Routes of administration, reasons for use, and approved indications of medical cannabis in oncology: a scoping review

Abstract

Introduction Some patients diagnosed with cancer use medical cannabis to self-manage undesirable symptoms, including nausea and pain. To improve patient safety and oncological care quality, the routes of administration for use of medical cannabis, patients’ reasons, and prescribed indications must be better understood. Methods Based on the Joanna Briggs Institute guidelines, a scoping review was conducted to map the current evidence regarding the use of medical cannabis in oncological settings based on the experiences of patients diagnosed with cancer and their healthcare providers. A search strategy was developed with a scientific librarian which included five databases (CINAHL, Web of Science, Medline, Embase, and PsycINFO) and two grey literature sources (Google Scholar and ProQuest). The inclusion criteria were: 1) population: adults aged 18 and over diagnosed with cancer; 2) phenomena of interest: reasons for cannabis use and/or the prescribed indications for medical cannabis; 3) context: oncological setting. French- or English-language primary empirical studies, knowledge syntheses, and grey literature published between 2000 and 2021 were included. Data were extracted by two independent reviewers and subjected to a thematic analysis. A narrative description approach was used to synthesize and present the findings. Results We identified 5,283 publications, of which 163 met the eligibility criteria. Two main reasons for medical cannabis use emerged from the thematic analysis: limiting the impacts of cancer and its side effects; and staying connected to others. Our results also indicated that medical cannabis is mostly used for three approved indications: to manage refractory nausea and vomiting, to complement pain management, and to improve appetite and food intake. We highlighted 11 routes of administration for medical cannabis, with oils and oral solutions the most frequently reported. Conclusion Future studies should consider the multiple routes of administration for medical cannabis, such as inhalation and edibles. Our review highlights that learning opportunities would support the development of healthcare providers’ knowledge and skills in assessing the needs and preferences of patients diagnosed with cancer who use medical cannabis.

Experience With Medical Marijuana for Cancer Patients in the Palliative Setting

“…This dose dependency could also be affected by various forms of medical marijuana administration. Vinette et al discussed the importance of tracking the multiple routes of administration for future studies because of the lack of information in the current literature [ 12 ]. Although medical marijuana dosage is not quantified through research, we found that optimal medical marijuana of 470 mg per product was beneficial.…”

Role of Cannabidiol for Improvement of the Quality of Life in Cancer Patients: Potential and Challenges

“…Interest in the use of CBD to treat cancer is currently high among researchers and clinicians, as indicated by the large number of recently published articles. Several recent reviews of the topic have examined relevant aspects, including the biochemical, pharmacological, and molecular mechanisms of CBD activity in cells [ 4 , 23 ]; CBD’s mechanism-of-action in cell and mouse models of cancer treatment [ 105 , 106 ]; and its clinical use to manage cancer symptoms [ 107 , 108 ]. We have aimed to synthesize this information and identify unmet needs in the field (standard dosing and true randomization, comparison between pure CBD and CBD+THC formulations, and impact of drug combinations on CBD efficacy), which could serve as the focus for future research and, thus, hasten the clinical translation of CBD.…”

Medical cannabis use in oncology and associated outcomes: A scoping review

“…These manifestations can arise from disease progression and the adverse effects of antitumor treatments. [4][5][6][7] In response, patients have increasingly turned to cannabis-derived products to alleviate these symptoms, thereby enhancing their quality of life and facilitating adherence to cancer treatments. 2,6 Notably, cannabinoids prove especially valuable in clinical practice for patients unresponsive to conventional treatments.…”

“…[4][5][6][7] In response, patients have increasingly turned to cannabis-derived products to alleviate these symptoms, thereby enhancing their quality of life and facilitating adherence to cancer treatments. 2,6 Notably, cannabinoids prove especially valuable in clinical practice for patients unresponsive to conventional treatments. 8 Both preclinical and clinical studies have underscored the efficacy of natural and synthetic cannabinoids in managing symptoms such as nausea and vomiting, surpassing the effect of domperidone.…”