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Integrating Cannabis into Clinical Cancer Care

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Cannabis species have been used as medicine for thousands of years; only since the 1940s has the plant not been widely available for medical use. However, an increasing number of jurisdictions are making it possible for patients to obtain the botanical for medicinal use.

For the cancer patient, cannabis has a number of potential benefits, especially in the management of symptoms. Cannabis is useful in combatting anorexia, chemotherapy-induced nausea and vomiting, pain, insomnia, and depression. Cannabis might be less potent than other available antiemetics, but for some patients, it is the only agent that works, and it is the only antiemetic that also increases appetite. Inhaled cannabis is more effective than placebo in ameliorating peripheral neuropathy in a number of conditions, and it could prove useful in chemotherapy-induced neuropathy. A pharmacokinetic interaction study of vaporized cannabis in patients with chronic pain on stable doses of sustained-release opioids demonstrated no clinically significant change in plasma opiates, while suggesting the possibility of synergistic analgesia.

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Aside from symptom management, an increasing body of in vitro and animal-model studies supports a possible direct anticancer effect of cannabinoids by way of a number of different mechanisms involving apoptosis, angiogenesis, and inhibition of metastasis. Despite an absence adequate clinical trials abundant anecdotal reports that describe patients having remarkable responses to cannabis as an anticancer agent, especially when taken as a high-potency orally ingested concentrate, are circulating. Human studies should be conducted to address critical questions related to the foregoing effects.

Furthermore, CBD is known for mitigating chemotherapy side effects, such as nausea, vomiting etc. Therefore, this palliative treatment could improve the overall quality of life for pancreatic cancer patients. In order to understand the benefits of CBD for cancer, we must first clarify what cancer is and how it occurs.

Cancer starts when the body’s cells begin uncontrollably dividing. This leads to tumors, which can cause an array of complications. The symptoms and prognosis depend on the cancer in question. It is also possible for some cancers to spread to other tissues.

Clinically, I have observed that many cancer patients benefit from adding cannabis to their pain regimen. Although the effect on chemotherapy-induced peripheral neuropathy has not been glaringly obvious, other sorts of cancer-related pain appear to respond. Patients who have been put on high doses of opiates at the end of life by their well-meaning oncologist or palliative care team frequently feel totally unable to communicate with their loved ones in their precious remaining time because of altered cognition. Many have successfully weaned themselves down or off their opiate dose by adding cannabis to their regimen. Although it would seem that THC-dominant strains of cannabis would be most likely to have analgesic effects, patients often report significant pain reduction from strains that are predominantly CBD-rich. Although CBD does not actually bind to the cb1 receptor, it does block the fatty-acid binding protein that transports the endocannabinoid intracellularly to be hydrolyzed by the fatty-acid amide hydrolase, hence allowing the endogenous cannabinoid complexed with the receptors to persist

The CBD (Cannabidiol) effect rather amplifies the working of cannabinoid receptors, consequently improving the effectiveness of THC and other cannabinoids. Therefore, patients should use a combined treatment of THC and CBD for best results.

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