A cross-sectional survey of cancer patients seen at the Seattle Cancer Care Alliance was conducted over a 6-week period between 2015 and 2016.[18] In Washington State, Cannabis was legalized for medicinal use in 1998 and for recreational use in 2012. Of the 2,737 possible participants, 936 (34%) completed the anonymous questionnaire. Twenty-four percent of patients considered themselves active Cannabis users. Similar numbers of patients inhaled (70%) or used edibles (70%), with dual use (40%) being common. Non–mutually exclusive reasons for Cannabis use were physical symptoms (75%), neuropsychiatric symptoms (63%), recreational use/enjoyment (35%), and treatment of cancer (26%). The physical symptoms most commonly cited were pain, nausea, and loss of appetite. The majority of patients (74%) stated that they would prefer to obtain information about Cannabis from their cancer team, but less than 15% reported receiving information from their cancer physician or nurse.
Content updates feature essential information related to the state’s commercial cannabis regulations and guidelines, the licensing application process, and announcements from the state’s three cannabis licensing authorities and business partners. Links to each state agency’s cannabis information are listed towards to the bottom of the homepage under the “Collaborating State Agencies” header. 
"We still don't fully understand all of the mechanisms involved in CBD's actions," says Marcel Bonn-Miller, Ph.D, who studies CBD and its effects, primarily on PTSD. "We know some pieces but definitely not the whole story at this point. A lot of our understanding of the many potential benefits of CBD is rooted in work either on the cellular level or in preclinical models with rodents."
Low concentrations of CBD aren’t the only concern, either. Cannabis plants are hardy and tough, and their thick stalks possess a special property: bioremediation. When grown in contaminated soil, hemp plants absorb heavy metals and other chemical waste, effectively cleansing the terrain. While all plants absorb some chemicals from the soil, the structure, size, and genetic makeup of hemp make it especially adept at this task. Cannabis is so effective that crops of industrial hemp were planted in the aftermath of the 1986 Chernobyl disaster to help purify heavily irradiated soil. When hemp stalks are used for fiber, paper, and other nonconsumptive industrial purposes, the contaminants absorbed into the plants pose no threat to humans.
The psychoactive effects of cannabis are known to have a triphasic nature. Primary psychoactive effects include a state of relaxation, and to a lesser degree, euphoria from its main psychoactive compound, tetrahydrocannabinol. Secondary psychoactive effects, such as a facility for philosophical thinking, introspection and metacognition have been reported among cases of anxiety and paranoia.[93] Finally, the tertiary psychoactive effects of the drug cannabis, can include an increase in heart rate and hunger, believed to be caused by 11-OH-THC, a psychoactive metabolite of THC produced in the liver.
The effects of delta-9-THC and a synthetic agonist of the CB2 receptor were investigated in HCC.[15] Both agents reduced the viability of HCC cells in vitro and demonstrated antitumor effects in HCC subcutaneous xenografts in nude mice. The investigations documented that the anti-HCC effects are mediated by way of the CB2 receptor. Similar to findings in glioma cells, the cannabinoids were shown to trigger cell death through stimulation of an endoplasmic reticulum stress pathway that activates autophagy and promotes apoptosis. Other investigations have confirmed that CB1 and CB2 receptors may be potential targets in non-small cell lung carcinoma [16] and breast cancer.[17]
Cannabis for industrial uses is valuable in tens of thousands of commercial products, especially as fibre[106] ranging from paper, cordage, construction material and textiles in general, to clothing. Hemp is stronger and longer-lasting than cotton. It also is a useful source of foodstuffs (hemp milk, hemp seed, hemp oil) and biofuels. Hemp has been used by many civilizations, from China to Europe (and later North America) during the last 12,000 years.[106][107] In modern times novel applications and improvements have been explored with modest commercial success.[108][109]
Images in this summary are used with permission of the author(s), artist, and/or publisher for use within the PDQ summaries only. Permission to use images outside the context of PDQ information must be obtained from the owner(s) and cannot be granted by the National Cancer Institute. Information about using the illustrations in this summary, along with many other cancer-related images, is available in Visuals Online, a collection of over 2,000 scientific images.

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