New study shows cannabis effective for cancer pain

New research suggests cannabis may reduce pain, depression and opioid use in cancer patients

A new study has found that medical marijuana use reduces pain intensity in cancer patients and, for some, offers a safe and effective alternative to opioids.

Cannabis use has also been found to have a positive effect on relieving anxiety, elevating mood and alleviating depression – which pose significant quality of life issues for people dealing with cancer.

More than half of all patients using cannabis stopped all other pain medications by the end of the study period.

The study, The Effectiveness and Safety of Medical Cannabis for Treating Cancer Related Symptoms in Oncology Patients, was published May 20 in the journal Frontiers in Pain Research. It’s the first study to evaluate the possible benefits of medicinal cannabis for cancer pain, according to author David Meiri, an assistant professor at the Technion Israel Institute of Technology.

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An alternative to opioids?

Cancer pain is intense and complex. Traditionally, opioids have been considered the most effective treatment for cancer pain. But opioids come with risks. A focus on opioid treatments may increase the risk of opioid abuse, abuse, and dependence in oncology patients.

Opioids can also increase a patient’s suffering by worsening comorbidities associated with cancer – conditions such as anxiety, depression and insomnia.

For decades, medical marijuana has been used by cancer patients to quell the nausea that often accompanies chemotherapy. But cannabis also has known analgesic (pain-relieving) properties, and some cancer patients have used it to help manage both conditions, nausea and pain. However, until recently there has been a lack of research on the effectiveness of cannabis in relieving cancer pain.

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How they did it: Studying patients for more than 2 years

Between January 2019 and September 2021, the Israel-based researchers monitored medicinal cannabis use in a trial group of consenting oncology patients over the age of 18 who were eligible to use medicinal cannabis in Israel.

At the start of the study, researchers partnered with oncologists who could issue licenses for medicinal cannabis. These oncologists, who are all co-authors of the study, then shared the opportunity with their patients.

From there, 324 patient participants volunteered for the study, after which their oncologists provided the researchers with basic information about the patient, including the cancer diagnosis, classification of their tumors, and cancer treatment protocol. From that point forward, the oncologists who treated the patients throughout the duration of the study never saw the data collected in the patient questionnaires to prevent providers from using the data to change their treatment plans and monitor the results of the study influence.

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After the oncologist’s initial report to the researchers, the patients reported on their initial symptoms in an anonymous questionnaire before starting medical cannabis treatment. Patients were asked to self-assess their pain levels, which were calculated using a pain index called the Short-form McGill Pain Questionnaire (SF-MPQ), as well as their sleep quality, anxiety, sexual problems, and other potential side effects. Patients then re-completed these anonymous questionnaires after one, three, and six months of medicinal cannabis use.

Throughout the study, patients most commonly used medicinal cannabis oil sublingually. For each questionnaire, patients indicated which products they used and how often.

At the end of the study period, researchers pooled data from all questionnaires to calculate each patient’s monthly THC and CBD dose and draw other conclusions about cancer comorbidities and pain.

126 patients completed the study

Although the study started with 324 participants, 126 patients stayed throughout the study and completed all questionnaires.

A variety of factors led to an ever-declining number of participants, including the death of 69 patients during the six-month follow-up period, 55 patients who did not return for medical evaluation, 24 who left the study after reporting no change in their study symptoms with the introduction of cannabis, 36 patients who dropped out due to cannabis-related side effects, and 14 patients who had completed their cancer therapies and no longer required pain management.

Those who stayed for the duration of the study averaged 64 years of age and were mostly female. They had a variety of cancers, including breast, lung, ovarian and colon cancer, and almost half of the participants had a stage IV diagnosis.

While most of the demographic measures listed above for the group did not change during the study, over time the researchers found that participating patients consumed THC-rich products more frequently, while the amounts of CBD consumed per month remained roughly the same.

Significant pain relief with cannabis use

At the end of the study, the data indicated that there was an overall reduction in cancer pain in participants who used cannabis between the start of the study and the six-month mark.

In fact, 36% of the sample group reported an average 30% reduction in pain intensity and 33% of the cohort reported a 30% reduction in their total SF-MPQ score. More than half of the study participants discontinued all other pain-relieving medications during the six months of medicinal cannabis use.

Overall, nearly 40% of the sample group reported a reduction in their overall burden of cancer symptoms, as assessed using the Memorial Symptom Assessment Scale, which assesses the average intensity of 32 symptoms rated from 0 to 4 by intensity.

Surprising results on mood, anxiety and depression

Although these data appear promising, the study authors attributed this finding to the indirect effect of cannabis on the comorbidities of cancer and not necessarily to the direct treatment of cancer pain.

What it means: In the group of 124 patients, not only was medicinal cannabis well tolerated, but comorbidities such as mood issues, insomnia, and other side effects that opioids can exacerbate improved with the introduction of medicinal cannabis. This was especially true for anxiety and depression, which decreased by a median of 22% and 12%, respectively.

One study does not necessarily constitute conclusive fact, and more research is needed to fully understand the effects medicinal cannabis could have on oncology patients. But in cases where opioids and other pain-relieving drugs aren’t well tolerated, this new study suggests cannabis could be an alternative source of pain relief for some patients fighting and treating cancer.

Alex Peters

Alexa Peters is a freelance writer specializing in music, writing, travel, feminism and self-help. Her work has appeared in The Washington Post, Paste, The Seattle Times, Seattle Magazine and Amy Poehler’s Smart Girls.

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