Multinational Association of Supportive Care in Cancer (MASCC) guidelines: cannabis for psychological symptoms including insomnia, anxiety, and depression

Feo, Giulia De; Case, Amy A.; Crawford, Gregory B.; Hui, David; To, Josephine; Sbrana, Andrea; Alderman, Bryony; Mukhopadhyay, Sandip; Bouleuc, Carole; Amano, Koji; Tanco, Kimberson; Garsed, Jessica; Davis, Mellar P.

doi:10.1007/s00520-023-07628-3

Cited by 13 publications

(10 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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. 44 These publications were added to the current review.…”

Section: Characteristics Of Studies Identified In the Literature Searchmentioning

confidence: 99%

“…None or small detrimental effect None Anxiety and depression 33 Very low for THC, THC:CBD, dronabinol, nabilone, nabiximols recommendations, clinicians should explore goals, educate, and seek to minimize harm (Good practice statement).…”

Section: Evidence Quality Assessmentmentioning

confidence: 99%

“…The authors concluded that no recommendation was possible regarding use of cannabis for anxiety or depression. 33 An additional RCT published after the search window of the MASCC review addressed CBD oil versus placebo in patients with advanced cancer. Anxiety was a secondary outcome and did not differ significantly between study arms.…”

Section: Anxiety and Depression A 2023 Mascc Systematic Reviewmentioning

confidence: 99%

“…A 2023 MASCC systematic review assessed cannabis in relation to anxiety, depression, and insomnia. 33 The review noted that none of the included studies addressed psychological symptoms as primary outcomes in adults with cancer. The authors concluded that no recommendation was possible regarding use of cannabis for anxiety or depression.…”

Section: Recommendationsmentioning

confidence: 99%

See 3 more Smart Citations

Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline

Braun,

Bohlke,

Abrams

et al. 2024

JCO

View full text Add to dashboard Cite

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 .

show abstract

Section: Characteristics Of Studies Identified In the Literature Searchmentioning

confidence: 99%

Section: Evidence Quality Assessmentmentioning

confidence: 99%

Section: Anxiety and Depression A 2023 Mascc Systematic Reviewmentioning

confidence: 99%

Section: Recommendationsmentioning

confidence: 99%

See 2 more Smart Citations

Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline

Braun,

Bohlke,

Abrams

et al. 2024

JCO

View full text Add to dashboard Cite

show abstract

“…Given the heterogeneity in data and approaches, it remains difficult to draw robust conclusions despite the popularised effects of cannabis on appetite stimulation. Similarly, for psychological effects (e.g., on sleep, anxiety, depression), MASCC were unable to make any recommendations with most studies investigating these outcomes as secondary analyses with inconsistent data across studies [ 51 ].…”

Section: Medicinal Cannabis Use In Cancer Care: What Is the Evidence?mentioning

confidence: 99%

Supporting gut health with medicinal cannabis in people with advanced cancer: potential benefits and challenges

Wardill,

Wooley,

Bellas

et al. 2023

Br J Cancer

Self Cite

View full text Add to dashboard Cite

The side effects of cancer therapy continue to cause significant health and cost burden to the patient, their friends and family, and governments. A major barrier in the way in which these side effects are managed is the highly siloed mentality that results in a fragmented approach to symptom control. Increasingly, it is appreciated that many symptoms are manifestations of common underlying pathobiology, with changes in the gastrointestinal environment a key driver for many symptom sequelae. Breakdown of the mucosal barrier (mucositis) is a common and early side effect of many anti-cancer agents, known to contribute (in part) to a range of highly burdensome symptoms such as diarrhoea, nausea, vomiting, infection, malnutrition, fatigue, depression, and insomnia. Here, we outline a rationale for how, based on its already documented effects on the gastrointestinal microenvironment, medicinal cannabis could be used to control mucositis and prevent the constellation of symptoms with which it is associated. We will provide a brief update on the current state of evidence on medicinal cannabis in cancer care and outline the potential benefits (and challenges) of using medicinal cannabis during active cancer therapy.

show abstract