Medical Cannabis Review Articles and Reports on Cancer

Medical Cannabis Review Articles and Reports on Cancer

A Comprehensive Review of Cannabis in Patients with Cancer: Availability in the USA, General Efficacy, and Safety
Steele G, Arneson T, Zylla D. A comprehensive review of cannabis in patients with cancer: Availability in the USA, general efficacy, and safety. Curr Oncol Rep 2019 Feb 1;21(1):10. doi: 10.1007;s11912-019-0757-7.

“Purpose of Review: As the legalization of medical cannabis continues across the USA, oncology care providers will be increasingly asked to provide recommendations regarding its use in the cancer setting. In this article, we review recent literature that analyzes cannabis use specifically in patients with cancer and provide an accessible guide for clinicians, researchers, and patients.”

Oncology clinicians and the Minnesota medical cannabis program: A survey on medical cannabis practoce patterns, barriers to enrollment, and educational needs
Zylla D, Steele G, Eklund J, Mettner J, Arneson T. Cannabis Cannabinoid Research 2018;3:195-202.
Survey of Minnesota physicians, advanced practice registered nurses, and physician assistants who care for patients with cancer. Responses received from 153 of 529 (29% response rate). Most (82%) identified themselves as a medical oncologist or medical oncology nurse practitioner/physician assistant, and most (67%) practiced in a community setting. Overall, 65% supported the use of medical cannabis. Perceived cost and inadequate research were the highest barriers to enrollment in the state’s medical cannabis program. The lowest barriers included lack of health group support for allowing certification of patients and risk of social stigma. Of all respondents, 36% lacked confidence in discussing the risks and benefits of medical cannabis and 85% wanted more education.

The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research
A report published by the U.S. National Academies of Sciences, Engineering, and Medicine.  2017. 
A rigorous review of relevant scientific research published since 1999, summarizing the current state of evidence regarding what is known about the health impacts of cannabis and cannabis-derived products, including effects related to therapeutic uses of cannabis and potential health risks related to certain cancers, diseases, mental health disorders, and injuries.  Sections on evidence of therapeutic effects include: chronic pain, cancer treatment, chemotherapy-induced nausea and vomiting, anorexia and weight loss associated with HIV/AIDS, cancer-associated anorexia-cachexia syndrome, anorexia nervosa, irritable bowel syndrome, epilepsy, spasticity associated with multiple sclerosis or spinal cord injury, Tourette syndrome, amyotrophic lateral sclerosis, Huntington’s disease, Parkinson’s disease, dystonia, dementia, glaucoma, traumatic brain injury/intracerebral hemorrhage, substance addiction, anxiety, depression, sleep disorders, posttraumatic stress disorder, and schizophrenia and other psychoses.  Chapters summarizing evidence of harms include: cancer, cardiometabolic risk, respiratory disease, immunity, injury and death, prenatal/perinatal/neonatal exposure, psychosocial, mental health, cannabis use problems, and abuse of other substances.

A Review of Medical Cannabis Studies relating to Chemical Compositions and Dosages for Qualifying Medical Conditions (PDF)
Office of Medical Cannabis.
Summary of clinical trials and prospective observational studies in humans, published in peer-reviewed journals, which focus on medical cannabis formulations consistent with Minnesota’s medical cannabis program.

Information for Health Care Professionals: Cannabis and the cannabinoids (PDF)
Health Canada. February, 2013.
Endocannabinoid system, clinical pharmacology, dosing, potential therapeutic uses (by condition), precautions, warnings, adverse effects, and overdose/toxicity.

Handbook of Cannabis
Roger G Pertwee, Oxford University Press, 2014. 747 pages.

  • Constituents, History, International Control, Cultivation, and Phenotypes of Cannabis
  • Pharmacology, Pharmacokinetics, Metabolism, and Forensics
  • Medical Cannabis and Cannabinoids: Clinical Data
  • Approved Therapeutic Targets for Phytocannabinoids: Preclinical Pharmacology
  • Some Potential Therapeutic Targets for Phytocannabinoids
  • Recreational Cannabis: Sought-After Effects, Adverse Effects, Designer Drugs, and Harm Minimization

Cannabinoids for Medical Use: A Systematic Review and Meta-analysis
Whiting PF, Wolff RF, Deshpande S, Di Nisio M, et al JAMA 2015;313(24):2456-2473.
Systematic review of the benefits and adverse effects of therapeutic use of cannabinoids.  The study included randomized clinical trials of cannabinoids for the following indications: nausea and vomiting due to chemotherapy, appetite stimulation in HIV/AIDS, chronic pain, spasticity due to multiple sclerosis or paraplegia, depression, anxiety disorder, sleep disorder, psychosis, glaucoma, or Tourette syndrome.

Here is JAMA’s summary of the Whiting article, “In a systematic review, Whiting and colleagues identified 79 randomized trials, involving 6462 participants, that compared cannabinoid use with active comparators or placebo for the treatment of several medical conditions.  The authors found moderate-quality evidence supporting cannabinoid treatment of chronic pain and spasticity due to multiple sclerosis or paraplegia.  Low-quality evidence suggests cannabinoids may lessen nausea and vomiting due to chemotherapy, foster weight gain in patients with HIV infection, and improve symptoms of sleep disorders or Tourette syndrome.  In an Editorial, D’Souza and Ranganathan discuss the need for high-quality evidence to guide decisions about medical marijuana use.” 

Cannabis: The Evidence for Medical Use
Barnes MP, Barnes JC. Report published by Northumberland, Tyne & Wear NHS Foundation Trust, May 2016.
Literature review and discussion of strength of evidence of effectiveness for a wide variety of medical conditions.  This report was commissioned by the All Party Parliamentary Group for Drug Policy Reform (UK).  The authors note they received no renumeration other than a small grand from the APPG for Drug Policy Reform for their work and that they have no commercial interests in cannabis or cannabis products.  The report includes good discussions of the evidence – or lack thereof – for long-term negative effects often ascribed to marijuana use: psychotic disorders, dependence, respiratory system cancer, cognition, amotivational syndrome, and decreased brain volume.

Integrating cannabis into clinical cancer care
Abrams DJ. Current Oncology 2016;23:S8-S14. 
Review article by prominent medical cannabis researcher and oncologist.  This article covers the current literature regarding therapeutic use of cannabis, cannabinoids, and cannabis extract products for relief of pain, nausea and vomiting, and decreased appetite caused by cancer or its treatment.  It also includes a section on pre-clinical evidence that cannabis can have an anticancer effect.

Medical marijuana for cancer
Kramer JL.CA Cancer J Clin. 2015 Mar;65(2):109-22. doi: 10.3322/caac.21260. Epub 2014 Dec 10.
Potential medical uses for marijuana and cannabinoids in cancer, based on systematic literature review. Includes good short sections on cannabinoid receptors and cannabinoids and pharmaceutical forms of cannabinoids.

The Medical Necessity for Medicinal Cannabis: Prospective, Observational Study Evaluating the Treatment in Cancer Patients on Supportive or Palliative Care
Bar-Sela G, Vorobeichik M, Drawsheh S, Omer A, Goldberg V, Muller E. Evid Based Complement Alternat Med 2013;2013:510392. doi: 10.1155/2013/510392 
Observational study of 211 cancer patients from one cancer clinic in Israel who received a license to use medical cannabis. Information was gathered in person on the day the license was granted and by telephone approximately 6-8 weeks later. Of the 211, 106 (50%) patients continued use of cannabis for longer than a week and had a second interview.  24% died before the second interview, 12% stopped treatment after less than a week, mainly because of side effects or absence of clinical improvement, 10% did not start cannabis treatment, and 5% were lost to follow-up. Among the 106 patients with continued cannabis use and a second interview statistically significant improvement was seen in all cancer and anti-cancer treatment-related symptoms, including nausea, vomiting, mood disorders, fatigue, weight loss, anorexia, constipation, sexual function, sleep disorders, itching, and pain.

Cannabis use among patients at a comprehensive cancer center in a state with legalized medicinal and recreational use
Pergam SA, Woodfield MC, Lee CM, Cheng G, et al. Cannabis use among patients at a comprehensive cancer center in a state with legalized medicinal and recreational use. Cancer 2017;123:4488-4497.
Anonymous paper survey presented to cancer patients at cancer clinics at Seattle Cancer Care Alliance during a six-week period between 2015 and 2016. In Washington State, cannabis was legalized for medical use in 1998 and for recreational use in November, 2012. Response rate was 34% (from 926 patients). Median age was 58 years. Previous use was common (66%), 24% used cannabis in the last year, and 21% used cannabis in the last month. Random urine tests found a similar proportion of weekly users (14%). Most of the patients indicated a strong interest in learning more about cannabis treatment (≥6 on 0-10 scale) and wanted information from cancer providers (74%), but <15% received such information from their cancer care team.

Updated Friday, May 29, 2020 at 11:39AM