The story of Rick Simpson and his namesake cannabis oil has made him a hero to some and a menace to others. Simpson's claim that he used the oil to cure his own skin cancer has spread online like a viral tidal wave.
The recipe for Rick Simpson oil (RSO), which he says he has never sold, is translated in 72 languages on his website, which also carries first-person stories extolling the product's "miraculous" properties.
Doris's 20-yr-old granddaughter was diagnosed last fall with non-Hodgkin's lymphoma and went through standard chemo and radiation 'treatments'. She suffered severe burns to her esophagus and was unable to take food or fluids. We began giving her the oil about six weeks ago. Her cancer is in remission, no sign of it... You are my hero, sir!
—Testimonial on Rick Simpson's website
But clinicians familiar with Simpson and his cult-like following take a different view.
"It's terrifying," said Adam Friedman, MD, professor of dermatology at the George Washington School of Medicine & Health Sciences in Washington, DC. "This guy's gotta be stopped."
In fact, for those who believe that randomized, double-blind, placebo-controlled studies should guide evidence-based medicine, this is the kind of story that makes you want to pull your hair out.
"I have patients out there claiming on the Internet that cannabis cures cancer, but they seem to forget that they also had chemo and surgery," said oncologist Donald Abrams, MD, professor of clinical medicine at the University of California, San Francisco.
Because he is a cannabis expert, Abrams also hears frequently from people outside his practice who believe that cannabis cured their cancer. "Do we know that these were really cancers?" he asked. "Patients send me these emails all the time. Many times they never had a biopsy. Maybe they just had an infection, who knows?"
'A Healer, Not a Dealer'?
The Rick Simpson story begins back in the late 1990s in a small town in Nova Scotia, where he began growing his own marijuana plants in his backyard. He then made highly concentrated extracts from the whole plant, first to treat a head injury and later to "cure" what he says was basal cell carcinoma on his arm. Thrilled with the results, he started giving it away to ailing friends and neighbors, and teaching others how to make their own oil, which was highly psychoactive, with 90% tetrahydrocannabinol (THC).
This harmless non addictive natural medication can be used with great success, to cure or control cancer, MS, pain, diabetes, arthritis, asthma, infections, inflammations, blood pressure, depression, sleeping problems and just about any other medical issues that one can imagine, he writes on his website.
That's the kind of messaging that drew attention from the start of his journey and still resonates today. A message posted on the website states: "Due to the overwhelming amount of emails we are now receiving everyday ... we simply cannot keep up with the demands the public are now placing upon us."
But despite Simpson's apparent popularity, the Canadian is an exile from his country.
Growing marijuana was not legal there when he began his self-treatment, and as soon as he gained some notoriety, he attracted the attention of law enforcement officials.
When the Canadian Mounted Police raided Simpson's property in 2005, seizing his cannabis crop, they "netted 1,190 plants that a police marijuana expert said would yield 83,000 grams of usable marijuana that would take a heavy user more than 76 years to smoke," according to local news coverage.
Simpson was charged with trafficking, but even then, there were hints of the legend he was to become.
"Justice Cacchione said Mr. Simpson truly believed the paste he made and gave away cured diseases like cancer," wrote reporter Tim McCoag for the (Amherst) Chronicle Herald. "He said that Mr. Simpson, unlike any other trafficker he had seen in his years on the bench, did not grow marijuana ... to gain a profit. Mr. Simpson also told the court that he distributed the oil free of charge to about 300 people who wanted his cure."
Though Simpson was hailed by supporters as "a healer, not a dealer," his philanthropy was not enough to absolve him, and after a few more run-ins with the law, he finally left Canada. On the basis of limited correspondence with Medscape, Simpson and his wife, Danijela Smiljanic Simpson, currently use a mailing address in Zagreb, Croatia. Requests for an interview went unanswered for several weeks; Danijela Simpson finally responded that an interview would not be possible for several more weeks.
In the meantime, she wrote, they are busy shutting down "scammers" who use Rick's name to sell their own RSO online.
Oil called "RSO" is actually a thick, viscous syrup, usually sold in needleless syringes to allow for dispensing tiny amounts. It is available at many dispensaries where marijuana is legal.
Folklore vs Evidence
Ironically, some outspoken critics of Simpson actually find some merit in the use of cannabinoids as medicinal therapy. Dermatologist Friedman, who described the Simpson phenomenon as "terrifying," is something of a cannabis guru himself, having coauthored scholarly articles such as The Therapeutic Potential of Cannabinoids in Dermatology and Cannabinoids: Potential Role in Inflammatory and Neoplastic Skin Diseases. He's had "some success" using cannabidiol (CBD) oils, which are not psychoactive, for chronic wounds and inflammatory conditions such as hidradenitis suppurativa. But he draws a line at claims about cancer.
"I think there's a role for cannabinoids in managing symptoms and inducing appetite," Friedman said, "but my issue is him saying this cures all cancer, which is an absolute lie, and a dangerous one at that.
"Each type of cancer is unique in how it behaves, how it interacts with the immune system, what signals it will create or respond to," he continued. "To say that one thing will treat everything is absolutely idiotic. I think he's actually doing significant harm to the medical cannabinoid world by making outrageous, unfounded, non–evidence-based claims."
For Mark Kirchhof, MD, PhD, head of dermatology at the University of Ottawa, in Ontario, Canada, the RSO story is a symptom of a larger problem of misleading claims made by medical cannabis dispensaries, both in the United States and Canada.
"Our data indicate that the suggested and advertised uses of medical cannabis are largely unsubstantiated," he wrote in a recent dermatology article.
"The claims are broad and varied," he explained by email. "Some [dispensaries] use vague language and generalization, with claims that cannabis can cure cancer or treat inflammation, as examples. In reality, cancer is not one disease but thousands. Every cancer behaves differently, so cannabis would need to be tested for each type of cancer."
Similarly, the term "cannabis" can be used to mean different things. RSO is highly psychoactive because of the high concentration of THC and low level of CBD. In contrast, many CBD oils and other products have little to no psychoactive effects and are even available over the counter in areas where marijuana is legal.
Abrams, an oncologist and integrative medicine specialist, has published at least 13 articles on the medical benefits of cannabis, but his most recent article sums it up: "Although there is a growing body of in vitro evidence and data from animal models suggesting that cannabinoids may have some antitumor effects, evidence from human studies published to date to support such a claim is lacking."
Yet, "the cannabinoid 1 receptor is one of the most densely populated receptors in the human brain, so it might make some sense that cannabinoids may have some activity against a tumor that may be expressing a lot of this receptor," he added.
While the complexity of treating and curing cancers makes it hard for the scientific community to swallow the claims about RSO, the man behind the oil continues to capture the imagination of thousands of people yearning for comfort and a cure.
"We should never underestimate the power of suggestion," said Friedman. "There's no question there's a mind-body connection, so if you believe something will work, you are going to get a benefit...
"I can't say there's no way whatever he makes works; we just don't know, because it's never been studied."
Medscape Oncology © 2019 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Rick Simpson Oil: Cancer Cure or Pipe Dream? - Medscape - Feb 20, 2019.