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Can Marijuana Cause Head And Neck Cancer?!

With growing consumptions of weed (as cannabis is known in popular culture) now it is being evaluated what are the harms and benefits of cannabis. The AIIMS Delhi study found that in India there were 7.2 million marijuana in the past year and the prevalence of lifetime marijuana use was determined to be high., there is a tangible gap within the current literature in understanding the role of cannabis causing cancer. 

Bridging this gap in knowledge and understanding is important to better explore the relationship between marijuana and Head and Neck Cancer. Marijuana has been proposed to have a potential therapeutic role in these patients due to its ability to enhance relaxation, decrease stress, and improve quality of life; however, there is a lack of direct evidence at this time. Other than the potential mood effects of marijuana, its role as a carcinogen is not yet established as the literature has been inconclusive in finding a link between marijuana as a cause for Head and Neck Cancers. 

To understand what is going on, we need to distinguish between two elements found in marijuana plants: TetraHydroCannabinol and CBD. To put it simply: CBD gives one the benefits of marijuana, without the high, whereas THC stands for the psychoactive ingredient tetrahydrocannabinol, which will give you a buzz.

A recent epidemiological study showed that marijuana smoking was associated with an increased risk of head and neck cancer. The carcinogenicity of delta9-tetrahydrocannabinol (THC) is not clear, but according to laboratory studies, it appears to have antitumor properties such as apoptosis as well as tumour-promoting properties such as limiting immune function and increasing reactive oxygen species. 

Marijuana tar contains similar carcinogens to tar from tobacco cigarettes, but each marijuana cigarette may be more harmful than a tobacco cigarette since more tar is inhaled and retained when smoking marijuana. More molecular alterations have been observed in bronchial mucosa specimens of marijuana smokers compared to nonsmokers. Field cancerization may be occurring on the bronchial epithelium due to marijuana smoking exposure. Several case studies were suggestive of an association of marijuana smoking with head and neck cancers and oral lesions. However, in a cohort study with 8 years of follow-up, marijuana use was not associated with increased risks of all cancers or smoking-related cancers. 

According to laboratory studies, it seems that THC may have a dual effect, with characteristics that promote tumorigenesis such as limiting immune function and increasing reactive oxygen species, in addition to a protective effect against tumours with its antiproliferative properties. 

Examining the effects of THC in humans will be crucial, possibly with epidemiological studies that examine different modes of marijuana use. Marijuana smoking involves the inhalation of approximately three times the amount of tar and retention of one-third more the amount of tar in the respiratory tract relative to tobacco smoking. So, till the time we don’t have conclusive evidence in favour or against of cannabis use, we should we cautious in using it for recreational as well as medicinal purposes.

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Dr Niranjan Naik

Guest Author The author Dr Niranjan Naik is Director – Breast & Gastro-intestinal (GI) Onco-Surgery, FMRI

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