Can Cannabidiol Affect the Efficacy of Chemotherapy and Epigenetic Treatments in Cancer?

The success of cannabinoids with chronic neuropathic pain and anxiety has been demonstrated in a multitude of studies. With the high availability of a non-intoxicating compound, cannabidiol (CBD), an over-the-counter medication, has generated heightened interest in its use in the field of oncology. This review focuses on the widespread therapeutic potential of CBD with regard to enhanced wound healing, lowered toxicity profiles of chemotherapeutics, and augmented antitumorigenic effects. The current literature is sparse with regard to determining the clinically relevant concentrations of CBD given the biphasic nature of the compound's response. Therefore, there is an imminent need for further dose-finding studies in order to determine the optimal dose of CBD for both intermittent and regular users. We address the potential influence of regular or occasional CBD usage on therapeutic outcomes in ovarian cancer patients. Additionally, as the development of chemoresistance in ovarian cancer results in treatment failure, the potential for CBD to augment the efficacy of conventional chemotherapeutic and epigenetic drugs is a topic of significant importance. Our review is focused on the widespread therapeutic potential of CBD and whether or not a synergistic role exists in combination with epigenetic and classic chemotherapy medications.

Causal effect of obesity on gynecologic malignancies.

INTRODUCTION: Gynecologic malignancies are estimated to affect 110,070 women and will be the cause of death in approximately 32,120 in 2018. Endometrial cancer is among the most prevalent with 63,320 estimated new cases and approximately 11,350 deaths, followed by ovarian cancer with an estimate of 22,000 new cases and 14,000 deaths annually. Obesity is one of the most modifiable risk factors. Providers should engage in a multifaceted approach to patient education and healthcare to decrease the projected cases of obesity-related cancers. BACKGROUND: The literature demonstrates a significant link between obesity and the development of certain malignancies such as endometrial, pancreatic, and renal cancer. Specific mechanisms found to play a role in the development of these malignancies include alterations of the metabolic pathway attributed to lipid accumulation as well as a chronic inflammatory process. Obesity also predisposes patients to other medical comorbidities as well as a poorer prognosis once a diagnosis of cancer is established. Factors contributing to poorer prognosis include challenges with treatment planning, specifically pertaining to inappropriate chemotherapy dosing and delivery of radiation therapy. Surgical approach and perioperative management are similarly challenging in obese patients and are associated with increased risk of complications. CONCLUSION: Obesity is a modifiable factor which is associated with an increased risk of cancer and poorer outcomes. Providers should educate patients on all health hazards of obesity, including increased risk of cancer, and encourage them to participate in a structured weight loss plan.

Perceptions of prenatal testing for birth defects among rural Latinas.

Objectives To examine rural Latinas' understandings of prenatal testing, birth defects, and risk in the context of their expanded AFP (XAFP) screening decisions. Design We conducted a qualitative study using data from in-depth interviews with 33 Latina women receiving prenatal care at three clinic sites in rural areas of California. We analyzed qualitative data by identifying themes that emerged during iterative transcript readings. Quantitative data was used to generate descriptive summary statistics. Results The majority of the participants had not completed high school and had low levels of acculturation. Women in our study tended to view XAFP screening as a routine component of prenatal care that was important for the "health of the baby." Reasons for accepting the XAFP test included reassurance, emotional preparation, and desire for information. Misconceptions included a belief that a normal screening result provides a guarantee of the fetus's health. Generally, participants indicated that, regardless of the screening results, they would not undergo amniocentesis because of the potential miscarriage risk nor would they terminate a pregnancy if their fetus was found to have a chromosome problem. Numerous specific beliefs that differ substantially from medical models regarding birth defects were articulated. Conclusions XAFP screening decisions among rural Latinas are sometimes based on misconceptions of the meaning of test results and the risks associated with undergoing or foregoing testing, and therefore are frequently incongruent with personal testing philosophies and values. Educational efforts and counseling should include clear communication regarding the goals of prenatal screening programs to help these women make informed testing decisions that are reflective of their values and preferences.