There are different types of oil made from parts of the cannabis plant. Some are sold legally in health food stores as a food supplement. Other types of oil are illegal.
Clinical trials need to be done in large numbers where some patients have the drug and some don’t. Then you can compare how well the treatment works.
CBD oil, cannabis oil and hemp oil
This means a cannabis based product used to relieve symptoms.
CBD oil comes as a liquid or in capsules.
Anorexia, early satiety, weight loss, and cachexia are problems experienced by cancer patients. Such patients are faced not only with the disfigurement associated with wasting but also with an inability to engage in the social interaction of meals.
Added text about a retrospective analysis that examined the effect of Cannabis on chemotherapy-induced peripheral neuropathy in Israeli cancer patients who received oxaliplatin-based regimens for gastrointestinal malignancies (cited Waissengrin et al. as reference 68 and level of evidence 2Diii).
Although few relevant surveys of practice patterns exist, it appears that physicians caring for cancer patients in the United States who recommend medicinal Cannabis do so predominantly for symptom management. A growing number of pediatric patients are seeking symptom relief with Cannabis or cannabinoid treatment, although studies are limited. The American Academy of Pediatrics has not endorsed Cannabis and cannabinoid use because of concerns about brain development.
Anxiety and Sleep
Another study examined the effects of a plant extract with controlled cannabinoid content in an oromucosal spray. In a multicenter, double-blind, placebo-controlled study, the THC:CBD nabiximols extract and THC extract alone were compared in the analgesic management of patients with advanced cancer and with moderate-to-severe cancer-related pain. Patients were assigned to one of three treatment groups: THC:CBD extract, THC extract, or placebo. The researchers concluded that the THC:CBD extract was efficacious for pain relief in advanced cancer patients whose pain was not fully relieved by strong opioids. In a randomized, placebo-controlled, graded-dose trial, opioid-treated cancer patients with poorly controlled chronic pain demonstrated significantly better control of pain and sleep disruption with THC:CBD oromucosal spray at lower doses (1–4 and 6–10 sprays/d), compared with placebo. Adverse events were dose related, with only the high-dose group (11–16 sprays/d) comparing unfavorably with the placebo arm. These studies provide promising evidence of an adjuvant analgesic effect of THC:CBD in this opioid-refractory patient population and may provide an opportunity to address this significant clinical challenge. An open-label extension study of 43 patients who had participated in the randomized trial found that some patients continued to obtain relief of their cancer-related pain with long-term use of the THC:CBD oromucosal spray without increasing their dose of the spray or the dose of their other analgesics.
Three trials have evaluated the efficacy of inhaled Cannabis in chemotherapy-induced N/V.[43-46] In two of the studies, inhaled Cannabis was made available only after dronabinol failure. In the first trial, no antiemetic effect was achieved with marijuana in patients receiving cyclophosphamide or doxorubicin, but in the second trial, a statistically significant superior antiemetic effect of inhaled Cannabis versus placebo was found among patients receiving high-dose methotrexate. The third trial was a randomized, double-blind, placebo-controlled, crossover trial involving 20 adults in which both inhaled marijuana and oral THC were evaluated. One-quarter of the patients reported a favorable antiemetic response to the cannabinoid therapies. This latter study was reported in abstract form in 1984. A full report, detailing the methods and outcomes apparently has not been published, which limits a thorough interpretation of the significance of these findings.
Data from 2,970 Israeli cancer patients who used government-issued Cannabis were collected over a 6-month period to assess for improvement in baseline symptoms. The most improved symptoms from baseline include the following:
An Israeli retrospective observational study assessed the impact of Cannabis use during nivolumab immunotherapy. One hundred forty patients with advanced melanoma, non-small cell lung cancer, and renal cell carcinoma received the checkpoint inhibitor nivolumab (89 patients received nivolumab alone and 51 patients received nivolumab plus Cannabis). In a multivariate model, Cannabis was the only significant factor that reduced the response rate to immunotherapy (37.5% in patients who received nivolumab alone compared with 15.9% in patients who received nivolumab plus Cannabis [odds ratio, 3.13; 95% confidence interval, 1.24–8.1; P = .016]). There was no difference in progression-free survival or overall survival. A subsequent prospective observational study from the same investigators followed 102 patients with metastatic cancers initiating immunotherapy.[Level of evidence: 2Dii] Sixty-eight patients received immunotherapy alone while 34 patients used Cannabis during immunotherapy. Over half of the patients in each group had stage IV non-small cell lung cancer. Cannabis users were less likely to receive immunotherapy as a first-line intervention (24%) compared with nonusers (46%) (P = .03). Cannabis users showed a significantly lower percentage of clinical benefit (39% of Cannabis users with complete or partial responses or stable disease compared with 59% of nonusers [P = .035]). In this analysis, the median time to tumor progression was 3.4 months in Cannabis users compared with 13.1 months in nonusers and the overall survival was 6.4 months in Cannabis users compared with 28.5 months in nonusers. The investigators also noted that Cannabis users reported a lower rate of overall treatment-related adverse experiences compared with nonusers, with fewer immune-related adverse events (P = .057). The investigators postulated that this finding may be related to the possible immunosuppressive effects of Cannabis and concluded that Cannabis consumption should be carefully considered in patients with advanced malignancies who are treated with immunotherapy.
Cannabinoids have been shown to reduce symptoms of secretory diarrhoea, particularly Δ9-THC. It does so by agonising the CB1-receptors in the GI tract and thereby assisting in the regulation of intestinal motility and secretions.
Diarrhoea can be a side-effect of chemotherapy and radiotherapy, and may also be a direct symptom of several cancers, including lymphoma, colon cancer, pancreatic cancer, medullary carcinoma of the thyroid, and neuroendocrine cancers.
2. Appetite stimulation by cannabis
Depression in cancer patients is one of the most overlooked symptoms, but can be severely detrimental to quality of life, and is experienced by the majority of sufferers. If untreated, depression can lead to a range of complications that can work together to effectively make the patient even more ill. For example, the appetite loss associated with chemotherapy can be significantly increased in depressed patients.
It is believed that certain genetic variations in the expression of CB1-receptors render some individuals more susceptible to the mood-elevating effects of cannabis.
Much is being made of the potential of cannabis to cure cancer, but the scientific community is far from reaching consensus on this. Although the medical community is more certain about cannabis’ ability to manage side-effects related to cancer therapy, there is controversy about whether cannabis can or cannot reduce tumour size. Here, we look at the ways in which cannabis may help.