find with google scholar:

I'm no expert, but it is clear from this incomplete gallery that the endocannabinoid system is pretty involved in our bodies and is being targeted as a treatment for many ailments. Perhaps now is a good time to have an expert break it down for us. Dr. Raphael Mechoulam is one of the most decorated and most cited biochemists working today. Here's how he sums up the endocannabinoid system:

The endocannabinoid system acts essentially in just about every physiological system that people have looked into, so it appears to be a very central system. Actually, the cannabinoid receptors are found in higher concentrations than any other receptor in the brain, and they are found in very specific areas. They are not found all over, but rather in those places that one would expect them to be—such as areas that have to do with the coordination of movement, emotions, memory, reduction of pain, reward systems, and reproduction. So, I believe that this is a very central and essential system that works together and communicates with many other systems.

So there you have it. The discovery of the endocannabinoid system in the early '90s led to large amounts of research in, well, everything physiological, including cancer. Consistently promising results led to research in cannabinoids and glioblastoma, and the promising results of these tests was enough to get the FDA to approve it for more in-depth research. Some broad strokes admittedly, but at least the FDA's decision doesn't seem quite so mysterious now.

As surely as we can see the evolution of our understanding of cannabinoids, and how they may help those with glioblastoma, we can see just as clearly, in the very existence of this article and others, how Gord's brave act of going public with his diagnosis has furthered public knowledge of this horrible affliction.

I don't know why, but this research seems to rarely get discussed. I suppose this article is an attempt to draw attention to the work of these scientists, who toil away, without glamour, searching for a cure.

In a world of false idols, I humbly suggest these are some of the true heroes of today, dedicating their existence to finding a cure, rather than, say, groping a bunch of beauty pageant contestants.

If I could move through the world with the tenacity of these researchers, the bravery of Gord Downie, and the humility of Proust, I believe I would be alright.

UPDATES: Since this is an area of great interest to researchers, new studies are being done all the time. For example, I just found this.  Also, though I am not actively looking, I keep stumbling into more studies, for example, this article cites this study and this and this and this. Also, this. Here's another. This is interesting.

Andy Swan is not a writer, researcher, journalist, doctor, or medical expert of any kind.

He is a shaving consultant and soap maker.

This article was inspired by Follow The Medicine, which used google scholar to compile some of  the research on cannabinoids and concussions and brain injury.

He recommends you go to the gym and activate your endocannabinoid system through vigorous exercise.

I haven't really spent much time designing my home page, but here it is.