Skip to main content

Cannabinoid-Based Medicines and Cancer Symptom Management

  • Chapter
  • First Online:
Cannabis and Cannabinoid-Based Medicines in Cancer Care

Abstract

Preclinical studies have indicated that the endocannabinoidome plays a significant role in modulating many physiological functions related to pain, anxiety, sleep, and appetite, among others. Patient surveys and observational studies have shown that cannabis relieves multiple symptoms and increases quality of life in cancer patients. As such, cannabis may be better at alleviating clusters of endocannabinoid-mediated symptoms as opposed to producing a focused effect on a single symptom. This may explain in part the inconsistent findings in clinical trials and warrants further trial design adjustments. Thus, extrapolated data from preclinical research and observational studies does not yet translate to established clinical benefits, and until further data confirms these preliminary findings, the use of cannabis in cancer care should be regarded as a multimodal treatment option in order to increase the likelihood of clinical benefits.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Abuhasira R, Schleider LB-L, Mechoulam R, Novack V. Epidemiological characteristics, safety and efficacy of medical cannabis in the elderly. Eur J Intern Med. 2018;49:44–50. https://doi.org/10.1016/j.ejim.2018.01.019.

  2. Aggarwal SK. Use of cannabinoids in cancer care: palliative care. Curr Oncol. 2016;23:S33–6. https://doi.org/10.3747/co.23.2962.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Aviram J, Lewitus GM, Vysotski Y, Uribayev A, Procaccia S, Cohen I, Leibovici A, Abo-Amna M, Akria L, Goncharov D, Mativ N, Kauffman A, Shai A, Hazan O, Bar-Sela G, Meiri D. Short-term medical cannabis treatment regimens produced beneficial effects among palliative cancer patients. Pharmaceuticals (Basel). 2020;13:E435. https://doi.org/10.3390/ph13120435.

    Article  CAS  Google Scholar 

  4. Aviram J, Pud D, Gershoni T, Schiff-Keren B, Ogintz M, Vulfsons S, Yashar T, Adahan H-M, Brill S, Amital H, Goor-Aryeh I, Robinson D, Green L, Segal R, Fogelman Y, Tsvieli O, Yellin B, Vysotski Y, Morag O, Tashlykov V, Sheinfeld R, Goor R, Meiri D, Eisenberg E. Medical cannabis treatment for chronic pain: outcomes and prediction of response. Eur J Pain. 2021;25:359–74. https://doi.org/10.1002/ejp.1675.

    Article  CAS  PubMed  Google Scholar 

  5. Babson KA, Sottile J, Morabito D. Cannabis, cannabinoids, and sleep: a review of the literature. Curr Psychiatry Rep. 2017;19:23. https://doi.org/10.1007/s11920-017-0775-9.

    Article  PubMed  Google Scholar 

  6. Babalonis S, Lofwall MR, Sloan PA, Nuzzo PA, Fanucchi LC, Walsh SL. Cannabinoid modulation of opioid analgesia and subjective drug effects in healthy humans. Psychopharmacology. https://doi.org/10.1007/s00213-019-05293-1.

  7. Bar-Sela G, Vorobeichik M, Drawsheh S, Omer A, Goldberg V, Muller E. The medical necessity for medicinal cannabis: prospective, observational study evaluating the treatment in cancer patients on supportive or palliative care. Evid Based Complement Alternat Med. 2013;2013:510392. https://doi.org/10.1155/2013/510392.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Bar-Sela G, Zalman D, Semenysty V, Ballan E. The effects of dosage-controlled cannabis capsules on cancer-related cachexia and anorexia syndrome in advanced cancer patients: pilot study. Integr Cancer Ther. 2019;18:1534735419881498. https://doi.org/10.1177/1534735419881498.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Beal JE, Olson R, Laubenstein L, Morales JO, Bellman P, Yangco B, Lefkowitz L, Plasse TF, Shepard KV. Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS. J Pain Symptom Manag. 1995;10:89–97. https://doi.org/10.1016/0885-3924(94)00117-4.

    Article  CAS  Google Scholar 

  10. Beaulieu P, Boulanger A, Desroches J, Clark AJ. Medical cannabis: considerations for the anesthesiologist and pain physician. Can J Anaesth. 2016;63:608–24. https://doi.org/10.1007/s12630-016-0598-x.

    Article  PubMed  Google Scholar 

  11. Black N, Stockings E, Campbell G, Tran LT, Zagic D, Hall WD, Farrell M, Degenhardt L. Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysis. Lancet Psychiatry. 2019; https://doi.org/10.1016/S2215-0366(19)30401-8.

  12. Bloechl-Daum B, Deuson RR, Mavros P, Hansen M, Herrstedt J. Delayed nausea and vomiting continue to reduce patients’ quality of life after highly and moderately emetogenic chemotherapy despite antiemetic treatment. J Clin Oncol. 2006;24:4472–8. https://doi.org/10.1200/JCO.2006.05.6382.

    Article  CAS  PubMed  Google Scholar 

  13. Boland EG, Bennett MI, Allgar V, Boland JW. Cannabinoids for adult cancer-related pain: systematic review and meta-analysis. BMJ Support Palliat Care. 2020;10:14–24. https://doi.org/10.1136/bmjspcare-2019-002032.

    Article  PubMed  Google Scholar 

  14. Bonini SA, Premoli M, Tambaro S, Kumar A, Maccarinelli G, Memo M, Mastinu A. Cannabis sativa: a comprehensive ethnopharmacological review of a medicinal plant with a long history. J Ethnopharmacol. 2018;227:300–15. https://doi.org/10.1016/j.jep.2018.09.004.

    Article  CAS  PubMed  Google Scholar 

  15. Bonnie RJ. The marijuana conviction: a history of marijuana prohibition in the United States. Lindesmith Center; 1974.

    Google Scholar 

  16. Camacho-Rivera M, Islam JY, Rodriguez DL, Vidot DC. Cannabis use among cancer survivors amid the COVID-19 pandemic: results from the COVID-19 cannabis health study. Cancers (Basel). 2021;13:3495. https://doi.org/10.3390/cancers13143495.

    Article  CAS  Google Scholar 

  17. Carley DW, Prasad B, Reid KJ, Malkani R, Attarian H, Abbott SM, Vern B, Xie H, Yuan C, Zee PC. Pharmacotherapy of apnea by cannabimimetic enhancement, the PACE clinical trial: effects of dronabinol in obstructive sleep apnea. Sleep. 2017;41:zsx184. https://doi.org/10.1093/sleep/zsx184.

    Article  PubMed Central  Google Scholar 

  18. Carley DW, Radulovacki M. Pharmacology of vagal afferent influences on disordered breathing during sleep. Respir Physiol Neurobiol. 2008;164:197–203. https://doi.org/10.1016/j.resp.2008.06.021.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Carver AC, Foley KM. Therapeutic approaches to cancer pain. In: Holland-Frei cancer medicine. 6th ed. BC Decker; 2003.

    Google Scholar 

  20. Cherny N. Oxford textbook of palliative medicine, Oxford textbook of palliative medicine. Oxford University Press; 2015.

    Book  Google Scholar 

  21. Chiu L, Chow R, DeAngelis C, Lock M, Simone CB. Secondary and cumulative meta-analysis of olanzapine for antiemetic prophylaxis for chemotherapy-induced nausea and vomiting: do we still need to study its effectiveness? Ann Palliat Med. 2021;10:2540–7. https://doi.org/10.21037/apm-20-1462.

    Article  PubMed  Google Scholar 

  22. Chiu L, Chow R, Popovic M, Navari RM, Shumway NM, Chiu N, Lam H, Milakovic M, Pasetka M, Vuong S, Chow E, DeAngelis C. Efficacy of olanzapine for the prophylaxis and rescue of chemotherapy-induced nausea and vomiting (CINV): a systematic review and meta-analysis. Support Care Cancer. 2016;24:2381–92. https://doi.org/10.1007/s00520-016-3075-8.

    Article  PubMed  Google Scholar 

  23. Chow R, Herrstedt J, Aapro M, Chiu L, Lam H, Prsic E, Lock M, DeAngelis C, Navari RM. Olanzapine for the prophylaxis and rescue of chemotherapy-induced nausea and vomiting: a systematic review, meta-analysis, cumulative meta-analysis and fragility assessment of the literature. Support Care Cancer. 2021:1–21. https://doi.org/10.1007/s00520-020-05935-7.

  24. Cooper ZD, Bedi G, Ramesh D, Balter R, Comer SD, Haney M. Impact of co-administration of oxycodone and smoked cannabis on analgesia and abuse liability. Neuropsychopharmacology. 2018;43:2046–55. https://doi.org/10.1038/s41386-018-0011-2.

  25. Cousins MM, Jannausch ML, Coughlin LN, Jagsi R, Ilgen MA. Prevalence of cannabis use among individuals with a history of cancer in the United States. Cancer. 2021; https://doi.org/10.1002/cncr.33646.

  26. Curto-Reyes V, Llames S, Hidalgo A, Menéndez L, Baamonde A. Spinal and peripheral analgesic effects of the CB2 cannabinoid receptor agonist AM1241 in two models of bone cancer-induced pain. Br J Pharmacol. 2010;160:561–73. https://doi.org/10.1111/j.1476-5381.2009.00629.x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Cyr C, Arboleda MF, Aggarwal SK, Balneaves LG, Daeninck P, Néron A, Prosk E, Vigano A. Cannabis in palliative care: current challenges and practical recommendations. Ann Palliat Med. 2018;7:463–77. https://doi.org/10.21037/apm.2018.06.04.

    Article  PubMed  Google Scholar 

  28. Dunn KE, Bergeria CL, Huhn AS, Speed TJ, Mun CJ, Vandrey R, Campbell CM. Within-subject, double-blinded, randomized, and placebo-controlled evaluation of the combined effects of the cannabinoid dronabinol and the opioid hydromorphone in a human laboratory pain model. Neuropsychopharmacology. 2021;46:1451–9. https://doi.org/10.1038/s41386-021-01007-4.

  29. Duran M, Pérez E, Abanades S, Vidal X, Saura C, Majem M, Arriola E, Rabanal M, Pastor A, Farré M, Rams N, Laporte J-R, Capellà D. Preliminary efficacy and safety of an oromucosal standardized cannabis extract in chemotherapy-induced nausea and vomiting. Br J Clin Pharmacol. 2010a;70:656–63. https://doi.org/10.1111/j.1365-2125.2010.03743.x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Dzierżanowski T. Prospects for the use of cannabinoids in oncology and palliative care practice: a review of the evidence. Cancers (Basel). 2019;11:E129. https://doi.org/10.3390/cancers11020129.

    Article  CAS  Google Scholar 

  31. Fallon MT, Albert Lux E, McQuade R, Rossetti S, Sanchez R, Sun W, Wright S, Lichtman AH, Kornyeyeva E. Sativex oromucosal spray as adjunctive therapy in advanced cancer patients with chronic pain unalleviated by optimized opioid therapy: two double-blind, randomized, placebo-controlled phase 3 studies. Br J Pain. 2017;11:119–33. https://doi.org/10.1177/2049463717710042.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Farokhnia M, McDiarmid GR, Newmeyer MN, Munjal V, Abulseoud OA, Huestis MA, Leggio L. Effects of oral, smoked, and vaporized cannabis on endocrine pathways related to appetite and metabolism: a randomized, double-blind, placebo-controlled, human laboratory study. Transl Psychiatry. 2020;10:1–11. https://doi.org/10.1038/s41398-020-0756-3.

    Article  CAS  Google Scholar 

  33. Fisher E, Moore RA, Fogarty AE, Finn DP, Finnerup NB, Gilron I, Haroutounian S, Krane E, Rice ASC, Rowbotham M, Wallace M, Eccleston C. Cannabinoids, cannabis, and cannabis-based medicine for pain management: a systematic review of randomised controlled trials. Pain. 2021;162:S45–66. https://doi.org/10.1097/j.pain.0000000000001929.

    Article  CAS  PubMed  Google Scholar 

  34. Goodman SN, Fanelli D, Ioannidis JPA. What does research reproducibility mean? Sci Transl Med. 2016;8:341ps12.

    Google Scholar 

  35. Good PD, Greer RM, Huggett GE, Hardy JR. An open-label pilot study testing the feasibility of assessing total symptom burden in trials of cannabinoid medications in palliative care. J Palliat Med. 2020;23:650–5. https://doi.org/10.1089/jpm.2019.0540.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Grimison P, Mersiades A, Kirby A, Lintzeris N, Morton R, Haber P, Olver I, Walsh A, McGregor I, Cheung Y, Tognela A, Hahn C, Briscoe K, Aghmesheh M, Fox P, Abdi E, Clarke S, Della-Fiorentina S, Shannon J, Gedye C, Begbie S, Simes J, Stockler M. Oral THC:CBD cannabis extract for refractory chemotherapy-induced nausea and vomiting: a randomised, placebo-controlled, phase II crossover trial. Ann Oncol. 2020;31:1553–60. https://doi.org/10.1016/j.annonc.2020.07.020.

    Article  CAS  PubMed  Google Scholar 

  37. Guerrero AV, Quang P, Dekker N, Jordan RCK, Schmidt BL. Peripheral cannabinoids attenuate carcinoma induced nociception in mice. Neurosci Lett. 2008;433:77–81. https://doi.org/10.1016/j.neulet.2007.12.053.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Haack M, Simpson N, Sethna N, Kaur S, Mullington J. Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications. Neuropsychopharmacology. 2020;45:205–16. https://doi.org/10.1038/s41386-019-0439-z.

    Article  PubMed  Google Scholar 

  39. Hardy J, Haywood A, Gogna G, Martin J, Yates P, Greer R, Good P. Oral medicinal cannabinoids to relieve symptom burden in the palliative care of patients with advanced cancer: a double-blind, placebo-controlled, randomised clinical trial of efficacy and safety of 1:1 delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Trials. 2020;21:611. https://doi.org/10.1186/s13063-020-04541-6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Häuser W, Welsch P, Klose P, Radbruch L, Fitzcharles M-A. Efficacy, tolerability and safety of cannabinoid based medicines for cancer pain: a systematic review with meta-analysis of randomised controlled trials. Schmerz. 2019;33:424–36. https://doi.org/10.1007/s00482-019-0373-3.

    Article  PubMed  Google Scholar 

  41. Hawley P, Gobbo M. Cannabis use in cancer: a survey of the current state at BC cancer before recreational legalization in Canada. Curr Oncol. 2019;26:e425–32. https://doi.org/10.3747/co.26.4743.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Hernandez Torres C, Mazzarello S, Ng T, Dranitsaris G, Hutton B, Smith S, Munro A, Jacobs C, Clemons M. Defining optimal control of chemotherapy-induced nausea and vomiting-based on patients’ experience. Support Care Cancer. 2015;23:3341–59. https://doi.org/10.1007/s00520-015-2801-y.

    Article  PubMed  Google Scholar 

  43. Hesketh PJ, Kris MG, Basch E, Bohlke K, Barbour SY, Clark-Snow RA, Danso MA, Dennis K, Dupuis LL, Dusetzina SB, Eng C, Feyer PC, Jordan K, Noonan K, Sparacio D, Lyman GH. Antiemetics: ASCO guideline update. JCO. 2020;38:2782–97. https://doi.org/10.1200/JCO.20.01296.

    Article  CAS  Google Scholar 

  44. Ioannidis JPA. Why most published research findings are false. PLoS Med. 2005;2(8):e124. https://doi.org/10.1371/journal.pmed.0020124.

  45. Ioannidis JPA. Effect of formal statistical significance on the credibility of observational associations. Am J Epidemiol. 2008;168:374–83.; discussion 384-390. https://doi.org/10.1093/aje/kwn156.

    Article  PubMed  Google Scholar 

  46. Jatoi A, Windschitl HE, Loprinzi CL, Sloan JA, Dakhil SR, Mailliard JA, Pundaleeka S, Kardinal CG, Fitch TR, Krook JE, Novotny PJ, Christensen B. Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a North Central Cancer Treatment Group study. J Clin Oncol. 2002;20:567–73. https://doi.org/10.1200/JCO.2002.20.2.567.

    Article  CAS  PubMed  Google Scholar 

  47. Jiang H, Li X, Zhao Y-X, Ferguson D, Hueber F, Bera S, Wang Y-F, Zhao L-C, Liu C-J, Li C-S. A new insight into Cannabis sativa (Cannabaceae) utilization from 2500-year-old Yanghai Tombs, Xinjiang, China. J Ethnopharmacol. 2007;108:414–22. https://doi.org/10.1016/j.jep.2006.05.034.

    Article  Google Scholar 

  48. Johnson JR, Burnell-Nugent M, Lossignol D, Ganae-Motan ED, Potts R, Fallon MT. Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain. J Pain Symptom Manag. 2010;39:167–79. https://doi.org/10.1016/j.jpainsymman.2009.06.008.

    Article  Google Scholar 

  49. Jordan K, Kasper C, Schmoll H-J. Chemotherapy-induced nausea and vomiting: current and new standards in the antiemetic prophylaxis and treatment. Eur J Cancer. 2005;41:199–205. https://doi.org/10.1016/j.ejca.2004.09.026.

    Article  CAS  PubMed  Google Scholar 

  50. Kesner AJ, Lovinger DM. Cannabinoids, endocannabinoids and sleep. Front Mol Neurosci. 2020;13:125. https://doi.org/10.3389/fnmol.2020.00125.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Kleckner AS, Kleckner IR, Kamen CS, Tejani MA, Janelsins MC, Morrow GR, Peppone LJ. Opportunities for cannabis in supportive care in cancer. Ther Adv Med Oncol. 2019;11:1758835919866362. https://doi.org/10.1177/1758835919866362.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Kuhathasan N, Dufort A, MacKillop J, Gottschalk R, Minuzzi L, Frey BN. The use of cannabinoids for sleep: a critical review on clinical trials. Exp Clin Psychopharmacol. 2019;27:383–401. https://doi.org/10.1037/pha0000285.

    Article  PubMed  Google Scholar 

  53. Lichtman AH, Lux EA, McQuade R, Rossetti S, Sanchez R, Sun W, Wright S, Kornyeyeva E, Fallon MT. Results of a double-blind, randomized, placebo-controlled study of nabiximols oromucosal spray as an adjunctive therapy in advanced cancer patients with chronic uncontrolled pain. J Pain Symptom Manag. 2018;55:179–188.e1. https://doi.org/10.1016/j.jpainsymman.2017.09.001.

    Article  Google Scholar 

  54. Longo R, Oudshoorn A, Befus D. Cannabis for chronic pain: a rapid systematic review of randomized control trials. Pain Manag Nurs. 2021;22:141–9. https://doi.org/10.1016/j.pmn.2020.11.006.

    Article  PubMed  Google Scholar 

  55. Lozano-Ondoua AN, Wright C, Vardanyan A, King T, Largent-Milnes TM, Nelson M, Jimenez-Andrade JM, Mantyh PW, Vanderah TW. A cannabinoid 2 receptor agonist attenuates bone cancer-induced pain and bone loss. Life Sci. 2010;86:646–53. https://doi.org/10.1016/j.lfs.2010.02.014.

    Article  CAS  PubMed  Google Scholar 

  56. Luba R, Earleywine M, Farmer S, Slavin M. Cannabis in end-of-life care: examining attitudes and practices of palliative care providers. J Psychoactive Drugs. 2018;50:348–54. https://doi.org/10.1080/02791072.2018.1462543.

    Article  PubMed  Google Scholar 

  57. Lynch ME, Cesar-Rittenberg P, Hohmann AG. A double-blind, placebo-controlled, crossover pilot trial with extension using an oral mucosal cannabinoid extract for treatment of chemotherapy-induced neuropathic pain. J Pain Symptom Manag. 2014;47:166–73. https://doi.org/10.1016/j.jpainsymman.2013.02.018.

    Article  Google Scholar 

  58. Machado Rocha FC, Stéfano SC, De Cássia Haiek R, Rosa Oliveira LMQ, Da Silveira DX. Therapeutic use of Cannabis sativa on chemotherapy-induced nausea and vomiting among cancer patients: systematic review and meta-analysis. Eur J Cancer Care (Engl). 2008;17:431–43. https://doi.org/10.1111/j.1365-2354.2008.00917.x.

    Article  CAS  Google Scholar 

  59. Maida V. Medical cannabis in the palliation of malignant wounds-a case report. J Pain Symptom Manag. 2017;53:e4–6. https://doi.org/10.1016/j.jpainsymman.2016.09.003.

    Article  Google Scholar 

  60. Maida V, Corban J. Topical medical cannabis: a new treatment for wound pain-three cases of pyoderma gangrenosum. J Pain Symptom Manag. 2017;54:732–6. https://doi.org/10.1016/j.jpainsymman.2017.06.005.

    Article  Google Scholar 

  61. Maida V, Ennis M, Irani S, Corbo M, Dolzhykov M. Adjunctive nabilone in cancer pain and symptom management: a prospective observational study using propensity scoring. J Support Oncol. 2008;6:119–24.

    CAS  PubMed  Google Scholar 

  62. Martell K, Fairchild A, LeGerrier B, Sinha R, Baker S, Liu H, Ghose A, Olivotto IA, Kerba M. Rates of cannabis use in patients with cancer. Curr Oncol. 2018;25:219–25. https://doi.org/10.3747/co.25.3983.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Martin BR, Wiley JL. Mechanism of action of cannabinoids: how it may lead to treatment of cachexia, emesis, and pain. J Support Oncol. 2004;2:305–14; discussion 314-316.

    CAS  PubMed  Google Scholar 

  64. Meiri E, Jhangiani H, Vredenburgh JJ, Barbato LM, Carter FJ, Yang H-M, Baranowski V. Efficacy of dronabinol alone and in combination with ondansetron versus ondansetron alone for delayed chemotherapy-induced nausea and vomiting. Curr Med Res Opin. 2007;23:533–43. https://doi.org/10.1185/030079907x167525.

    Article  CAS  PubMed  Google Scholar 

  65. Mohiuddin M, Blyth FM, Degenhardt L, Di Forti M, Eccleston C, Haroutounian S, Moore A, Rice ASC, Wallace M, Park R, Gilron I. General risks of harm with cannabinoids, cannabis, and cannabis-based medicine possibly relevant to patients receiving these for pain management: an overview of systematic reviews. Pain. 2021;162:S80–96. https://doi.org/10.1097/j.pain.0000000000002000.

    Article  PubMed  Google Scholar 

  66. Montero-Oleas N, Arevalo-Rodriguez I, Nuñez-González S, Viteri-García A, Simancas-Racines D. Therapeutic use of cannabis and cannabinoids: an evidence mapping and appraisal of systematic reviews. BMC Complement Med Ther. 2020;20:12. https://doi.org/10.1186/s12906-019-2803-2.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Monti JM, et al., editors. Cannabinoids and sleep, advances in experimental medicine and biology; 2021. p. 1297. https://doi.org/10.1007/978-3-030-61663-2_1.

    Book  Google Scholar 

  68. Moulin D, Boulanger A, Clark AJ, Clarke H, Dao T, Finley GA, Furlan A, Gilron I, Gordon A, Morley-Forster PK, Sessle BJ, Squire P, Stinson J, Taenzer P, Velly A, Ware MA, Weinberg EL, Williamson OD, Canadian Pain Society. Pharmacological management of chronic neuropathic pain: revised consensus statement from the Canadian Pain Society. Pain Res Manag. 2014;19:328–35. https://doi.org/10.1155/2014/754693.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Mücke M, Carter C, Cuhls H, Prüß M, Radbruch L, Häuser W. Cannabinoids in palliative care: systematic review and meta-analysis of efficacy, tolerability and safety. Schmerz. 2016;30:25–36. https://doi.org/10.1007/s00482-015-0085-2.

    Article  PubMed  Google Scholar 

  70. Mücke M, Phillips T, Radbruch L, Petzke F, Häuser W. Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2018;3:CD012182. https://doi.org/10.1002/14651858.CD012182.pub2.

    Article  PubMed  Google Scholar 

  71. National Academies of Sciences, Engineering, and Medicine. Therapeutic effects of cannabis and cannabinoids. In: The health effects of cannabis and cannabinoids: the current state of evidence and recommendations for research. National Academies Press; 2017.

    Google Scholar 

  72. Nielsen S, Sabioni P, Trigo JM, Ware MA, et al. Opioid-sparing effect of cannabinoids: a systematic review and meta-analysis. Neuropsychopharmacology. 2017;42;1752–65. https://doi.org/10.1038/npp.2017.51.

  73. Pain S. A potted history. Nature. 2015;525:S10–1. https://doi.org/10.1038/525S10a.

    Article  CAS  PubMed  Google Scholar 

  74. Pergam SA, Woodfield MC, Lee CM, Cheng G-S, Baker KK, Marquis SR, Fann JR. Cannabis use among patients at a comprehensive cancer center in a state with legalized medicinal and recreational use. Cancer. 2017;123:4488–97. https://doi.org/10.1002/cncr.30879.

    Article  CAS  PubMed  Google Scholar 

  75. Pertwee R, editor. Handbook of cannabis. Oxford: Oxford University Press; 2014. https://doi.org/10.1093/acprof:oso/9780199662685.001.0001.

    Book  Google Scholar 

  76. Peters EN, Mosesova I, MacNair L, Vandrey R, Land MH, Ware MA, Turcotte C, Bonn-Miller MO. Safety, pharmacokinetics and pharmacodynamics of Spectrum yellow oil in healthy participants. J Analytical Toxicol. 2021a;00:1–15. https://doi.org/10.1093/jat/bkab026.

    Article  Google Scholar 

  77. Peters EN, Mosesova I, MacNair L, Vandrey R, Land MH, Ware MA, Turcotte C, Bonn-Miller MO. Safety, pharmacokinetics and pharmacodynamics of Spectrum Red softgels in healthy participants. Poster P4-17, 31st Annual ICRS Symposium on the Cannabinoids 2021b.

    Google Scholar 

  78. Pisanti S, Bifulco M. Medical cannabis: a plurimillennial history of an evergreen. J Cell Physiol. 2019;234:8342–51. https://doi.org/10.1002/jcp.27725.

    Article  CAS  PubMed  Google Scholar 

  79. Portenoy RK, Ganae-Motan ED, Allende S, Yanagihara R, Shaiova L, Weinstein S, McQuade R, Wright S, Fallon MT. Nabiximols for opioid-treated cancer patients with poorly-controlled chronic pain: a randomized, placebo-controlled, graded-dose trial. J Pain. 2012;13:438–49. https://doi.org/10.1016/j.jpain.2012.01.003.

    Article  CAS  PubMed  Google Scholar 

  80. Pritchard ER, Dayer L, Belz J, Forseth B, Harrington SE, Painter JT. Effect of cannabis on opioid use in patients with cancer receiving palliative care. J Am Pharm Assoc. 2020;60;244e247.

    Google Scholar 

  81. Reuter SE, Martin JH. Pharmacokinetics of cannabis in cancer cachexia-anorexia syndrome. Clin Pharmacokinet. 2016;55:807–12. https://doi.org/10.1007/s40262-015-0363-2.

    Article  CAS  PubMed  Google Scholar 

  82. Roberts CA, Jager G, Christiansen P, Kirkham TC. Exploring the munchies: an online survey of users’ experiences of cannabis effects on appetite and the development of a Cannabinoid Eating Experience Questionnaire. J Psychopharmacol. 2019;33:1149–59. https://doi.org/10.1177/0269881119862526.

    Article  PubMed  Google Scholar 

  83. Rock EM, Limebeer CL, Parker LA. Anticipatory nausea in animal models: a review of potential novel therapeutic treatments. Exp Brain Res. 2014;232:2511–34. https://doi.org/10.1007/s00221-014-3942-9.

    Article  CAS  PubMed  Google Scholar 

  84. Rock EM, Parker LA. Cannabinoids as potential treatment for chemotherapy-induced nausea and vomiting. Front Pharmacol. 2016;7:221. https://doi.org/10.3389/fphar.2016.00221.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  85. Rock EM, Sticht MA, Limebeer CL, Parker LA. Cannabinoid regulation of acute and anticipatory nausea. Cannabis Cannabinoid Res. 2016;1:113–21. https://doi.org/10.1089/can.2016.0006.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  86. Rock EM, Limebeer CL, Pertwee RG, Mechoulam R, Parker LA. Therapeutic potential of cannabidiol, cannabidiolic acid, and cannabidiolic acid methyl ester as treatments for nausea and vomiting. Cannabis Cannabinoid Res. 2021;6(4):266–74. https://doi.org/10.1089/can.2021.0041.

  87. Roeland EJ, Bohlke K, Baracos VE, Bruera E, del Fabbro E, Dixon S, Fallon M, Herrstedt J, Lau H, Platek M, Rugo HS, Schnipper HH, Smith TJ, Tan W, Loprinzi CL. Management of cancer cachexia: ASCO guideline. JCO. 2020;38:2438–53. https://doi.org/10.1200/JCO.20.00611.

    Article  CAS  Google Scholar 

  88. Rukwied R, Watkinson A, McGlone F, Dvorak M. Cannabinoid agonists attenuate capsaicin-induced responses in human skin. Pain. 2003;102:283–8. https://doi.org/10.1016/S0304-3959(02)00401-3.

    Article  CAS  PubMed  Google Scholar 

  89. Salamone JD, McLaughlin PJ, Sink K, Makriyannis A, Parker LA. Cannabinoid CB1 receptor inverse agonists and neutral antagonists: effects on food intake, food-reinforced behavior and food aversions. Physiol Behav. 2007;91:383–8. https://doi.org/10.1016/j.physbeh.2007.04.013.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  90. Sallan SE, Zinberg NE, Frei E. Antiemetic effect of delta-9-tetrahydrocannabinol in patients receiving cancer chemotherapy. N Engl J Med. 1975;293:795–7. https://doi.org/10.1056/NEJM197510162931603.

    Article  CAS  PubMed  Google Scholar 

  91. Schleider LB-L, Mechoulam R, Lederman V, Hilou M, Lencovsky O, Betzalel O, Shbiro L, Novack V. Prospective analysis of safety and efficacy of medical cannabis in large unselected population of patients with cancer. Eur J Intern Med. 2018;49:37–43. https://doi.org/10.1016/j.ejim.2018.01.023.

    Article  Google Scholar 

  92. Schwartzberg LS. Chemotherapy-induced nausea and vomiting: which antiemetic for which therapy? Oncology. 2007;21:946–53; discussion 954, 959, 962 passim.

    PubMed  Google Scholar 

  93. Sharkey KA, Darmani NA, Parker LA. Regulation of nausea and vomiting by cannabinoids and the endocannabinoid system. Eur J Pharmacol. 2014;722 https://doi.org/10.1016/j.ejphar.2013.09.068.

  94. Sihota A, Smith BK, Ahmed S-A, Bell A, Blain A, Clarke H, Cooper ZD, Cyr C, Daeninck P, Deshpande A, Ethans K, Flusk D, Le Foll B, Milloy M-J, Moulin DE, Naidoo V, Ong M, Perez J, Rod K, Sealey R, Sulak D, Walsh Z, O’Connell C. Consensus-based recommendations for titrating cannabinoids and tapering opioids for chronic pain control. Int J Clin Pract. 2021:e13871. https://doi.org/10.1111/ijcp.13871.

  95. Slatkin NE. Cannabinoids in the treatment of chemotherapy-induced nausea and vomiting: beyond prevention of acute emesis. J Support Oncol. 2007;5:1–9.

    CAS  PubMed  Google Scholar 

  96. Smetana GW, Tetrault JM, Hill KP, Burns RB. Should you recommend cannabinoids for this patient with painful neuropathy? Grand rounds discussion from Beth Israel Deaconess Medical Center. Ann Intern Med. 2021;174:237–46. https://doi.org/10.7326/M20-7945.

    Article  PubMed  Google Scholar 

  97. Smith LA, Azariah F, Lavender VT, Stoner NS, Bettiol S. Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy. Cochrane Database Syst Rev. 2015; https://doi.org/10.1002/14651858.CD009464.pub2.

  98. Ständer S, Schmelz M, Metze D, Luger T, Rukwied R. Distribution of cannabinoid receptor 1 (CB1) and 2 (CB2) on sensory nerve fibers and adnexal structures in human skin. J Dermatol Sci. 2005;38:177–88. https://doi.org/10.1016/j.jdermsci.2005.01.007.

    Article  CAS  PubMed  Google Scholar 

  99. Strasser F, Luftner D, Luftner D, Possinger K, Ernst G, Ruhstaller T, Meissner W, Ko Y-D, Schnelle M, Reif M, Cerny T. Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-In-Cachexia-Study-Group. J Clin Oncol. 2006;24:3394–400. https://doi.org/10.1200/JCO.2005.05.1847.

    Article  CAS  PubMed  Google Scholar 

  100. Suraev AS, Marshall NS, Vandrey R, McCartney D, Benson MJ, McGregor IS, Grunstein RR, Hoyos CM. Cannabinoid therapies in the management of sleep disorders: a systematic review of preclinical and clinical studies. Sleep Med Rev. 2020;53:101339. https://doi.org/10.1016/j.smrv.2020.101339.

    Article  PubMed  Google Scholar 

  101. Sznitman SR, Vulfsons S, Meiri D, Weinstein G. Medical cannabis and insomnia in older adults with chronic pain: a cross-sectional study. BMJ Support Palliat Care. 2020a;10:415–20. https://doi.org/10.1136/bmjspcare-2019-001938.

    Article  PubMed  Google Scholar 

  102. Teunissen SCCM, Wesker W, Kruitwagen C, de Haes HCJM, Voest EE, de Graeff A. Symptom prevalence in patients with incurable cancer: a systematic review. J Pain Symptom Manag. 2007;34:94–104. https://doi.org/10.1016/j.jpainsymman.2006.10.015.

    Article  Google Scholar 

  103. Turcott JG, Núñez MD, Flores-Estrada D, Oñate-Ocaña LF, Zatarain-Barrón ZL, Barrón F, Arrieta O. The effect of nabilone on appetite, nutritional status, and quality of life in lung cancer patients: a randomized, double-blind clinical trial. Support Care Cancer. 2018;26:3029–38. https://doi.org/10.1007/s00520-018-4154-9.

    Article  PubMed  Google Scholar 

  104. Volicer L, Stelly M, Morris J, McLaughlin J, Volicer BJ. Effects of dronabinol on anorexia and disturbed behavior in patients with Alzheimer’s disease. Int J Geriatr Psychiatry. 1997;12:913–9.

    Article  CAS  Google Scholar 

  105. Vučković S, Srebro D, Vujović KS, Vučetić Č, Prostran M. Cannabinoids and pain: new insights from old molecules. Front Pharmacol. 2018;9:1259. https://doi.org/10.3389/fphar.2018.01259.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  106. Waissengrin B, Urban D, Leshem Y, Garty M, Wolf I. Patterns of use of medical cannabis among Israeli cancer patients: a single institution experience. J Pain Symptom Manag. 2015;49:223–30. https://doi.org/10.1016/j.jpainsymman.2014.05.018.

    Article  Google Scholar 

  107. Walsh D, Donnelly S, Rybicki L. The symptoms of advanced cancer: relationship to age, gender, and performance status in 1,000 patients. Support Care Cancer. 2000;8:175–9. https://doi.org/10.1007/s005200050281.

    Article  CAS  PubMed  Google Scholar 

  108. Wang J, Wang Y, Tong M, Pan H, Li D. Medical cannabinoids for cancer cachexia: a systematic review and meta-analysis. Biomed Res Int. 2019;2019:e2864384. https://doi.org/10.1155/2019/2864384.

    Article  CAS  Google Scholar 

  109. Ware MA, Daeninck P, Maida V. A review of nabilone in the treatment of chemotherapy-induced nausea and vomiting. Ther Clin Risk Manag. 2008;4:99–107.

    Article  CAS  Google Scholar 

  110. Whiting PF, Wolff RF, Deshpande S, Di Nisio M, Duffy S, Hernandez AV, Keurentjes JC, Lang S, Misso K, Ryder S, Schmidlkofer S, Westwood M, Kleijnen J. Cannabinoids for medical use: a systematic review and meta-analysis. JAMA. 2015;313:2456–73. https://doi.org/10.1001/jama.2015.6358.

    Article  CAS  PubMed  Google Scholar 

  111. Wickham RJ. Nausea and vomiting not related to cancer therapy: intractable problem or clinical challenge? J Adv Pract Oncol. 2020;11:476–88. https://doi.org/10.6004/jadpro.2020.11.5.4.

    Article  PubMed  PubMed Central  Google Scholar 

  112. Yanai T, Iwasa S, Hashimoto H, Ohyanagi F, Takiguchi T, Takeda K, Nakao M, Sakai H, Nakayama T, Minato K, Arai T, Suzuki K, Shimada Y, Nagashima K, Terakado H, Yamamoto N. A double-blind randomized phase II dose-finding study of olanzapine 10 mg or 5 mg for the prophylaxis of emesis induced by highly emetogenic cisplatin-based chemotherapy. Int J Clin Oncol. 2018;23:382–8. https://doi.org/10.1007/s10147-017-1200-4.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Paul Daeninck MD MSc FRCPC .

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Daeninck, P., Rudney, R., Davis, M.P. (2022). Cannabinoid-Based Medicines and Cancer Symptom Management. In: Cannabis and Cannabinoid-Based Medicines in Cancer Care. Springer, Cham. https://doi.org/10.1007/978-3-030-89918-9_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-89918-9_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-89917-2

  • Online ISBN: 978-3-030-89918-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics