engleski

New Insights Into the Potential Use of Medical Cannabis in Cancer Care

Cannabis sativa L. (Cannabaceae) is one of the earliest known medicinal plants. Despite long- standing controversial and limited medical use by unavoidable psychotropic effects, lately it is receiving renewed scientific interest. The last two decades have brought a new evidence of cannabis therapeutic potential, especially in cancer care. Cannabis is a source of over 100 active compounds known as phytocannabinoids whose numerous effects on the human body are primarily exerted through interactions with cannabinoid receptor types 1 (CB1) and 2 (CB2). Delta-9- tetrahydrocannabinol (THC) having psychoactive properties and non-psychotropic cannabidiol (CBD) are the principal plant constituents. The therapeutic value of cannabis and cannabinoid-based medicines has been evaluated in numerous clinical trials, several of them are still ongoing. Obtained results indicated that cannabis, its main components, and their synthetic analogues may have a meaningful clinical impact on several common cancer-related symptoms, including chemotherapy-induced nausea and vomiting, pain, cachexia, and anorexia. Nausea and vomiting are the chemotherapy side effects considered by patients as the most stressful. Cannabis extracts and synthetic THC (dronabinol) added to standard antiemetic therapy were well tolareted and provided better protection against these chemotherapy-induced symptoms. Cancer-related pain is often multidimensional and can affect all aspects of a patient’s life. At this time, data supporting the effectiveness of cannabis and cannabinoids in the treatment of cancer-related pain is limited. However, available studies indicate that the cannabis extract containing THC and CBD may be an effective addition to cancer pain treatment in those who are not optimized by opioid therapy, but the effectiveness varies widely between patients. Great number of cancer patients also suffer from anorexia which can lead to poor chemotherapy response and decreased survival. In contrast to cannabis extracts and THC, synthetic cannabinoids dronabinol and nabilone showed appetite improvement properties. In addition, surveys collected data implicated the potential use of cannabis for palliative indications in oncology as well-tolerated, effective and a safe option to help patients cope with the malignancy related symptoms. In conclusion, the current evidence for the use of cannabis-based medical products in cancer patients is still weak because of clinical trials with small populations, multiple dosage forms and products, and inconsistent results. Given the increased use of cannabis and cannabinoids in oncology patients, it is needed to conduct larger, high quality randomised controlled trials including patients with similar cancer diagnoses and medical conditions to elucidate their efficiency and safety in cancer care.

Cannabis sativa ; cannabinoids ; THC ; CBD ; chemotherapy ; side effects ; cancer-related pain

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