Cannabis: Coping with Cancer Symptoms, Addressing US Opioid Epidemic

The use of cannabis may be safe and effective palliative treatment for patients with cancer, according to large scientific study results published in the European Journal of Internal Medicine.

For the first time, a study conducted at Tikun Olam clinics in Israel showed that 95.9 percent of respondents reported an improvement in their cancer-related symptoms such as sleep problems, pain, nausea and decreased appetite.

“Treatment with medical cannabis is increasingly commonplace and rates of clinical use have increased in many countries,” lead author Lihi Bar-Lev Schleider, research manager at Tikun-Olam - the first and largest medical cannabis supplier in Israel — said in an interview with CURE.

“The vast use of cannabis in the medical field is mainly driven by the subjective feeling of the patients and their personal evaluation of the impact of cannabis on their condition,” she added. “There is a serious lack of clinical evidence that supports the safety and efficacy of this treatment for specific conditions, for example, cancer patients, a sensitive population that is often characterized with large number of symptoms and polypharmacy.”

The researchers analyzed data from 2,970 patients with cancer treated with medical cannabis between 2015 and 2017 to characterize the epidemiology of those receiving medical cannabis treatment and to describe the safety and efficacy of this therapy as a palliative treatment.

All patients were prescribed one or more of Tikun Olam's proprietary cannabis strains, which were developed to address specific symptoms.

Patients were approximately 60 years old, and majority were women (54.6 percent). Only 26.7 percent of patients reported previously using cannabis. The most frequent malignancies in the trial included breast (20.7 percent), lung (13.6 percent), pancreatic (8.1 percent) and colorectal (7.9 percent) cancers, and 51.2 percent of patients had stage 4 disease.

Patients were typically treated for sleep problems (78.4 percent), pain (77.7 percent; median intensity, 8/10), weakness (72.7 percent), nausea (64.6 percent) and lack of appetite (48.9 percent).

After six months of follow-up, 902 patients (24.9 percent) died and 682 (18.8 percent) stopped treatment. Of the remaining 1,211 patients, 95.9 percent reported an improvement in the condition they were being treated for with the cannabis.

The most improved symptoms were nausea and vomiting (91 percent), sleep disorders (87.5 percent), restlessness (87.5 percent), anxiety and depression (84.2 percent), pruritus (82.1 percent) and headaches (81.4 percent). Of note, only 4.6 percent of patients reported pain intensity of 8/10 after six months of treatment.

“Moreover, as can be expected in this population, less than 20 percent of patients reported good quality of life prior to treatment initiation,” Bar-Lev Schleider said. “Impressively, approximately 70 percent reported good quality of life after six months of treatment.”

Cannabis-associated side effects were reported by 362 patients (30.1 percent of patients who reported at least one side effect), including 96 patients with dizziness (8 percent), 88 with dry mouth (7.3 percent), 43 with increased appetite (3.6 percent), 40 with sleepiness (3.3 percent) and 34 with a psychoactive effect (2.8 percent).

Only 45 patients (3.7 percent) reported no change and four patients (0.3 percent) reported deterioration in their medical condition.

When looking at the big picture, Bar-Lev Schleider and colleagues are hoping these results help to address the opioid epidemic currently going on in the United States.

“In our study, opioids were the most prevalent drug consumed by 344 patients (33.9 percent) at intake, 36 percent of them stopped taking opioids (and) 9.9 percent decreased dose,” she explained.

Most importantly, Bar-Lev Schleider noted, the treatment option appeared to be well-tolerated, safe and effective in helping patients with cancer copy with their associated disease symptoms.

“In an age where a physician often prescribes a different medication for each symptom, cannabis, as a comprehensive treatment that affects several symptoms, should be considered as desirable therapeutic option,” she added.