Cannabis and Cannabinoids

About this approach

Cannabis contains compounds called cannabinoids, including THC and CBD. People with cancer may ask about them for nausea, pain, appetite or sleep, but the evidence differs by symptom and product. Certain prescription cannabinoid medicines have a role in treating chemotherapy-related nausea and vomiting.

Where it fits: Selected symptom-management uses; cancer-control benefit is unproven

Where this treatment is used

Prescription dronabinol and nabilone have evidence and US approvals for particular chemotherapy-related nausea and vomiting uses. These medicines should be distinguished from variable commercial cannabis products. Product composition, route and accompanying medicines can materially affect results. NCI also describes concerns about drug interactions and the uncertainty surrounding cannabis use during immunotherapy. A symptom-management plan should define the target, consider better-studied alternatives and review effects and adverse reactions over time.

Procedure and practical considerations

THC-containing products can impair attention, coordination and driving, and may cause dizziness, anxiety or confusion. Sedating medicines and alcohol can increase impairment. Cannabinoids can interact with other drugs; CBD can also affect liver function. Product labeling and contaminant control may be unreliable, particularly outside regulated pharmaceutical supply. Smoking adds respiratory exposure. Share the complete product and ingredient information with clinicians, and seek advice promptly if severe vomiting, marked confusion or other concerning symptoms develop.

Clinics reporting this approach

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