Cannabis and cannabinoid products may have potential as adjuvant therapy for some adult patients with cancer, but the role of these products in the management of cancer-related symptoms remains unclear, according to research. The findings were presented in a poster at the 47th Annual Oncology Nursing Society (ONS) Congress.
Researchers sought to explore the safety, efficacy, and implications of cannabis for symptom management in patients with cancer. Specifically, the team sought to discover the effects of cannabis on pain, anorexia, nausea/vomiting, anxiety, and quality of life.
The researchers performed a literature review, searching Pubmed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Embase databases. Studies were included if they were conducted within the last 5 years, conducted outside the United States, and published in English. Studies were excluded if participants had preexisting chronic pain, were younger than 18 years, and had noncancer pain.
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A total of 8 studies were included in the review. Some of the studies evaluated tetrahydrocannabinol (THC), which produces the psychological effects of cannabis; some evaluated cannabidiol (CBD), which produces the physiological effects; and some evaluated both.
The study results were a mix of support for cannabis use and cautions regarding its effects on patients.
Cannabis alone did not provide sufficient pain relief. However, when cannabis was used in conjunction with opioid therapy, some patients achieved greater pain relief than with opioid therapy alone.
Chemotherapy-induced nausea and vomiting (CINV), anorexia, and cachexia were improved in patients using cannabis. Use of rescue medications for CINV were reduced in patients who used THC/CBD products. Patients who used these products also experienced weight gain and improved appetite.
There were no standardized measures used to assess quality of life. However, cannabinoid receptors had wide-ranging effects on patients, including control of symptoms such as depression, anxiety, sleep, and appetite, which may have improved quality of life.
Adverse effects reported included dizziness, somnolence, disorientation, gastrointestinal disturbances, hallucinations, and altered functional status. These symptoms often led to high attrition in studies.
“While these results seemed promising at first, there were many limitations to these studies, as there was high attrition, no uniform dosing strategies, high variability of cannabis products, and a high likelihood of possible confounders with other therapies,” said study author Amber Nenner, BSN, RN, of Columbia University School of Nursing in New York, New York.
“Therefore, results of these [studies] may be anecdotal at best, and further high quality studies are needed to create standardized guidelines for clinical application.”
Reference
Nenner A, Salim F, Sandler R. Cannabis and symptom management in cancer: Safety, efficacy, and implications for clinical use. Poster presented at: 47th Annual ONS Congress; April 27-May 1, 2022; Anaheim, California.
This article originally appeared on Oncology Nurse Advisor
