Seventy-four patients with newly diagnosed head and neck cancer self-described as current Cannabis users were matched to 74 nonusers in a Canadian study investigating quality of life using the EuroQol-5D and Edmonton Symptom Assessment System instruments. Cannabis users had significantly lower scores in the anxiety/depression (difference, 0.74; 95% CI, 0.557–0.930) and pain/discomfort (difference, 0.29; 95% CI, 0.037–1.541) domains. Cannabis users were also less tired, had more appetite, and better general well-being.
Three trials have evaluated the efficacy of inhaled Cannabis in chemotherapy-induced N/V.[43-46] In two of the studies, inhaled Cannabis was made available only after dronabinol failure. In the first trial, no antiemetic effect was achieved with marijuana in patients receiving cyclophosphamide or doxorubicin, but in the second trial, a statistically significant superior antiemetic effect of inhaled Cannabis versus placebo was found among patients receiving high-dose methotrexate. The third trial was a randomized, double-blind, placebo-controlled, crossover trial involving 20 adults in which both inhaled marijuana and oral THC were evaluated. One-quarter of the patients reported a favorable antiemetic response to the cannabinoid therapies. This latter study was reported in abstract form in 1984. A full report, detailing the methods and outcomes apparently has not been published, which limits a thorough interpretation of the significance of these findings.
Some of the reference citations in this summary are accompanied by a level-of-evidence designation. These designations are intended to help readers assess the strength of the evidence supporting the use of specific interventions or approaches. The PDQ Integrative, Alternative, and Complementary Therapies Editorial Board uses a formal evidence ranking system in developing its level-of-evidence designations.
Cannabis and Cannabinoids
Patients often experience mood elevation after exposure to Cannabis, depending on their previous experience. In a five-patient case series of inhaled Cannabis that examined analgesic effects in chronic pain, it was reported that patients who self-administered Cannabis had improved mood, improved sense of well-being, and less anxiety.
One study in mice and rats suggested that cannabinoids may have a protective effect against the development of certain types of tumors. During this 2-year study, groups of mice and rats were given various doses of THC by gavage. A dose-related decrease in the incidence of hepatic adenoma tumors and hepatocellular carcinoma (HCC) was observed in the mice. Decreased incidences of benign tumors (polyps and adenomas) in other organs (mammary gland, uterus, pituitary, testis, and pancreas) were also noted in the rats. In another study, delta-9-THC, delta-8-THC, and cannabinol were found to inhibit the growth of Lewis lung adenocarcinoma cells in vitro and in vivo. In addition, other tumors have been shown to be sensitive to cannabinoid-induced growth inhibition.[5-8]
The potential for cytochrome P450 interactions with highly concentrated oil preparations of delta-9-tetrahydrocannabinol and/or cannabidiol is a concern. Few pharmacokinetic interaction studies have been conducted with Cannabis or cannabinoids and conventional cancer therapies. A small study investigated the effect of Cannabis tea in 24 patients who received irinotecan or docetaxel. Administration of the Cannabis tea did not significantly influence exposure to and clearance of either intravenous agent.
A pooled analysis of three case-cohort studies of men in northwestern Africa (430 cases and 778 controls) showed a significantly increased risk of lung cancer among tobacco smokers who also inhaled Cannabis.
There are 2 synthetic cannabis medications, nabilone (Cesamet) and dronabinol (Marinol or Syndros), that are FDA-approved to treat nausea and vomiting related to chemotherapy. These medications are made in a laboratory.
Studies to answer this question are underway. Some scientists are studying whether CBD could relieve some of the side effects of cancer and its treatment, such as pain, insomnia, anxiety, or nausea. Other scientists are studying whether CBD could potentially slow or stop the growth of cancer.
You may also be wondering if CBD is legal in your area. Some states allow the sale and possession of cannabis, including CBD and THC, for medical and recreational use. Others have stricter regulations, so state-by-state laws should always be learned before transporting CBD across state lines. Things are more complicated at the federal level. In 2018, the U.S. government recognized that hemp can be grown and manufactured legally as part of the Farm Act. Hemp can be used to make things like rope and clothing, in addition to CBD oil. In other words, hemp is no longer a controlled substance, which means it is not regulated by the government. This means that consumers have to evaluate the safety and quality of CBD products on their own. Some CBD, for example, may have much higher levels of THC than what is labeled.
Can CBD help people with cancer?
There have been some studies that show that CBD, alone or together with THC, may relieve pain, insomnia, or anxiety, but these studies were not specific to people with cancer. While no studies to date have shown that CBD eases these side effects specifically in people with cancer or people receiving cancer treatment, some people with cancer have reported benefits in taking CBD, such as helping with nausea, vomiting, depression, and other side effects. According to ASCO guidelines, your doctor may consider prescribing cannabinoids for chronic pain management if you live in a state where it is legal. However, ASCO guidelines state that there is not enough evidence to support the use of cannabinoids for preventing nausea and vomiting in people with cancer receiving radiation therapy or chemotherapy.
Yet there’s very little research around CBD and its use in treating people with cancer. Here’s what to know about what CBD is and what science currently shows about whether it’s safe and effective for people with cancer to use.
You may find stories online of people discussing the benefits of CBD as a cancer treatment or as relief for side effects. Please remember that such personal stories, while they may be well-meaning, are shared without scientific study and do not constitute evidence. The safety and efficacy of CBD for people with cancer still has to be proven in large, randomized, controlled clinical trials.
CBD comes from cannabis plants called hemp that are specifically grown with high levels of CBD and low levels of THC. Cannabis plants grown with high levels of THC are usually called marijuana. CBD comes from oil that is extracted from the cannabis plant. That oil can then be ingested as a liquid, a capsule, a gummy, or inhaled through vaping. It can also be added as an ingredient in such products as lotions and skin patches.