U of C cancer research psychedelics
The Canadian Cancer Society with the support of Brain Canada has committed over $5 million to a cancer research project at the University of Calgary involving the macrodosing of psychedelics.
New funding will boost groundbreaking research into psychedelic-assisted cancer therapy, also known as PACT, at the University of Calgary.
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The research focuses on treating feelings of anxiety, depression and hopelessness in people with advanced cancer through macrodosing psychedelics such as psilocybin.
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Macrodosing differs from microdosing, in that it involves taking a larger dose at once, while microdosing involves taking small amounts over a long period.
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“This is the largest grant in psychedelic assisted therapy in (Canadian) history … it’s actually one of the largest in North America,” said Dr. Linda Carlson of the U of C’s Cumming School of Medicine, who is leading the research alongside Dr. Ronald Shore from Queen’s University.
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The Canadian Cancer Society with the support of Brain Canada has committed more than $5 million to the project — part of a total $17.9 million grant toward three separate research projects across Canada.
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Jennifer Wilson, the vice-president of research and programs at the cancer society, said they are fortunate to have Carlson’s leadership on the project.
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Carlson’s proposal “really tackle(s) this from multiple perspectives,” said Wilson, adding that it’s brining a “network of people” invested in the research and who will be positively impacted by it to the table.
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“We’re trying to bring together everybody in Canada who is already working or interested in this area, because it’s very new,” said Carlson, who’s also an oncology professor at U of C.
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That team will include patients, health-care providers and policy makers — which Carson says will aim to influence research, treatment and policy around PACT to alleviate barriers.
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One key barrier at the moment is the regulatory framework for accessing psychedelics.
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“The most promising one in this space is psilocybin, or magic mushrooms, but there’s no easy access to it for patients,” said Carlson, adding that they’re currently only available through the Special Access Program.
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“A second big issue is training, because the way we deliver these therapies is through psychedelic assisted therapy, and you have to train clinicians to be able to do this,” she said.
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There have been some clinical trials in the United States, but not enough large scale research to really understand “if it works, how it works, and what’s the best way to roll it out,” said Carlson.
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Wilson said April is daffodil month for the Canadian Cancer Society, when the organization raises a lot of its funds.
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It “helps to fund high quality research, as well as all the programs and services that we deliver to really support people living in Canada,” she said.
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University of Calgary cancer researcher Dr. Linda Carlson. Brandon Coelho photo/Supplied
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What can PACT do for patients?
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Those diagnosed with advanced cancer, meaning its spread either locally or to different organs in the body, often face mental health challenges due to its pervasive nature.
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“Those types of cancers, a person can potentially live with it for many years, but it’s not curable … it’s eventually going to come back,” said Carlson.
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Sometimes, patients can become very discouraged and demoralized, she adds, amid the uncertainty as to “what’s going to happen when the cancer comes back?”
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“They can get really wound up in these worries about pain and death and dying, and fears of recurrence,” Carlson said, noting some get depressed or consider medical assistance in dying.
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“That’s kind of where many people find themselves,” she said.
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While microdosing occurs with smaller doses taken repeatedly over time with no noticeable effects on consciousness, macrodosing is a large dose taken only once or twice, Carlson said. “It has noticeable psychoactive effects like perceptual changes in vision, emotions and time perception.”
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Research on psilocybin in particular has shown that with one high dose, typically 25 milligrams, along with a few sessions of supportive psychotherapy can create a “complete reversal” of the negative feelings.
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“People have had a complete lifting of all these fears … they have sometimes a mystical experience where they feel at peace, they feel calm,” said Carlson.
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The benefits from just one dose can be very long lasting, with some studies indicating multiple years for some patients.
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“We’re looking to completely alleviate existential anxiety, demoralization,” she said.
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It can also help with symptoms like pain, sleep issues and fatigue that are bothersome day-to-day for cancer patients.
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University of Calgary cancer researcher Dr Ronald Shore. Supplied photo
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How PACT ‘reorganizes’ the brain
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There is quite a bit of neuroscience research done on psychedelics, psilocybin in particular, noted Carlson.
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“We do know that it targets the serotonin two-way receptor in the brain … it works mostly through the serotonergic system which is related to mood.”
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Psilocybin generates neuroplasticity, meaning it “reorganizes all the network connections in the brain.”
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Usually, interconnected areas that impact mood and thought processes are disconnected, opening up the brain to “reconnect in different ways.”
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That reorganization can functionally improve things like mood and depression.
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Through life, some may develop patterns of “depressogenic thinking” that support negative mood.
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“Those networks become cemented in place, and it’s very hard to stop thinking that way,” she said. “This idea of opening up or loosening those connections allows you to reestablish connections that support better mental health … more elevated mood.”
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Carlson highlighted the piece researchers really don’t understand is the “mystical experience” people get, which they can’t pinpoint.
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“We can see what’s happening in the brain, but the subjective experience doesn’t necessarily map onto that,” she said.
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Jennifer Wilson, vice-president of research and programs at the Canadian Cancer Society. Supplied
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A typical session, addressing psychedelic ‘stigma’
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Alleviating the potential for a “bad trip” in PACT patients is, in part, about preparation according to Carlson.
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They talk about “set” and “setting,” the former is the mindset of the person going into it, while the latter is about the environment.
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Preparatory sessions help to get patients in the right mindset, be open to the experience.
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“Which is not to be fearful, to be open, to be curious … to be in the moment, and to try and just let go and go with it,” said Carlson.
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For the setting, there’s always one or two trained guides or facilitators by the person’s side.
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“They’re in a safe environment, in a medical setting or in a clinic, but also a comfortable environment … there’s soft music playing, they can wear an eye shade,” she said.
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When an actual dosing session takes place, it’s about eight hours long.
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“There might be half that time where a person’s ‘tripping’, which means they could be having really intense visual(s) kind of colors and shapes, or they’ll have really strong emotions coming up,” said Carlson.
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In a therapeutic setting, she said they might have that “mystical feeling of connection.”
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The current interest in psychedelics represents a pivot from the “stigma” of the “war on drugs” era of the 1970s, where many drugs were prohibited and considered dangerous.
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“There was no access to psychedelics for a couple of decades, and only in the 1990s some researchers started to revisit the earlier work that had actually shown promise in these areas,” Carlson said.
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“We see attitudes shifting … and when you talk to the health-care providers, they just want to see the evidence,” she said. “They’re pretty open to different treatments, but they’re saying there’s not enough research.”
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She added that the safety profile of most of the psychedelics is “pretty good,” much safer than many other drugs that people routinely have access to.
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“There’s very little addictive potential and for the psychedelics, they don’t work that way,” she said. “It’s more opioids and other kind(s) of compounds that are more prone to be addictive.”
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