Medical Cannabis in Oncology: a Valuable Unappreciated Remedy or an Undesirable Risk?

Curr Treat Options Oncol. 2021 Jan 13;22(2):16. doi: 10.1007/s11864-020-00811-2.

Abstract

The use of the cannabis plant by cancer patients has been rising significantly in the past few years worldwide, primarily driven by public demand. There is an obvious need for more reliable scientific data, pharmacology information, a better understanding of its mode of action, and available clinical evidence supporting its robust use. Physicians must complete a thorough medical assessment, screening for potential drugs, or treatment contraindications before allowing its consumption. In light of the growing popularity of cannabis usage, it is highly essential that, in the near future, the medical community will be able to provide practical recommendations and explicit guidelines, including doses, and that cannabinoid concentrations in the used products are defined regarding its prescription before any medical procedure involving its usage is authorized. Here, we review and describe the favorable outcomes demonstrating the benefits of cannabis as an adjunctive treatment to conventional medicines for chemotherapy-induced nausea, vomiting, and cancer-related pain (primarily refractory chronic or neuropathic pain). Although not yet substantial enough, the treatment of anorexia, insomnia, depression, and anxiety is also seemingly favorable. To date, reports regarding its anti-neoplastic effects or its potent immunosuppressive properties influencing response to immunotherapy are still very conflicting and controversial. Thus, with the current state of evidence, cannabis use is not advisable as initial treatment, as an adjunct or an advanced line of care. In the coming years, we expect that preclinical data and animal models will shift to the clinical arena, and more patients will be recruited for clinical trials, and their reports will advance the field. Thus, physicians should prescribe cannabis only if careful clarification and consideration is provided together with a follow-up response evaluation.

Keywords: Cancer; Cannabinoids; Cannabis; Medical marijuana; Oncology; Pain; Palliative care.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cancer Pain / drug therapy
  • Cancer Pain / etiology
  • Cancer Pain / prevention & control
  • Clinical Trials as Topic
  • Health Impact Assessment
  • Humans
  • Medical Marijuana / administration & dosage
  • Medical Marijuana / adverse effects
  • Medical Marijuana / therapeutic use*
  • Medical Oncology / methods*
  • Medical Oncology / standards
  • Nausea / chemically induced
  • Nausea / drug therapy
  • Nausea / prevention & control
  • Neoplasms / complications
  • Neoplasms / drug therapy
  • Prognosis
  • Risk Assessment
  • Treatment Outcome
  • Vomiting / chemically induced
  • Vomiting / drug therapy
  • Vomiting / prevention & control

Substances

  • Medical Marijuana