Cannabis for cancer? The answer is still ‘no’

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View this email in your browser Thursday 11 April 2024

Hello Nature readers, This week, we discover a 'paradigm-shifting' idea for treating a deadly childhood cancer, learn that cannabis still isn't being recommended by oncologists as a first-line treatment and hear that prostate cancer is on the rise.

Rhabdoid tumours are a rare type of childhood cancer that can affect the kidneys, brain and spinal cord. (FatCamera/Getty)

'Paradigm-shift' for deadly childhood cancer It might be possible to treat an aggressive childhood cancer by stabilizing damaged tumour-suppressing proteins. Rhabdoid tumours are generally driven by mutations in the SMARCB1 protein, which forms part of a larger complex called SWI/SNF (known as Switch-Sniff). SWI/SNF cracks down on any cancer-like changes in the cell, but is dismantled by a quality-control protein called DCAF5 when SMARCB1 isn't present. When the researchers depleted DCAF5, the complex sprang back into action and cancers vanished in mice. "I was really stunned," says molecular oncologist and co-author Charles Roberts. It's a "paradigm-shifting idea," says molecular biologist Emily Dykhuizen. STAT | 7 min read Reference: Nature paper (27 March)

Prostate-cancer cases to double by 2040 The number of prostate-cancer cases worldwide is likely to double by 2040 as people live longer and populations age. Deaths from the disease are projected to increase by 85% over that period, according to The Lancet Commission on prostate cancer. "We know this surge in cases is coming, so we need to start planning and take action now," says cancer researcher and co-author Nick James. The Commission found that combining a prostate-specific antigen test with an MRI could make prostate-cancer screening more accurate and avoid unnecessary treatments that can cause incontinence and erectile dysfunction. The Guardian | 5 min read Reference: The Lancet report (4 April)

Lactate buildup could cause wasting disease An accumulation of lactate could be driving a deadly muscle-wasting disease called cachexia that affects up to 80% of people with cancer. Lactate was elevated in mice that developed cachexia after being injected with cancer cells. In 26 people with lung cancer, those with cachexia also had higher lactate levels. Mice infused with lactate lost a significant amount of muscle and fat over a fortnight, and cachexia was reduced or reversed in mice that were genetically engineered to lack a lactate receptor called GPR81. But not everyone is convinced: cachexia researcher Marilia Seelaender says it's unusual for people with cancer to have high lactate levels. Science | 5 min read Reference: Nature Metabolism paper (18 March)

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In the news Around half of cancer drugs given accelerated approval by the US Food and Drug Administration do not improve survival or quality of life after more than five years of follow-up in clinical trials. (STAT | 5 min read) Reference: JAMA paper People who have markers of accelerated biological ageing have a higher risk of cancer than those without, according to a study of more than 148,000 people aged 37 to 54. (CNN | 5 min read) Tumours shrank in almost one-third of people with advanced liver cancer given a personalized vaccine and the immunotherapy pembrolizumab. (Reuters | 2 min read) Reference: Nature Medicine paper By 2050, the number of people with cancer globally is projected to rise by 77%, according to a report by the American Cancer Society. (CNN | 8 min read) Reference: CA: A Cancer Journal for Clinicians paper

Features & opinion

Cannabis for cancer? The answer is still 'no' Oncologist Ranjana Srivastava vividly recalls her first encounter with cannabis in healthcare: the son of a dying man fervently believed the drug could cure his father's cancer. A decade on, cannabis is still not prescribed by most doctors. The American Society of Clinical Oncology has called for doctors to remain open and non-judgemental on the topic, but says cannabis should not be recommended outside of clinical trials. Cannabis might help for nausea and vomiting, but it shouldn't be used as a first-line treatment, says Srivastava. "When patients ask, 'Doctor, should I take cannabis for my cancer?', the answer is still no. But at least we are talking," she writes. The Guardian | 5 min read Reference: Journal of Clinical Oncology paper (13 March)

'I'll never be able to have sex' Medical student Ellie Waters underwent intense radiotherapy for the soft-tissue cancer rhabdomyosarcoma at the age of 14, but — because of her age — she was not told about the long-term impacts. "I was never prepared for potentially not being able to have sex… I'll never be able to have sex in the way I want to again," she says. Waters processed her grief by breaking the taboo and talking openly with family and friends about her loss. "I feel like there's not enough support in place for those who do have sexual dysfunction after cancer," she says. BBC | 3 min read

Infographic of the week

Researchers have discovered how white blood cells called neutrophils get hijacked by the tumour microenvironment (TME). Neutrophils exit the bone marrow and spleen and travel to tumours where they undergo epigenetic and transcriptomic reprogramming and become pro-tumour neutrophils. See a larger version of this image here. (Signal Transduction and Targeted Therapy | 6 min read) Reference: Science paper (12 January) (Carlos Silvestre-Roig et al/Signal Transduction and Targeted Therapy (CC BY 4.0))

Quote of the week "Until you're in a room, speaking to a family whose wife has a recurrent tumour in her brain stem and can't access services because she's early pregnant… I really don't appreciate someone telling me what the right thing to do is." Women with life-threatening illnesses are struggling to access medically necessary abortions in Texas, says physician Todd Ivey. (The New Yorker | 17 min read)

I've been dreaming of cancer-drug packaging that reads: 'Made in space'. The microgravity on the International Space Station could be precisely what manufacturers need to crystallize immunotherapies into concentrated, injectable doses, according to Wired. Send space drugs, tips and feedback to cancerbriefing@nature.com. Thanks for reading, Felicity Nelson, editor, Nature Briefing: Cancer

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