Cannabis in Palliative Care: A Systematic Review of Current Evidence

Doppen, Marjan; Kung, Stacey; Maijers, Ingrid; John, Mary; Dunphy, Harriette; Townsley, Hermaleigh; Eathorne, Allie; Semprini, Prof Alex; Braithwaite, Irene

doi:10.1016/j.jpainsymman.2022.06.002

Cited by 19 publications

(12 citation statements)

References 58 publications

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“…QOL, however, tended to be a secondary outcome. 32 QOL was also reported in a 2022 systematic review of THC, THC plus CBD, dronabinol, and nabilone in relation to appetite and weight. 30 The intervention did not improve appetite or weight and had a small, detrimental effect on QOL (standardized mean difference, -0.25 [95% CI, -0.43 to -0.07]).…”

Section: Quality Of Lifementioning

confidence: 92%

“…A total of 366 publications were identified in the literature search. After applying the eligibility criteria, 16 remained: 11 systematic reviews 24,25,[27][28][29][30]32,[37][38][39][40] and five RCTs or cohort studies not captured by the included systematic reviews. 21,26,[41][42][43] After the completion of the literature search, the Multinational Association for Supportive Care in Cancer (MASCC) published two additional cannabis systematic reviews, one on psychological symptoms 33 and one on cancer pain.…”

Section: Characteristics Of Studies Identified In the Literature Searchmentioning

confidence: 99%

“…a None Low weight or poor appetite 30,31 Low for dronabinol, nabilone, THC/CBD extract, THC -a None Quality of life 21,30,32 Low for THC, THC/CBD, dronabinol, nabilone, and CBD…”

Section: Evidence Quality Assessmentmentioning

confidence: 99%

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Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline

Braun,

Bohlke,

Abrams

et al. 2024

JCO

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PURPOSE To guide clinicians, adults with cancer, caregivers, researchers, and oncology institutions on the medical use of cannabis and cannabinoids, including synthetic cannabinoids and herbal cannabis derivatives; single, purified cannabinoids; combinations of cannabis ingredients; and full-spectrum cannabis. METHODS A systematic literature review identified systematic reviews, randomized controlled trials (RCTs), and cohort studies on the efficacy and safety of cannabis and cannabinoids when used by adults with cancer. Outcomes of interest included antineoplastic effects, cancer treatment toxicity, symptoms, and quality of life. PubMed and the Cochrane Library were searched from database inception to January 27, 2023. ASCO convened an Expert Panel to review the evidence and formulate recommendations. RESULTS The evidence base consisted of 13 systematic reviews and five additional primary studies (four RCTs and one cohort study). The certainty of evidence for most outcomes was low or very low. RECOMMENDATIONS Cannabis and/or cannabinoid access and use by adults with cancer has outpaced the science supporting their clinical use. This guideline provides strategies for open, nonjudgmental communication between clinicians and adults with cancer about the use of cannabis and/or cannabinoids. Clinicians should recommend against using cannabis or cannabinoids as a cancer-directed treatment unless within the context of a clinical trial. Cannabis and/or cannabinoids may improve refractory, chemotherapy-induced nausea and vomiting when added to guideline-concordant antiemetic regimens. Whether cannabis and/or cannabinoids can improve other supportive care outcomes remains uncertain. This guideline also highlights the critical need for more cannabis and/or cannabinoid research. Additional information is available at www.asco.org/supportive-care-guidelines .

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Section: Quality Of Lifementioning

confidence: 92%

Section: Characteristics Of Studies Identified In the Literature Searchmentioning

confidence: 99%

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Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline

Braun,

Bohlke,

Abrams

et al. 2024

JCO

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“…Cannabis has already been found to have certain biological activities that could allow it to be used for medicinal purposes. Among the permitted therapeutic potentials, it mentions the ability to regulate sleep disorders [ 8 ], inflammation [ 9 ], neuro-degeneration [ 10 ], pain [ 11 ], nausea [ 12 ], anorexia [ 13 ], diseases of cancer and epilepsy [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Repositioning Cannabinoids and Terpenes as Novel EGFR-TKIs Candidates for Targeted Therapy Against Cancer: A virtual screening model using CADD and biophysical simulations

Daoui¹,

Mali²,

Elkhattabi³

et al. 2023

Heliyon

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“…Patients surveyed at a US comprehensive cancer center reported that cannabis commonly alleviated pain, nausea, stress, and poor appetite, and more than half believed that cannabis helped treat cancer symptoms 5 . A recent systematic review of cancer‐specific outcomes in palliative care concluded that medical cannabis had positive effects on quality of life, pain, nausea/vomiting, sleep, appetite, and fatigue, 15 although the quality of the evidence was considered low. Many questions remain regarding associations of cannabis use with psychological symptoms (e.g., anxiety and depression), 13 cannabis dependence, 16 respiratory symptoms, 17 and cancer.…”

Section: Introductionmentioning

confidence: 99%

Cannabis use among adults undergoing cancer treatment

Azizoddin

Cohn

Ulahannan

et al. 2023

Cancer

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BackgroundLittle is known about the risks and benefits of cannabis use in the context of cancer care. This study characterized the prevalence, reasons for use, and perceived benefits of cannabis and compared symptoms and perceived risks between those who reported past 30‐day cannabis use and those who did not.MethodsAdults undergoing cancer treatment at a National Cancer Institute–designated cancer center completed measures of sociodemographic characteristics, cannabis use, use modalities, reasons for use, perceived harms/benefits of use, physical and psychological symptoms, and other substance/medication use. Analyses compared patients who used or did not use cannabis in the past 30 days.ResultsParticipants (N = 267) were 58 years old on average, primarily female (70%), and predominantly White (88%). Over a quarter of respondents (26%) reported past 30‐day cannabis use, and among those, 4.5% screened positive for cannabis use disorder. Participants who used cannabis most often used edibles (65%) or smoked cannabis (51%), and they were younger and more likely to be male, Black, and disabled, and to have lower income and Medicaid insurance than participants who did not use cannabis. Those who used cannabis reported more severe symptoms and perceived cannabis as less harmful than those who did not use cannabis. The most common medical reasons for cannabis use were pain, cancer, sleep problems, anxiety, nausea/vomiting, and poor appetite. Participants reported the greatest cannabis‐related symptom relief from sleep problems, nausea/vomiting, headaches, pain, muscle spasms, and anxiety.ConclusionsPatients with cancer who used cannabis perceived benefits for many symptoms, although they showed worse overall symptomatology.Plain language summary Among adults undergoing cancer treatment, 26% reported cannabis use in the past 30 days. Those who used cannabis were more likely to be male and disabled and to have lower income and Medicaid insurance than those who did not use cannabis. Participants most commonly reported using cannabis for pain, cancer, sleep, anxiety, and nausea/vomiting and reported the greatest perceived benefits for sleep, nausea/vomiting, headaches, pain, muscle spasms, and anxiety, yet participants who used cannabis also reported feeling worse physically and psychologically compared to those who did not use cannabis. Participants who used cannabis were more likely to report that cannabis was less risky to their health than alcohol, smoking, and opioids than those who did not use cannabis.

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Cannabis in Palliative Care: A Systematic Review of Current Evidence

Cited by 19 publications

References 58 publications

Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline

Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline

Repositioning Cannabinoids and Terpenes as Novel EGFR-TKIs Candidates for Targeted Therapy Against Cancer: A virtual screening model using CADD and biophysical simulations

Cannabis use among adults undergoing cancer treatment

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