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Medical Cannabis in Oncology: a Valuable Unappreciated Remedy or an Undesirable Risk?

  • Palliative and Supportive Care (MP Davis, Section Editor)
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Opinion statement

The use of the cannabis plant by cancer patients has been rising significantly in the past few years worldwide, primarily driven by public demand. There is an obvious need for more reliable scientific data, pharmacology information, a better understanding of its mode of action, and available clinical evidence supporting its robust use. Physicians must complete a thorough medical assessment, screening for potential drugs, or treatment contraindications before allowing its consumption. In light of the growing popularity of cannabis usage, it is highly essential that, in the near future, the medical community will be able to provide practical recommendations and explicit guidelines, including doses, and that cannabinoid concentrations in the used products are defined regarding its prescription before any medical procedure involving its usage is authorized. Here, we review and describe the favorable outcomes demonstrating the benefits of cannabis as an adjunctive treatment to conventional medicines for chemotherapy-induced nausea, vomiting, and cancer-related pain (primarily refractory chronic or neuropathic pain). Although not yet substantial enough, the treatment of anorexia, insomnia, depression, and anxiety is also seemingly favorable. To date, reports regarding its anti-neoplastic effects or its potent immunosuppressive properties influencing response to immunotherapy are still very conflicting and controversial. Thus, with the current state of evidence, cannabis use is not advisable as initial treatment, as an adjunct or an advanced line of care. In the coming years, we expect that preclinical data and animal models will shift to the clinical arena, and more patients will be recruited for clinical trials, and their reports will advance the field. Thus, physicians should prescribe cannabis only if careful clarification and consideration is provided together with a follow-up response evaluation.

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Funding

Dr. Idan Cohen is supported by the Israeli Cancer Association (ICA) (Grant number 20200021) and the Israel Ministry of Health, together with Prof. Gil Bar-Sela (Grant number 3000015198).

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  1. Cancer Center, Emek Medical Center, 21 Yitzhak Rabin Blvd, 1834111, Afula, Israel

    Mahmoud Abu-Amna MD, Talal Salti MSc, Mona Khoury MSc, Idan Cohen PhD & Gil Bar-Sela MD

  2. Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 320002, Haifa, Israel

    Talal Salti MSc, Mona Khoury MSc & Gil Bar-Sela MD

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  1. Mahmoud Abu-Amna MD
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Gil Bar-Sela declares no conflict of interest. Mahmoud Abu-Amna declares no conflict of interest. Talal Salti declares no conflict of interest. Mona Khoury declares no conflict of interest. Idan Cohen declares no conflict of interest.

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Abu-Amna, M., Salti, T., Khoury, M. et al. Medical Cannabis in Oncology: a Valuable Unappreciated Remedy or an Undesirable Risk?. Curr. Treat. Options in Oncol. 22, 16 (2021). https://doi.org/10.1007/s11864-020-00811-2

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