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Mesothelioma and Medical Cannabis Treatment

by Sarah Walker

April 10, 2020 11:18 am ET Estimated Read Time: 10 Minutes

Medically reviewed by Dr. Abraham Benavides Fact checked by Kymberly Drapcho

1. Mesothelioma Treatment: Can Cannabinoids Provide Relief?
2. The Role of the Endocannabinoid System in Treating Mesothelioma
3. What Preparations of Cannabis are Best for Mesothelioma?
4. Mesothelioma: Signs, Symptoms, and Types
5. Mesothelioma Causes and Complications
6. Talking to Your Doctor About Mesothelioma Diagnosis and Treatments
7. Complementary Treatments Worth Discussing with Your Doctor

Mesothelioma is a rare type of cancer that develops in the mesothelium, which is a thin layer of tissue that shields most of the body’s internal organs. This cellular membrane is composed of squamous epithelial cells of mesodermal origin. It covers the heart, the lungs, the reproductive organs, and the abdominal cavity. According to the American Lung Association (ALA), pleural mesothelioma of the lungs is the most common form of this rare and aggressive cancer (1).

Every year, doctors diagnose mesothelioma in approximately 3,000 people in the United States – constituting less than 0.3% of all cancer diagnoses across the U.S. In 2020, an estimated 26,278 people around the world lost their lives from mesothelioma (2). Statistics indicate that pleural mesothelioma accounts for over 75% of cases, and men above the age of 65 who work blue-collar jobs with occupational asbestos exposure, or military service, face the highest risk (3). 

Doctors typically diagnose pleural mesothelioma in patients at the age of 72, on average. In the United States, mesothelioma arises in males and White and Black people more often than it does in females and Asian American or Hispanic people. Fortunately, diagnosed cases are progressively decreasing in the male population as well as the U.S. population as a whole (2). 

Common cancer treatment options include radiation therapy, palliative procedures, chemotherapy, tumor-removal surgery, immunotherapy, and targeted therapy. A growing body of research has identified that cannabis may have the ability to control certain mesothelioma symptoms, such as chronic pain and loss of appetite.

Mesothelioma Treatment: Can Cannabinoids Provide Relief?

The main factors in choosing treatment for mesotheliomas include the tumor’s location and severity. During an oncology visit, you can find out whether or not it has spread to other organs and lymph nodes. This would be a good opportunity to discuss the medical uses of cannabis-based treatment options with a doctor. 

Although cannabis should not be used as a substitute for other types of doctor-prescribed medications, research indicates that cannabinoids – the naturally-produced therapeutic compounds produced by marijuana – may prove useful for the management of side effects and pain relief from the symptoms (4) of treatments like chemotherapy, e.g. nausea, vomiting, and appetite loss. This can help improve a patient’s quality of life.

The research has looked at marijuana not only as a means to control lung cancer symptoms and treatment side effects but also as an anti-cancer therapy. Studies in test tubes and mice indicate that several types of cancer may respond to the use of medical marijuana as an anti-cancer (5) therapy. Some cancer cells die when exposed to cannabinoids, and some stop spreading.

The majority of scientific research and clinical trials on medical marijuana in cancer care occur outside of U.S. territory because marijuana remains a federally illegal controlled substance. The growing support for federal cannabis legalization may encourage future cancer research, but the current research in the U.S. is heavily restricted. For now, there is a lack of scientific proof regarding marijuana’s impact on mesothelioma tumor progression.

The Role of the Endocannabinoid System in Treating Mesothelioma 

Cancer cells have cannabinoid receptors, but their specific function remains unclear. The endocannabinoid system (ECS) is a widespread neuromodulatory system that plays a pivotal role in central nervous system development, synaptic plasticity, and the response to endogenous and environmental attacks. 

The ECS comprises cannabinoid receptors, endogenous cannabinoids (endocannabinoids), and the enzymes that synthesize and degrade endocannabinoids. Exogenous cannabinoids, such as tetrahydrocannabinol (THC) and cannabidiol (CBD), release their biological effects by interacting with cannabinoid receptors (6).  

CB1 cannabinoid receptors are the most abundant, but certain cannabinoids may also influence CB2 cannabinoid receptors. The direct and indirect cytotoxic and anti-inflammatory functions of all these are noted in a 2022 review article, titled, “Cannabinoids as anticancer drugs: current status of preclinical research” (7). 

What Preparations of Cannabis are Best for Mesothelioma?

Contrary to popular belief, the use of cannabis plants doesn’t have to involve smoking. One of the main appeals associated with medical cannabis consumption is the diversity in terms of product options. Various cannabis preparations are available today for people with cancer, such as:

• Edibles 
• Pills, capsules, and tablets
• Powder cannabis 
• Topicals, salves, and transdermal patches 
• Vapes 
• Tinctures comprised of cannabis oil or CBD oil
• Suppositories

Mesothelioma: Signs, Symptoms, and Types

A mesothelioma diagnosis may not happen for months after you experience the first symptoms, as is the case for most people with this type of cancer. The symptoms may not even present themselves for 20-60 years after asbestos exposure, at which point the tumors will have grown and spread (8). Unfortunately, the median survival for malignant pleural mesothelioma is only one year (9), and long-term survival is extremely rare.

Most mesothelioma cancer patients will complain of chest pain, painful coughing, shortness of breath, unexplained weight loss, and abnormal tissue lumps under the chest skin. However, symptoms may vary depending on the type of mesothelioma.

Doctors will usually diagnose one of the following four types:

1. Pleural – Accounting for 85% of all cases, malignant pleural mesothelioma is the most common type. Reports from the Centers for Disease Control and Prevention (CDC) state that there are 2,400-2,800 new cases yearly in the United States (10). Symptoms include chest pain, shortness of breath, cough, facial and arm swelling, pleural effusion, and difficulty swallowing (11). 
2. Peritoneal – Peritoneal mesothelioma is a malignant type of cancer that occurs after asbestos fiber ingestion. It gets its name from its location in the abdominal tissue lining, known as the “peritoneum.”This kind occurs in abdominal tissue, and symptoms include abdominal pain, swelling and ascites, appetite loss, small bowel obstruction, nausea, vomiting, constipation, and unexplained weight loss.
3. Pericardial – Pericardial mesothelioma forms in the heart’s lining, which is called the “pericardium.” This rare type of mesothelioma accounts for fewer than 1% of all cases. Primary pericardial tumors may be classified as benign or malignant. Symptoms include weakness, chest pain, cough, irregular heartbeat (atrial fibrillation), low blood pressure, and leg swelling.
4. Testicular – Testicular mesothelioma is a cancer that forms in the testicular lining. Also referred to as “mesothelioma of the tunica vaginalis testis,” it accounts for just 1% of all cases. According to researchers, the median life expectancy is 20-23 months. While the data is scarce, the mortality rate rests at around 53% after two years (12). Common side effects include enlargement of the scrotum, finding a lump in the scrotum, and groin pain.

Mesothelioma Causes and Complications

A major risk factor for mesothelioma is working with asbestos. Upwards of 75% of mesothelioma patient cases are linked to asbestos exposure in the workplace (11). These heat, fire, and chemical-resistant chemicals contain thin microscopic fibers that can be inhaled or swallowed once they are released into the air. 

Individuals working in the automotive and construction industries more commonly encounter this group of hazardous minerals, which can contribute to a broad range of health problems. Residing with someone who works with asbestos, living in an area where asbestos has been mined or disturbed, or residing in a space with natural asbestos deposits are other potential causes.

The average survival rates for all types of mesothelioma vary based on a person’s age, general health, age, type, cancer stage, and treatment plan. If doctors detect the cancer at an early, localized stage, the 5-year relative survival rate is 24%. If tumors spread to the lymph nodes or nearby parts of the body, the 5-year relative survival rate sinks to 16% or 7% if the cancer moves to distant bodily regions (2). 

Talking to Your Doctor About Mesothelioma Diagnosis and Treatments

To diagnose mesothelioma, your doctor will conduct a physical exam to locate any suspicious lumps and note your medical history. They will likely also request your job history. A CT scan or chest X-ray will prove useful for spotting pleural plaques (thickened pleura with calcium deposits), which are major signs of asbestos exposure. 

Doctors may also recommend chest X-rays and CT scans to detect pleural effusion, a fluid build-up between the lung and the chest. Once the pleural fluid is identified, they must then drain it using ultrasound-guided needle aspiration. The goal of this procedure is to eliminate other causes of fluid buildup, but the results usually aren’t sufficient to confirm a diagnosis of mesothelioma.

The next step to accurately diagnose mesothelioma involves taking a biopsy sample from the chest wall with CT or ultrasound guidance. The doctor will administer local anesthesia before inserting a small camera between the lung and the chest wall. They will then send the tissue sample to a laboratory and closely examine it for signs of mesothelioma cells.

After diagnosing mesothelioma, your doctor will conduct tests to determine the extent of the disease’s progression. In addition to the chest CT, doctors typically use a positron-emission tomography scan (PET scan) to pinpoint other areas affected by the cancer. If the cancer has spread, additional biopsies may be necessary.

Complementary Treatments Worth Discussing with Your Doctor 

Mesothelioma may inflict uncomfortable pressure within your chest that can translate to persistent breathlessness can be distressing. To help you breathe, your doctor may encourage you to use supplemental oxygen or take medications such as bronchodilators.

Combining the use of doctor-recommended treatments with complementary therapies and alternative approaches could help you feel better faster. Alternative treatments that have shown some promise in helping people cope with breathlessness include:

• Acupuncture – Thin needles are inserted at precise points into the skin to help dilate the air passages in the lungs (13). 
• Breathwork training – Deep abdominal breathing promotes full oxygen exchange, which can slow the heartbeat, eliminate distracting thoughts, and stabilize blood pressure (14). 
• Relaxation exercises – Slowly tensing and relaxing different muscle groups may help you feel more at ease and breathe easier. Your doctor may refer you to a therapist who can teach you relaxation exercises so that you can do them on your own.
• Sitting close to a fan – Directing a fan to your face may help ease the sensation of breathlessness (15). 

If you or a loved one is considering using an FDA-approved, pharmaceutical cannabinoid product like nabilone or dronabinol to improve the symptoms of mesothelioma and cancer pain, you will need to consult with a medical professional beforehand. This is also true for any state-legal, dispensary cannabis options.

Although cannabis can provide symptomatic benefits, including for mental health, you must continue using any medication(s) or treatments prescribed by your doctor.

Note: The content on this page is for informational purposes only and is not intended to be professional medical advice. Do not attempt to self-diagnose or prescribe treatment based on the information provided. Always consult a physician before making any decision on the treatment of a medical condition.