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. 2021 Nov 28;2021(58):86-98.
doi: 10.1093/jncimonographs/lgab011.

The Management of Cancer Symptoms and Treatment-Induced Side Effects With Cannabis or Cannabinoids

Michelle Sexton  1 , Jose M Garcia  2 , Aminah Jatoi  3 , Carey S Clark  4 , Mark S Wallace  1
Affiliations

The Management of Cancer Symptoms and Treatment-Induced Side Effects With Cannabis or Cannabinoids

Michelle Sexton et al. J Natl Cancer Inst Monogr. .

Abstract

Cannabis and cannabinoids are increasingly being accessed and used by patients with advanced cancer for various symptoms and general quality of life. Specific symptoms of pain, nausea and vomiting, loss of appetite and cachexia, anxiety, sleep disturbance, and medical trauma are among those that have prompted patients with cancer to use cannabis. This conference report from the National Cancer Institute's "Cannabis, Cannabinoid and Cancer Research Symposium" on the topic of "Cancer Symptom/Treatment Side Effect Management" is an expert perspective of cannabis intervention for cancer and cancer treatment-related symptoms. The purpose of the symposium was to identify research gaps, describe the need for high-quality randomized prospective studies of medical cannabis for palliative care in patients with cancer, and evaluate the impact of medical cannabis on cancer survivors' quality of life. Further, education of clinicians and affiliated health-care providers in guiding cancer patients in using cannabis for cancer care would benefit patients. Together, these steps will further aid in refining the use of cannabis and cannabinoids for symptom palliation and improve safety and efficacy for patients.

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Figures

Figure 1.
Figure 1.
Association of delta-9-tetrahydrocannabinol (THC) plasma levels with pain benefits. Prospective trial of inhaled cannabis for painful diabetic peripheral neuropathy suggests a therapeutic window, between 16 ng/mL and 31 ng/mL, for optimal pain benefit. Low and high THC levels had a negative association (no reduction in pain scores), and THC levels within the window had a positive association (reduction in pain scores).
Figure 2.
Figure 2.
Compilation of studies on cannabis use and anxiety and prescription drug substitution. Ten cross-sectional analyses of cannabis use have been published. This graph displays the reported (top) anxiety benefits on behalf of the respondents and (bottom) reported substitution of antianxiety medications by cannabis users and respondents across these studies.
See this image and copyright information in PMC

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