Condition

CBD for Bladder Cancer

What is 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

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

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

Although common too many other conditions, early bladder cancer signs and symptoms may include:

• 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

Once bladder cancer spreads, the following symptoms may also present itself:

• 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

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.

Adenocarcinoma

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.

Sarcoma

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.

Pharmaceutical Interventions

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

Non-Pharmaceutical Interventions

Surgery, to remove the cancer cells and include:

• 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.

Bottom Line

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.