Cannabis in Cancer Care: Its Role Is Yet to Be Determined

alternative medicine green leaves of medicinal cannabis with extract oil on a wooden table

Many patients with cancer report that marijuana helped mitigate symptoms such as nausea and pain, but a lack of clinical studies is preventing clinicians and researchers from definitively understanding if and how cannabis can play a role in cancer care, according to Dr. Ali J. Zarrabi.

“I wish we had more elegant research, and I wish that we were able to actually do research with the products that our patients were using… for example, when my patients go to a dispensary and obtain a certain product, I would love to actually be able to test that in my own clinic,” Zarrabi, a physician at the Winship Cancer Institute and assistant professor at the Emory University School of Medicine, said.

For now, Zarrabi and his colleagues are surveying the patients on what kind of cannabis products they are using, and how they are helping manage symptoms. Patients typically report that it helps to decrease nausea, pain and anxiety.

While marijuana may be beneficial in side effect management, there is no evidence that it can actually shrink tumors or treat cancer in any way.

“I find cannabis to be a really extraordinary tool to help many of my patients,” Zarrabi said. “But it’s not magic.”

When patients come to Zarrabi with hopes that marijuana will cure their cancer, the doctor said that he has frank conversations that emphasize the fact that there is no available clinical data that says that this is the case.

Zarrabi hopes that more studies are conducted to better understand marijuana’s place in the world of medicine, including recommended dosing and frequency ratios for THC (the psychoactive compound in marijuana that makes people feel high) and CBD in patients with cancer and what they can expect regarding potential relief for nausea, pain, insomnia and other side effects.

Similar to understanding the benefits of marijuana, research is also needed on the potential harms that it can cause in patients with cancer. There have been reported side effects including increased risk of falling, dry mouth, confusion and paranoia.

“I’ve had quite a few patients who will come, either from YouTube or through friends and family, on frighteningly high doses of THC. They come in presenting with falls and they get referrals to palliative care saying this patient can’t tolerate chemotherapy, and we don’t know why. And we realize that – in my opinion – they’re inappropriately dosing THC as a cancer cure,” Zarrabi said.

Looking ahead, far more work still needs to be done in the field.

“As a community, we need to be much more vocal about identifying harmful use, and also developing scales and risk assessment tools for patients who are encouraged to use cannabis medically,” Zarrabi said. “Because right now, we have no validated tool for (patients with cancer) or really for anyone to assess risks and harms for patients who use cannabis as a therapeutic.”

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