Medicinal cannabis can safely relieve cancer pain - and act as a treatment when conventional drugs fail, according to a new study. Powerful opioids along with other meds, such as anti-inflammatory and anticonvulsant drugs, are usually prescribed for pain relief.
However, despite these treatments, one in three patients still experience pain, including side effects of opioids such as nausea, sleepiness, constipation, and respiratory depression. The issues with common drugs have led researchers to find other options, including three types of medicinal cannabis.
These are THC-dominant, THC and CBD-balanced, and CBD-dominant products. THC and CBD are found in cannabis, but while THC can cause a person to feel high, CBD does not.
While all these treatments were effective, the products with an equal balance of THC and CBD were the most successful. According to the study, over half of patients undergoing anticancer treatment, and two thirds of those with advanced or terminal disease, experience pain.
Researchers studied the treatment responses of 358 adults with cancer over a period of three and a half years from May 2015 to October 2018. The patients had an average age of 57 and 48 per cent were men. The three most common cancers diagnosed were breast, bowel and genitourinary, which includes prostate, kidney, bladder and testicular cancer.
Of the patients, 72.5 per cent suffered from pain, making it the most frequently reported symptom. THC-dominant, THC and CBD-balanced, and CBD-dominant products were authorised in 24.5 per cent, 38 per cent, and 16.5 per cent of patients, respectively.
Patients’ pain intensity, symptoms, total number of drugs taken, and daily morphine consumption were monitored quarterly for one year. Their level of pain was rated on a sliding scale. Zero referred to no pain at all, while those who reported a ten were feeling the worst pain possible.
Patients also reported their pain relief. This was rated on a sliding scale as well, with those feeling no difference reporting zero per cent and those whose pain completely went away reporting 100 per cent. The patients reported back 24 hours after being given the cannabis treatment.
Medicinal cannabis appeared to be safe and well tolerated, with only 15 moderate to severe side effects reported by 11 patients. Of those, 13 were regarded as minor. The two most common side effects were sleepiness, reported by three patients, and fatigue, reported by two.
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Two serious side effects, pneumonia and a cardiovascular event, were deemed unlikely to have been linked to medicinal cannabis.
Only five patients stopped taking the cannabis because of side effects. The total number of drugs taken fell consistently at each quarterly check-up, while opioid use fell over only the first three check-ups.
Study author Dr Antonio Vigano, of McGill University Health Centre in Canada, said: “The particularly good safety profile of medicinal cannabis found in this study can be partly attributed to the close supervision by healthcare professionals who authorised, directed, and monitored [the] treatment.” Of the three cannabis treatments, THC and CBD balanced products were the best at relieving pain.
Dr Vigano added: “Our data suggest a role for [medicinal cannabis] as a safe and complementary treatment option in patients with cancer failing to reach adequate pain relief through conventional analgesics, such as opioids.” He said that as the study, published in the journal BMJ Supportive and Palliative Care, was observational it cannot establish the cause of the pain relief.
