CBD for Bladder Cancer
The bladder is a hollow organ in the lower pelvis with flexible, muscular walls that can stretch to hold urine and squeeze to send it out of the body. The bladder’s primary function is to store urine (the liquid waste made by the kidneys) which is then carried to the bladder through two tubes called the ureters. When urinating, the muscles of the bladder contract, and the urine is forced out of the bladder through a tube called the urethra.
The wall of the bladder has many several layers, each of which comprises different cells. Bladder cancer is when the cells that make up the urinary bladder growing out of control. And as more cancer cells develop, they can form a tumor. Sometimes, it can also spread to other parts of the body.
Most bladder cancers start in the innermost lining of the bladder which is called the urothelium or transitional epithelium. As the cancer grows into or through the other layers in the bladder wall, it becomes more advanced, and can be harder to treat. Over time, the cancer may grow outside the bladder, and into nearby structures. It can also spread to nearby lymph nodes, as well as other parts of the body including the bones, lungs, or liver.
Bladder Cancer Classification
Medical practitioners usually describe your bladder cancers based on how far it has spread into the bladder wall:
Non-invasive bladder cancers (also called early or superficial) are only in the inner layer of cells (the transitional epithelium) and have not yet grown into the deeper muscle layers.
- Papillary carcinomas: Most early non-invasive bladder cancer usually appears as small growths, shaped like mushrooms that grow out of the bladder lining. A surgeon can remove these growths and they may never come back.
- Carcinoma in situ (CIS) is flat and does not grow out of the bladder wall. In CIS, the cancer cells look very abnormal and are likely to grow quickly. This is called high grade and is more likely to come back than other types of early bladder cancer.
- High grade T1 tumors are early cancers that have grown from the bladder lining into a layer underneath, called the lamina propria. High grade T1 tumors are early cancers, but they can grow very quickly.
Invasive bladder cancers have grown into deeper layers of the bladder wall, meaning the cancer has grown into a deeper (muscle) layer of the bladder, or beyond. Some people have invasive bladder cancer when they are first diagnosed.
However, sometimes transitional or urothelial cell bladder cancer can also become invasive. Invasive bladder cancer needs more intensive treatment than early (superficial) bladder cancer. This is because these cancers are more likely to spread and are tend to come back.
Symptoms of Bladder Cancer
- Blood in urine (hematuria), which may cause urine to appear bright red or cola colored, though sometimes the urine appears normal and blood is detected on a lab test
- Frequent urination
- Painful urination
- Back pain
- Inability to urinate even when feeling urgent
- Unexplained weight loss
- A loss of appetite
- Swollen feet
- Bones hurting
- Extreme weakness and / or fatigue
Bladder Cancer Types
Urothelial carcinoma, also known as transitional cell carcinoma (TCC), is by far the most common type of bladder cancer. As the name suggests, they start in the urothelial cells that line the inside of the bladder. Urothelial cells also line other parts of the urinary tract (incl., the renal pelvis, the ureters, and the urethra). People with bladder cancer sometimes have tumors in these places, too, so all the urinary tract needs to be checked for tumors.
Squamous cell carcinoma
Squamous cells are flat cells that make up the moist skin-like tissues lining your body organs. When squamous cells in the bladder form malignant neoplasms, they are called squamous cell carcinomas. Nearly all squamous cell carcinomas of the bladder are invasive.
All the moist skin-like tissues lining body organs, including the bladder, have some gland cells that produce mucus. Adenocarcinoma is an uncommon malignancy in the urinary bladder that develops from these cells in the lining of the bladder.
Small Cell Carcinoma
Small-cell carcinomas start in nerve-like cells called neuroendocrine cells. These cancers often grow quickly and is usually treated with the same chemotherapy used for small cell carcinoma of the lung.
Very rarely, some people get a cancer of the bladder muscle or other structural tissues rather than the bladder lining. Cancers that start in the bladder muscle are called sarcomas and are usually treated differently to other bladder cancers.
Bladder Cancer Medications & Treatments
The oncologist and members of the care team may recommend a combination of treatment approaches.
Chemotherapy in the bladder (intravesical chemotherapy), to treat cancers that are confined to the lining of the bladder but have a high risk of recurrence or progression to a higher stage
Chemotherapy for the entire body (systemic chemotherapy), to increase the chance for a cure in a person having surgery to remove the bladder, or as a primary treatment when surgery isn’t an option
Targeted therapy to treat advanced cancer when other treatments haven’t helped
Immunotherapy to trigger the body’s immune system to fight cancer cells, either in the bladder or throughout the body
- Transurethral resection of bladder tumor (TURBT) remove cancers confined to the inner layers of the bladder
- Cystectomy surgery to remove all or part of the bladder
- Neobladder reconstruction, a urinary diversion in which the surgeon creates a sphere-shaped reservoir out of a piece of your intestine
- Ileal conduit, a urinary diversion in which the surgeon creates a tube (ileal conduit) using a piece of your intestine that runs from the kidneys to an urostomy bag worn on the abdomen
- Continent urinary reservoir, a type of urinary diversion procedure where the surgeon uses a section of intestine to create a small pouch (reservoir) to hold urine, located inside the body from where urine can be drained.
Radiation therapy, a form of that uses beams of powerful energy, such as X-rays and protons, to destroy the cancer cells. Radiation therapy for bladder cancer usually is delivered from a machine that moves around the body, directing the energy beams to precise points. It is sometimes combined with chemotherapy to treat bladder cancer in certain situations, such as when surgery isn’t an option or isn’t desired.
CBD for Bladder Cancer
Research & Scientific Evidence
The clinical evidence for Cannabidiol (CBD) as a viable treatment option for Bladder Cancer is promising.
TRPV2 Activation Induces Apoptotic Cell Death in Human T24 Bladder Cancer Cells: A Potential Therapeutic Target for Bladder Cancer
Transient receptor potential (TRP) channels are calcium ion (Ca2+) permeable channels that are thought to contribute to calcium balance inside the cell. Evidence shows that these channels are implicated in the emergence and/or progression of certain epithelial cancers. Based on this, 2010 study published in Urology, investigated the role of vanilloid 2 (TRPV2) channel proteins in the development of human urothelial carcinoma (UC) cells.
They did this by using CBD (a known selective TRPV2 agonist) to investigate the association between TRPV2 and UC cell death as well as determine whether Ca2+ influx into UC cells through TRPV2 is involved in apoptotic cell death. Focussing on Ca2+ permeable TRP channels expressed abundantly in human bladder cancer cells, they examined, using Ca2+ imaging analysis and biochemical approaches, whether the regulation of channel activity could lead to an inhibitory effect on the viability of UC cells.
They showed CBD induces an influx of Ca2+ into human UC cells, predominantly stimulating TRPV2 channels, and increases Ca2+ in UC cells, with continuous exposure to CBD-mediated apoptotic cell death via these channels. Therefore, although not directly investigating the effects of CBD on UC cells, they showed the mechanism by which CBD causes cancer cell death in UC cancer cells, making it a novel strategy for anti-tumor therapeutics.
Bladder cancer cell growth and motility implicate cannabinoid 2 receptor-mediated modifications of sphingolipids metabolism
In a later study from 2017 published in Scientific Reports, researchers investigated cannabinoid receptor (CB) expression on normal and human bladder cancer (BC) cells using immunohistochemistry. Again, although the effect of CBD in particular was not investigated, they did draw conclusions about the effectiveness of cannabinoid such as CBD on BC cell growth and motility.
They exposed human BC cells with CB agonists, and assessed for BC cell proliferation, apoptosis, and motility. Their results showed that CB2 receptors may selectively control some cellular functions in BC cells and that altogether supporting the specific use of CB2 as anti-tumor target. In addition, BC cells react to the cannabinoid-induced stress by activating autophagy as a defective survival signal that eventually leads up to apoptosis.
In conclusion, the data reiterates the well-known anti-metastatic properties of cannabinoids, showing a similar molecular mechanism involving CB2 for selective tumor cytotoxicity in BC cells.
Anti-cancer properties of cannabidiol and Δ9-tetrahydrocannabinol and potential synergistic effects with gemcitabine, cisplatin and other cannabinoids in bladder cancer
Investigating the potential anti-tumor effects of cannabinoids in bladder cancer, and how cannabinoids could potentially synergize with chemotherapeutic agents, investigators prepublished their results in a 2021 paper on bioRxiv. Their study aimed to identify whether combining cannabinoids such as CBD and tetrahydrocannabinol (THC) with chemotherapeutic agents commonly used to treat bladder cancer (BC) are able to produce desirable synergistic effects.
Using concentration curves of the different agents, they identified 1) the range at which each exert anti-tumor effects; 2) evaluated the activation of the apoptotic cascade; and 3) whether cannabinoids have the ability to reduce invasion. They found that both CBD and THC reduce cell viability of BC cell lines. However, cannabinoids in combination with chemotherapeutic agents induced differential responses, ranging from antagonistic to additive synergistic effects.
They concluded that their results indicate that cannabinoids such as CBD can reduce human bladder transitional cell carcinoma cell viability, and that they can potentially exert synergistic effects when combined with other chemotherapeutic agents depending on the concentrations used.
Anecdotal Evidence on using CBD for bladder cancer
The internet is full of stories from people who have effectively treated their bladder cancer with cannabis oil. However, when it comes to CBD and bladder cancer, the anecdotal evidence centres more around CBD being used as a complementary therapy (more on that below).
CBD as a Complementary Treatment
Most of the available evidence indicates that CBD may complement cancer treatment and that CBD may help people with cancer by helping reduce pain and inflammation. In addition, many people suffering from cancer also report having other side effects from chemotherapy treatment, including sleep problems, feelings of anxiety and depression. In one large case series study investigating the effects of CBD on anxiety and sleep, the results show CBD helps improve sleep and/or anxiety in clinical populations. Similarly, CBD can further support cancer patients by reducing stress, anxiety, depression while also helping to promote REM sleep that is thought to help improve overall mood.
Scientific and anecdotal evidence both suggest that CBD can support bladder cancer patients, especially by helping to reduce chemotherapy-induced neuropathic pain, inflammation, nausea and vomiting. If you or a loved one are suffering from bladder cancer and want to try CBD, talk to your medical practitioner first. He or she can help put together a plan that includes CBD along with other treatment options to help you deal with your symptoms safely and effectively.
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CBD in Treating Cancer and Related Symptoms
An Emerging and Alternative Therapy That Still Requires Much Investigation
Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.
Gagandeep Brar, MD, is a board-certified hematologist and medical oncologist in Los Angeles, California.
Cannabidiol (CBD) is one of many compounds (called cannabinoids) found in the marijuana plant Cannabis sativa. CBD is known for its relaxing and pain-soothing effects.
CBD is non-psychoactive, so it does not give you the classic mind-altering euphoria or “high” felt from using marijuana—that effect comes from the cannabinoid called THC (tetrahydrocannabinol).
While the research is still very early, experts speculate that CBD may play a role in treating cancer, specifically by slowing tumor growth and inducing the death of cancer cells. CBD may also help manage unpleasant symptoms related to cancer and chemotherapy, such as pain, nausea, and vomiting.
CBD and Treating Cancer
There are a number of studies supporting CBD’s potential anti-cancer role—however, the majority are limited to in vitro and animal studies. For example, in various studies, there is evidence that CBD decreases the growth of lung and prostate tumors, provokes the cell death of colon, lung, and brain cancer cells, and reduces the spread (metastasis) of breast cancer.
While promising, large human clinical trials are needed to better understand whether CBD is truly effective in helping to treat cancer. Clinical trials would also allow experts to tease out issues like dosage, interaction with other cancer drugs, and CBD’s safety profile.
As of now, there are only a handful of human studies that have examined CBD’s anti-cancer role.
Here are a few examples:
- In one study of 119 cancer patients (most of the cancers were metastatic and traditional cancer therapies had been exhausted), CBD oil was given on a three day on and three days off schedule. In most of the patients, an improvement in their cancer was noted, such as a decrease in tumor size. No side effects from CBD were reported.
- In a case study, an elderly man with lung cancer refused traditional chemotherapy and radiation for his cancer treatment and instead, self-administered CBD oil. After one month of taking the CBD oil, a computed tomography (CT) scan revealed near-total resolution of his lung tumor along with a reduction in the number and size of chest lymph nodes.
- In another study, two patients with aggressive gliomas (a type of brain tumor) were given CBD capsules in addition to chemoradiation and a multidrug regimen. Both patients had a positive response to the treatment with no evidence of disease worsening for at least two years.
Keep in mind—these studies are extremely small and lack a control group, so no finite conclusions can be drawn from them. Nevertheless, they spark further interest in the possible role of CBD in treating cancer.
CBD and Treating Cancer-Related Symptoms
There is scientific evidence, although limited and not robust, that CBD, THC, or a combination of the two, may be effective in alleviating certain cancer-related symptoms, such as pain, appetite loss, and chemotherapy-induced nausea and vomiting.
For instance, the drugs Marinol (dronabinol) and Cesamet (nabilone), which are synthetic forms of THC, are approved in the United States for treating chemotherapy-induced nausea and vomiting. Research suggests that dronabinol may also improve the taste of food, appetite, sleep, and quality of life in cancer patients.
In addition, a mouth spray that contains both THC and CBD (called Sativex) is being investigated for its role in treating cancer pain (especially nerve-related pain) that is poorly controlled by opioids. The drug is currently not available in the United States, but it is available in Canada for treating advanced cancer pain.
Lastly, research has found that in the general population (so not necessarily patients with cancer), CBD can reduce anxiety and improve sleep quality. This finding is helpful, considering the diagnosis and treatment of cancer is often overwhelming and wrought with fear and worry.
With the potentially emerging use of CBD in treating cancer and/or its related symptoms, there are a few issues to consider.
CBD oil is perhaps the most commonly utilized formulation of CBD, as it’s easy to use and allows for a high dose of consumption. However, CBD comes in many other forms—gummies, tinctures, capsules, vapes, and ointments, to name a few.
Sorting out how to best administer CBD to patients with cancer may prove to be challenging, as various formulations may work or absorb differently.
While research suggests that CBD is generally well-tolerated, we need to more closely examine potential side effects in patients with cancer. In addition, we still do not know the long-term effects of taking CBD, or how it interacts with other medications.
Short-term side effects of CBD may include:
- Reduced or increased appetite
- Weight gain or loss
- Increase in liver enzymes
If CBD is combined with THC (in the form of medical marijuana), other side effects may occur, such as:
- Dry mouth
- Disorientation and confusion
- Loss of balance
While CBD by itself is federally legal (as long as the product is derived from hemp and contains no more than 0.3% THC), marijuana is not (although, it is legal in some states).
CBD is only available by prescription in the United States in the form of a drug called Epidiolex. This drug is used to treat refractory epilepsy.
Due to these legal conundrums, CBD products may not be as tightly regulated as hoped. With that, products that claim they have a certain CBD dosage may actually contain a different amount or even contain traces of THC. This is why it is important to only take CBD under the guidance of your personal healthcare provider.
A Word From Verywell
The prospect of incorporating CBD into cancer care is intriguing but still requires much more investigation. Until then, if you are considering trying CBD (whether you have cancer or not), it’s best to talk out the pros and cons with your healthcare provider.