Short-Term Medical Cannabis Treatment Regimens Produced Beneficial Effects among Palliative Cancer Patients

Abstract

In the last decade the use of medical cannabis (MC) for palliative cancer treatment has risen. However, the choice between products is arbitrary and most patients are using Tetrahydrocannabinol (THC)-dominant cannabis products. In this study, we aimed to assess the short-term outcomes of MC treatment prescribed by oncologists in relation to the type of cannabis they receive. A comparative analysis was used to assess the differences in treatment effectiveness and safety between THC-dominant (n = 56, 52%), cannabidiol (CBD)-dominant (n = 19, 18%), and mixed (n = 33, 30%) MC treatments. Oncology patients (n = 108) reported on multiple symptoms in baseline questionnaires, initiated MC treatment, and completed a one-month follow-up. Most parameters improved significantly from baseline, including pain intensity, affective and sensory pain, sleep quality and duration, cancer distress, and both physical and psychological symptom burden. There was no significant difference between the three MC treatments in the MC-related safety profile. Generally, there were no differences between the three MC treatments in pain intensity and in most secondary outcomes. Unexpectedly, CBD-dominant oil treatments were similar to THC-dominant treatments in their beneficial effects for most secondary outcomes. THC-dominant treatments showed significant superiority in their beneficial effect only in sleep duration compared to CBD-dominant treatments. This work provides evidence that, though patients usually consume THC-dominant products, caregivers should also consider CBD-dominant products as a useful treatment for cancer-related symptoms.

Keywords: CBD; THC; medical cannabis; oncology; palliative cancer treatment.

Figure 1

Consort flowchart diagram. T₀, Baseline; T₁, one-month follow-up; MC, medical cannabis; BL, baseline; AEs, adverse effects.

Figure 2

MC Treatment regimens significant differential effects. (A) Differences between the three MC treatments in weekly average pain intensity; (B) Differences between the three MC treatments in affective pain intensity; (C) Differences between the three MC treatments in sensory pain intensity; (D) Differences between the three MC treatments in sleep quality; (E) Differences between the three MC treatments in sleep duration; (F) Differences between the three MC treatments in MSAS general distress index; (G) Differences between the three MC treatments in MSAS physical index; (H) Differences between the three MC treatments in MSAS psychological index; CBD, Cannabidiol; THC, (−)-Δ⁹-trans-tetrahydrocannabinol; MSAS, Memorial Symptom Assessment Scale; The dashed lines represent the baseline (T₀) values of their corresponding parameters; The box-plot values represent the raw median change from baseline (T₀) to one-month follow-up (T₁); n, Number of patients; N.S, Non-significant; Type I, THC-dominant treatments; Type III, CBD-dominant treatments; Type II, equal THC:CBD concentration treatments; Median and IQR change from baseline are calculated individually for each patient, the presented change from BL is the median of all individual patients and not the difference between the medians of BL and one-month follow-up; p values are adjusted for multiple comparisons; The direction of the arrows indicates the desired symptoms improvement trajectory.