Cannabis derivatives

Cannabis is the dried preparation, or resinous extract, of the flowers or leaves of the cannabis plant, a member of the hemp family. It is an illegal drug in many countries, including the UK.

The parts of cannabis that are considered important for medical reasons are called cannabinoids. This is the name for the complex chemicals found in cannabis that are responsible for the effect cannabis has on the body. Two cannabinoids are of particular interest:

  • THC – delta-9 tetrahydrocannabinol (responsible for the psycho-active and addictive effects of cannabis)
  • CBD – cannabidiol

It's important to make clear the difference between cannabis, cannabis oil and CBD oil.

​Cannabis and cannabis oil

Cannabis and cannabis oil are classified as a class B drug in the UK, because they contain the component THC. It is illegal to possess or supply them. However, from 01 November 2018, cannabis-based products for medicinal use will be available in the UK in some circumstances only.

Only specialist doctors who are listed in the General Medical Council's (GMC) specialist register will be able to prescribe cannabis-based products. They will only be prescribed when the specialist considers that the patient will benefit and when the patient has an unmet special clinical need that cannot be met by licensed products.

  • Medicinal cannabis, therefore, will be prescribed on a case-by-case basis
  • Patients will NOT be able to get cannabis-based products from their GP
  • If you feel you might benefit from these products, speak to your consultant or healthcare team
  • Administration by smoking remains prohibited.

(For more information, see our blog on cannabis-based medicinal products.)

​CBD oil

CBD oil is different from cannabis oil, because it does not contain THC.

It is currently legal in the UK - as long as it has been produced from an EU approved strain of hemp and as long as it is marketed as a food supplement without any medicinal claims. You can buy it in many high street health food shops.

What is the evidence for cannabis-based products in the treatment of brain tumours?

Treating the side-effects of a brain tumour

There's now conclusive evidence for the use of cannabis and its products, such as cannabis oil and CBD oil, for other therapeutic purposes, i.e. pain relief and treating chemotherapy-induced nausea and vomiting.

As such, the cannabis-based drug, Nabilone, has a medical licence and can be legally prescribed for chemotherapy-induced nausea and vomiting.

For more information, see the government's review.

Treating the brain tumour itself

Currently, the evidence that cannabis-based products can treat brain tumours themselves is limited.

There have been some promising pre-clinical trials in mice, in which THC, CBD and radiotherapy used together appeared to slow tumour growth. More research involving clinical trials in people needs to be done.

There have also been some positive results using a drug called Sativex (a combination of THC and CBD) alongside the chemotherapy drug temozolomide (TMZ). It was found that in people with recurrent glioblastoma, those treated with Sativex had a higher chance of longer survival time, compared to those who didn't have the drug.

However, it was a small trial, on only 21 patients, to test the safety and effectiveness of using Sativex. The next stage will be to look at whether Sativex works better than standard treatment or whether it produces fewer side-effects. Although a large amount of progress has been made, it could be up to another five years before this drug is licensed for use in brain tumour patients.

(For more information, read our blog about cannabis-derived medication showing promise.)

How can I get cannabis-based products?

Speak to your healthcare team.

Apart from the special circumstances described earlier above, and the prescribing of Nabilone for chemotherapy-induced nausea and vomiting, it might be possible for Sativex to be accessed via off-label prescribing.

Off-label prescribing is where your doctor can prescribe a drug licenced for another condition, if they feel it would benefit you and there is no other licensed treatment or all licensed treatments have failed. Sativex is licensed for the treatment of spasticity (tightening of the muscles) in multiple sclerosis.

However, many doctors may be reluctant to prescribe off-label as the responsibility for the prescribing and any adverse effects, lies with them. Also the professional codes, ethics and prescribing policies of their hospital trust may prevent it. You can always speak to your doctor about this.

Some people affected by a brain tumour may decide to self-medicate with cannabis.

We would always recommend that any supplements, alternative or complementary treatments that you/your loved one wishes to use are discussed with your/their medical team. This is because it may, for example, interact with other medications, such as anti-epileptic medicines, steroids or chemotherapy.

It is important to be aware that you cannot be sure of the concentrations and ratios of THC and CBD in grown or street cannabis.

If you have further questions, need to clarify any of the information on this page, or want to find out more about research and clinical trials, please contact our team:

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support@thebraintumourcharity.org

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