For Cancer, Cannabis Has Many Virtues, Says Large Study

 In Cancer, Medical Marijuana

Medscape / Nick Mulcahy / March 19, 2018

Cannabis, or marijuana, may improve a variety of cancer-related symptoms, including nausea and vomiting, sleep disorders, pain, anxiety, and depression, conclude the authors of a 2960-patient observational study from Israel.

The study was published online March 5 in the European Journal of Internal Medicine.

It provides a large-scale portrait of who used medical cannabis for what cancers, and what benefits they derived during a 6-month period.

The study population consisted mostly of patients with advanced-stage cancers (51.2%, stage 4). At 6 months, about 25% of the study population had died.

Of the 1742 patients who survived to 6 months and who finished the study protocol, 60% achieved “treatment success,” report Victor Novack, MD, PhD, director of the Cannabis Clinical Research Center and Research Authority, Soroka University Medical Center, Beersheba, Israel, and colleagues

The study’s primary efficacy outcome was treatment success, which was defined as moderate or significant improvement in patients’ overall condition at 6 months, as well as not quitting treatment and not having serious side effects.

Notably, factors associated with success were previous experience with cannabis, high levels of pain, young age, and lack of concerns regarding possible negative effects of cannabis treatment.

With its effect on multiple symptoms, cannabis is a “desirable therapeutic option” for cancer patients, who often have multiple complaints, conclude the authors.

This is an “interesting and important study” in the field, said Mark S. Wallace, MD, professor of clinical anesthesiology at the University of California, San Diego, who was asked for comment.

Wallace highlighted the large number of patients as a study strength. He also believes in the drug’s efficacy. “I use cannabis a lot in my cancer population, with very positive results,” he said.

Palliation of Cancer Symptoms

Israel has a relatively lengthy experience with medical cannabis. The Ministry of Health in Israel approved its use in 2007. The primary use is palliation of cancer symptoms.

However, until now, there have been limited data on the epidemiology of Israeli cancer patients who use the drug and on the adverse effect and efficacy profile of their cannabis treatment.

“We feel that it is absolutely imperative to accelerate the development of the scientific research program [of cannabis] within the paradigm of evidence-based medicine,” Novack told Medscape Medical News in an email.

The new study was carried out by Novack in collaboration with other Israeli academics and with employees of Tikun-Olam (“repair the world” in Hebrew), a private Israeli company that grows medical cannabis, operates clinics, and conducts research on medical cannabis.

For the study, the team reviewed data from questionnaires at baseline, at 1 month, and at 6 months on nearly 3000 cancer patients who were prescribed medical cannabis between 2015 and 2017.
The mean age of the patients was 59.5 years; about half (43.1%) were older than 65 years. Most patients were either retired (31.8%) or did not work (46.9%). During the 6-month period before commencing cannabis treatment, 53.9% were hospitalized (median number of days, 10). There were slightly more women (54.6%) than men in the study.


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