Cannabinoids in Oncology

Date: 03.05.2019

''In oncology, cannabinoid-based medications are used for alleviation of symptoms of advanced malignant disease, as an addition to standard medication (add-on therapy).''

CervekBlog

Josipina Ana Červek, MD
Oncologist, former head of Palliative department of Institute of Oncology Lj. and recipient of national decoration

Cannabis is one of the oldest and most widely used medications in traditional medicine. It was used millennia ago by civilizations in Asia, The Middle East and also by the ancient Greeks and Romans. Later its usage spread to other parts of the world. What followed was expulsion of cannabis from medicine in the 1940’s. It was classified as a harmful substance without medicinal properties. This begun the systematic stigmatization and repression, all use in medicine and research was stopped.

Now, after multiple decades of prohibition by law, cannabis is making a return to medicinal use. More and more studies show potential healing properties, beneficial in numerous fields of medicine and refute the high probability of addiction. Changes have started in legislation and classification of cannabis, but they are still unjustifiably slow.

Some gradual changes were also made in Slovenia. Now the country has a modern legislation on use of cannabinoids in medicine, which, alongside phytocannabinoids and synthetic cannabinoids, also permits the use of medicinal cannabis. On the other hand, a steady supply of pharmacies and uninterrupted therapy are still not taken care of. The products available on the market include Dronabinol (synthetic THC analogue) and Cannnabidiol (synthetic or extracted from plants), all in the form of oral drops.

In oncology, cannabinoid-based medications are used for alleviation of symptoms of advanced malignant disease, as an addition to standard medication (add-on therapy). They are prescribed to patients with symptoms that are harder to manage, with multiple symptoms, or at unacceptable adverse effects of standard therapy. Cannabinoid-based medications have many specifics: addition of cannabinoids to standard medications in many cases increases the effect of these medications or produces same effect at lower doses of the standard medications, which decreases the adverse effects of those medications (ie. opioids), when choosing the cannabinoid-based medication, we take advantage of positive mutual effect in the form of increased efficacy (entourage effect) and lessening of adverse effects (ie. addition of CBD to THC). The use of the whole plant is thus more effective than the use of individual cannabinoids due to inclusion of the whole palette of its bioactive substances.

As a rule, symptoms of advanced malignant disease appear in bundles and are interdependent. For example, pain is usually accompanied by weight loss, insomnia, depression, cognitive decline and chronic fatigue. Cannabinoids as an addition to analgesic therapy with opioids increase the analgesic effect in chronic, especially neuropathic pain, have a positive effect on neuropsychological symptoms, such as anxiety and insomnia, as well as having an effect on loss of appetite, weight loss, nausea, vomiting and skin itching. Studies have shown that chronic inflammation due to an advanced malignant disease is the cause for most of the symptoms of said disease. By affecting the inflammation, cannabinoids have an important effect the symptoms, additionally, curtailing the inflammatory response can slow down the malignant growth.

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