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Cannabis in Oncology and Symptom Management

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Cannabis in Medicine

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Abstract

Marijuana has been used for medicinal purposes for over 5000 years. Shen Nung in the “Great Herbal” (2737 BC) described the drug as a liberator of sin and delight giver. Majority of controlled clinical trials supporting the medical use of cannabis/marijuana have been conducted with purified cannabinoids or single extract of Cannabis sativa (equimolecular proportion of Delta9-THC and CBD). At this time in the United States, the FDA has approved three cannabinoid medications for medicinal purposes (however, not for pain) including dronabinol, cannabidiol, and nabilone. The European Medicines Agency and Health Canada have similarly approved those approved by the FDA in addition to nabiximols. Cannabis is currently available for medicinal use in 33 States in America and for non-medicinal use in 10 states, although both remain illegal under federal law. In Canada, cannabis was legalized for non-medicinal use as of 2018. Crude cannabis is by far the most frequent source of cannabinoids for patients worldwide, few studies examine the therapeutic value of cannabis oils (for ingestion or topical use), or vaporized herbal cannabis. Cannabis affects the brain through interaction with the endogenous cannabinoid system inclusive of cannabinoid receptors and endogenous ligands. Acute intoxication with cannabis results in marked changes in mentation and impairs cognition. The acute effects on behavior, mood and cognition are biphasic and dose-dependent. Controversy remains regarding persistent effects of cannabis following cessation in domains of behavior, cognition, brain, and brain function.

Over half of all cancer patients will succumb to severe, uncontrollable pain during the course of their disease. Over 90% of cancer patients are familiar with cannabis, and a third of these patients have considered using cannabis for their own health issue with pain being the leading cause. Discordance among governing regulatory bodies and medical communities regarding the use of cannabis as well as its associated negative stigma as an illegal substance has driven patients (both cancer and non-cancer patients alike) to be tight-lipped about cannabis use. With this chapter we aim to address areas of understanding in the use of cannabis and cannabinoids in the cancer population.

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  1. Department of Pain Medicine, Division of Anesthesia, Critical Care and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Matthew Chung & Salahadin Abdi

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Chung, M., Abdi, S. (2020). Cannabis in Oncology and Symptom Management. In: Finn, K. (eds) Cannabis in Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-45968-0_12

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  • DOI: https://doi.org/10.1007/978-3-030-45968-0_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-45967-3

  • Online ISBN: 978-3-030-45968-0

  • eBook Packages: MedicineMedicine (R0)

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