Cancer remains one of the most challenging diseases to treat, often accompanied by debilitating symptoms and side effects from conventional treatments like chemotherapy and radiation therapy. In recent years, medical marijuana has emerged as a potential adjunct therapy for cancer patients, offering relief from symptoms such as pain, nausea, and loss of appetite. However, navigating the landscape of medical marijuana for cancer care requires a thorough understanding of its proven benefits and limitations. Let’s explore the evidence-based insights into the role of medical marijuana in cancer care and treatment.
Pain Management for Cancer Care
Chronic pain is a common and distressing symptom experienced by cancer patients, resulting from tumor growth, nerve damage, or treatment-related side effects. Medical marijuana, particularly formulations containing THC, has demonstrated efficacy in alleviating cancer-related pain. By activating cannabinoid receptors in the central nervous system, THC modulates pain perception pathways, providing relief for patients who may not respond adequately to traditional pain medications.
Further, pain perception is a complex experience that encompasses not only perception of painful stimuli, but also cognitive and emotional responses to those stimuli. THC, acting on Pre-frontal Cortex, Amygdala and Hippocampus in the brain alters those higher-order responses to diminish the “anguish” that pain creates.
Nausea and Vomiting
Chemotherapy-induced nausea and vomiting (CINV) is among the most distressing side effects of cancer treatment, significantly impacting patients’ quality of life. Medical marijuana, specifically THC, has been shown to effectively reduce CINV, particularly in cases where conventional antiemetic medications provide inadequate relief. Often various conventional anti-nausea medications can be used alongside cannabis for best results in cancer care.
By activating cannabinoid receptors in the Hypothalamus, THC regulates neurotransmitter release, thereby mitigating nausea and vomiting associated with chemotherapy.
Appetite Stimulation
Difficulty eating, also known as anorexia (and not to be confused with Anorexia Nervosa) is a common problem for cancer patients. Sometimes caused by the cancer and other times caused by the treatment of the cancer, loss of weight can diminish wellness, impede the cancer treatment, and diminish quality of life. Severe cases known as cancer cachexia (also called wasting syndrome), characterized by involuntary weight loss, muscle degradation, and loss of appetite, is a common complication in advanced cancer patients.
Medical marijuana, through its appetite-stimulating effects, can help improve nutritional intake and quality of life in cancer patients. THC’s activation of cannabinoid receptors in the brain’s appetite-regulating centers increases hunger and food consumption, addressing the metabolic imbalances associated with cancer cachexia.
Sleep Disturbances
Cancer patients often experience sleep disturbances due to factors such as pain, anxiety, and treatment-related side effects. Medical marijuana, particularly strains with higher THC content, has shown promise in improving sleep quality and duration. THC’s sedative properties help alleviate anxiety and promote relaxation, facilitating better sleep patterns in cancer patients undergoing treatment.
Insomnia falls into 3 types: trouble getting to sleep, trouble staying asleep, and both. The approach to insomnia will vary depending on the type. To get effective results, the approach is not simply based on the preferences of the user.
It is interesting that older studies demonstrated that cannabis can disrupt sleep, particularly the all-important REM stage. These studies, typically done in recreational users, were required by law and policy to avoid any interaction with the administration of cannabis. Subjects would use whatever and however much cannabis they wanted prior to the sleep study. As a result, doses much higher than would typically be used for therapeutic purposes were likely used, skewing the results. More recent studies that monitor dose show no such suppression of REM.
Mood and Anxiety
The psychological impact of a cancer diagnosis and treatment can manifest as anxiety, depression, and mood disturbances in patients. Medical marijuana, especially formulations containing THC, has demonstrated anti-anxiety (anxiolytic) and antidepressant effects, offering relief from psychological distress. By modulating neurotransmitter systems involved in mood regulation, THC helps mitigate anxiety and improve overall well-being in cancer patients.
However, evidence suggests that cannabis, while effective, is just not as effective as modern conventional medications such as SSRIs and SNRIs. Nonetheless, cannabis can be a useful addition for further benefit and also to address some of the side effects of these conventional medications.
One thing that is clear from the large body of research is that using excessive cannabis, particularly during the day time, can backfire causing increased anxiety and depression. Dose and timing of cannabis administration becomes critical to successful treatment in cancer care.
Many self-treating users who believe that they are self-treating anxiety and depression use excessive amounts throughout the day. As a result they get caught in a vicious cycle of use leading to worsening symptoms leading to more self-treatment leading to further worsening. Attention to dose and timing can avoid this situation.
Palliative Care for Cancer Care
In advanced stages of cancer, where curative treatment options may no longer be feasible, medical marijuana plays a vital role in palliative care. By addressing symptoms such as pain, nausea, and appetite loss, medical marijuana enhances patients’ comfort and quality of life during the end-of-life stage. Moreover, its relatively favorable safety profile makes it a valuable adjunct therapy in palliative care settings.
Hospice, which are organization dedicated to treating patients with the goal of enhanced quality of life (over length of life), are slowly coming around to the use of cannabis in their patients. Unfortunately, they still face insurance and legal obstacles. Choice of hospice organization becomes critical to whether the benefits of cannabis can be continued once they get involved.
Potential Anti-Tumor Effects
While preclinical studies suggest that certain cannabinoids may possess anti-tumor properties, clinical evidence supporting the use of medical marijuana as a standalone treatment for cancer is limited. While medical marijuana may complement conventional cancer therapies by alleviating symptoms and improving quality of life, further research is needed to elucidate its potential anti-cancer effects and optimize treatment strategies.
Advice for Those with Cancer
Cannabis offers tangible benefits in alleviating symptoms and improving quality of life for cancer patients. From pain management and nausea relief to appetite stimulation and palliative care, the evidence supporting the use of medical marijuana in cancer treatment is robust. However, as with all medications, there are risks and best-practices so it’s essential to approach its use judiciously. Healthcare is not a time to DIY, especially in relation to cancer.
Individual patient factors including other illnesses, potential drug interactions, and social considerations require the guidance of a knowledgeable and caring physician. A cannabinoid specialist physician, such as myself, can be instrumental in getting the best and safest results and properly integrating cannabis-care with the care you receive from the rest of your treating team.
Consult with a Qualified Boston Medical Marijuana Expert Today
Those considering using THC, CBD, or any type of medicine found in cannabis to help manage their condition should consider speaking to a trained medical expert who is knowledgeable about using cannabis therapeutically. Massachusetts medical marijuana doctor Jordan Tishler, M.D. sits on the faculty of Harvard Medical School and has years of experience helping patients treat pain and other ailments using cannabis. He and the team at InhaleMD stand ready to assist patients in determining whether medical marijuana is right for them.
For more information, or to set up a virtual consultation with the team at InhaleMD, call us at (617) 477-8886 today.