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Chemotherapy can cause several, sometimes debilitating, side effects. Studies have shown marijuana can make the adverse effects more manageable.
An Overview of the Side Effects of Chemotherapy
Chemotherapy is a category of cancer treatment that uses strong drugs, administered orally or intravenously. There are more than 100 chemotherapy drugs that are used in the treatment of cancer. The drugs prevent cancer from spreading to other parts of the body, slow the growth of tumors, and kill cancer cells. While chemotherapy can be effective against cancer, it does cause sometimes-serious side effects.
The side effects from chemotherapy develop because the chemotherapy drugs that attack cancerous cells also damage normal, healthy cells. Common side effects associated with chemotherapy are fever and chills, fatigue, nausea and vomiting, sore mouth, diarrhea, constipation, loss of appetite that can lead to anorexia, pain or difficulty with swallowing, swelling in the hands or feet, itching, shortness of breath, cough, and muscle or joint pain.
Individuals undergoing chemotherapy won’t necessarily experience all side effects and the severity of the side effects varies greatly from person to person. Most side effects will gradually go away after completion of the treatment.
Findings: Cannabis’ Impact on the Side Effects of Chemotherapy
Cannabis has shown to effectively reduce the nausea and vomiting that often occurs during and after chemotherapy treatments. Studies have found that one of the major cannabinoids found in cannabis, cannabidiol (CBD), is effective at treating the more difficult to control symptoms of nausea, as well as preventing anticipatory nausea in chemotherapy patients11,14. Other studies have found that tetrahydrocannabinol (THC), another major cannabinoid found in cannabis, is also effective at reducing conditioned rejection and chemotherapy-induced nausea10,12.
Cannabis has also demonstrated that it can significantly reduce neuropathic pain; even pain that traditional treatment had been unsuccessful at managing and without adversely effecting the efficacy of chemotherapy15,16. In one study, cancer patients with intractable pain, and who had previously and unsuccessfully tried to manage their discomfort with opioids, saw significant reductions in pain levels after being treated with cannabis containing both THC and CBD for two weeks9.
Cannabis can also help prevent weight loss and a loss of appetite in chemotherapy patients. THC has shown to significantly stimulate appetite in patients that have cachexia related to cancer8,13. In addition, patients undergoing chemotherapy and treated with THC have a larger appetite and report that food “tastes better”2.
Research also suggests that cannabis may help reduce the swelling in the hands and feet that can occur alongside chemotherapy. Both THC and CBD have shown to have anti-inflammatory properties3. In one study, CBD effectively reduced edema in an animal’s paw7.
A survey of 131 cancer patients participating in cannabis treatments for six to eight weeks reported significant improvements in all of the measured symptoms, including nausea, vomiting, mood disorders, fatigue, weight loss, anorexia, constipation, sexual function, sleep disorders, itching, and pain1. Patients treated with THC have also been shown to experience a higher quality of sleep and relaxation2. The National Cancer Institute, an organization run by the U.S. Department of Health and Human Services, recognizes cannabis as an effective treatment for providing relief of a number of symptoms associated with cancer and chemotherapy treatments, including pain, nausea and vomiting, anxiety and loss of appetite4.
States That Have Approved Medical Marijuana for Chemotherapy’s Side Effects
Currently, nearly all states that have legalized medical marijuana have specifically approved it for the treatment of cancer and therefore chemotherapy. These states include: Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire (also allowed for “chemotherapy induced anorexia”), New Jersey, New Mexico, New York, North Dakota, Oregon, Rhode Island, Vermont, Washington, and West Virginia.
Although the state of Maryland hasn’t approved medical marijuana to treat cancer, it has approved it for the treatment of nausea and chronic pain, two symptoms commonly associated with chemotherapy.
In addition, in Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment.
Recent Studies on Cannabis’ Impact on Chemotherapy’s Side Effects
- Bar-Sela, G., Vorobeichik, M., Drawsheh, S., Omer, A., Goldberg, V., and Muller, E. (2013). The Medical Necessity for Medicinal Cannabis: Prospective, Observational Study Evaluating the Treatment in Cancer Patients on Supportive or Palliative Care. Evidence-Based Complementary and Alternative Medicine, 2013, 510392. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3730175/.
- Brisbois, T.D., de Kock, I.H., Watanabe, S.M., Mirhosseini, M., Lamoureux, D.C., Chasen, M., MacDonald, N., Baracos, V.E., and Wismer, W.V. (2011, February 22). Delta-9-tetrahydrocannabinol may palliate altered chemosensory perception in cancer patients: results of a randomized-double-blind, placebo-controlled pilot trial. Annals of Oncology, 22, 2086-2093. Retrieved from https://academic.oup.com/annonc/article-lookup/doi/10.1093/annonc/mdq727.
- Burstein, S.H., and Zurier, R.B. (2009, March). Cannabinoids, endocannabinoids, and related analogs in inflammation. The AAPS Journal, 11(1), 109-19. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664885/.
- Cannabis and Cannabinoids (PDQ). (2015, July 15). National Cancer Institute. Retrieved from http://www.cancer.gov/about-cancer/treatment/cam/patient/cannabis-pdq.
- Chemo side effects. (2015, June 9). American Cancer Society. Retrieved from http://www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/chemotherapy/understandingchemotherapyaguideforpatientsandfamilies/understanding-chemotherapy-chemo-side-effects.
- Chemotherapy Side Effects Worksheet. (n.d). American Cancer Society. Retrieved from http://www.cancer.org/acs/groups/content/@nho/documents/document/acsq-009502.pdf.
- Costa, B., Colleoni, M., Conti, S., Parolaro, D., Franke, C., Trovato, A.E., and Giagnoni, G. (2004, March). Oral anti-inflammatory activity of cannabidiol, a non-psychoactive constituent of cannabis, in acute carrageenan-induced inflammation in the rat paw. Naunyn-Schmiedeberg’s Archives of Pharmacology, 369(3), 294-9. Retrieved from http://link.springer.com/article/10.1007%2Fs00210-004-0871-3.
- Jatoi, A., Windschitl, H.E., Loprinzi, C.L., Sloan, J.A., Dakhil, S.R., Mailliard, J.A., Pundaleeka, S., Kardinal, C.G., Fitch, T.R., Krook, J.E., Novotny, P.J. and Christensen, B. (2002). Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a North Central Cancer Treatment Group study. Journal of Clinical Oncology, 20(2), 567-73. Retrieved from http://ascopubs.org/doi/full/10.1200/JCO.2002.20.2.567.
- Johnson, J.R., Burnell-Nugent, M., Lossignol, D., Ganae-Motan, E.D., Potts, R., and Fallon, M.T. (2010, February). Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC: CBD extract and THC extract in patients with intractable cancer-related pain. Journal of Pain and Symptom Management, 39(2), 167-79. Retrieved from http://www.jpsmjournal.com/article/S0885-3924(09)00787-8/fulltext.
- Limebeer, C.L., and Parker, L.A. (1999, December 16). Delta-9-tetrahydrocannabinol interferes with the establishment and the expression of conditioned rejection reactions produced by cyclophosphamide: a rat model of nausea. Neuroreport, 10(19), 3769-72. Retrieved from http://journals.lww.com/neuroreport/pages/articleviewer.aspx?year=1999&issue=12160&article=00009&type=abstract.
- Machado Rocha, F.C., Stefano, S.C., De Cassia Haiek, R., Rosa Oliveira, L.M., and Da Silveira, D.X. (2008, September). Therapeutic use of Cannabis sativa on chemotherapy-induced nausea and vomiting among cancer patients: systematic review and meta-analysis. European Journal of Cancer Care, 17(5), 431-43. Retrieved from http://onlinelibrary.wiley.com/wol1/doi/10.1111/j.1365-2354.2008.00917.x/full.
- Mechoulam, R., and Hanus, L. (2001). The cannabinoids: An overview. Therapeutic implications in vomiting and nausea after cancer chemotherapy, in appetite promotion, in multiple sclerosis and in neuroprotection. Pain Research and Management, 6(2), 67-73. Retrieved from http://downloads.hindawi.com/journals/prm/2001/183057.pdf.
- Nauck, F., Klaschik, E. (2004, June). Cannabinoids in the treatment of the cachexia-anorexia syndrome in palliative care patients. Schmerz, 18(3), 197-202. Retrieved from http://link.springer.com/article/10.1007%2Fs00482-003-0277-z.
- Parker, L.A., Rock, E.M., and Limbeer, C.L. (2011, August). Regulation of nausea and vomiting by cannabinoids. British Journal of Pharmacology, 163(7), 1411-22. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3883513/.
- Ward, S.J., McAllister, S.D., Kawamura, R., Murase, R., Neelakantan, H., and Walker, E.A. (2014). Cannabidiol inhibits paclitaxel-induced neuropathic pain through 5-HT1A receptors without diminishing nervous system function or chemotherapy efficacy. British Journal of Pharmacology, 171, 636-645. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3969077/.
- Wilsey, B., Marcotte, T., Deutsch, R., Gouaux, B., Sakai, S., and Donaghe, H. (2013, February). Low-dose vaporized cannabis significantly improves neuropathic pain. The Journal of Pain, 14(2), 136-48. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3566631/.