Cannabis for Cancer Patients: Nausea, Pain and Quality of Life

One of the most common misconceptions about cannabis and cancer must be addressed right at the start: cannabis does not cure cancer. The claims circulating online that cannabis kills cancer cells or is a cure for cancer are based on preclinical cell culture and animal studies that have so far found no correspondence in controlled clinical trials in humans.

What cannabis can do – and what it is increasingly used for in cancer patients – is relieving symptoms and side effects: nausea, pain, loss of appetite, anxiety and sleep disturbances. In these areas, the evidence is considerably stronger.

## Antiemetic Effect: Cannabis Against Chemotherapy Nausea

Chemotherapy-induced nausea and vomiting (CINV) is one of the most burdensome side effects of cancer therapy. The endocannabinoid system plays an important role in regulating nausea and vomiting, which is why synthetic THC (dronabinol) has been approved for CINV treatment since the 1980s.

Approved cannabis-based medications: - Dronabinol (Marinol, Syndros): Synthetic THC, FDA-approved for CINV since 1985. Prescribable in Germany. - Nabilone (Cesamet): A synthetic THC analogue, also approved for CINV. - Nabiximols (Sativex): A THC/CBD spray, approved in Germany for MS spasticity, also used off-label for cancer pain.

A 2015 Cochrane review analysing 23 studies with over 1,300 patients found: cannabinoids are more effective than placebo and comparable with conventional antiemetics, but with a stronger side effect profile.

## Pain Relief in Cancer Patients

Cancer pain is often a mix of pain types: nociceptive pain from tumour growth, neuropathic pain from nerve damage, and inflammatory pain. Cannabis shows particular strength with neuropathic pain – an area where opioids are often less effective.

An important aspect is that cannabis may reduce opioid requirements (opioid-sparing effect). A 2011 study showed that THC/CBD spray significantly enhanced the pain-reducing effect of opioids and reduced the need for opioid dose increases.

## Appetite Loss and Weight Loss (Cachexia)

THC is known for stimulating appetite ("the munchies") – via CB1 receptors in the hypothalamus. Dronabinol is approved in the USA for anorexia in AIDS patients and used off-label for cancer cachexia.

## What BlattWerk Recommends for Cancer Patients

Seek dialogue with the oncologist; use medical cannabis on prescription for quality assurance and physician guidance; do not believe healing promises – products marketed as cancer cures are disreputable; in the palliative context, cannabis has a clear role in improving quality of life.