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This article discusses the evidence available for synthetic and plant-based cannabis for the treatment of people with cancer. The article is very much from a US perspective, where public demand has increased awareness of cannabis as a potential therapeutic option for cancer patients. However, this awareness has also highlighted some complex medical, financial and legal concerns. This controversy dates back to the decision to classify cannabis as a schedule I substance under the Controlled Substance Act (CSA) back in the 1970s.
Medical cannabis has been legalised in some US states for the treatment of cancer. However, in clinical practice, most doctors and nurse practitioners do not feel comfortable with their medical knowledge of cannabis to offer it to patients.
Synthetic cannabinoids are chemical compounds similar to those found in cannabis, while whole-plant or plant-based cannabis is derived directly from the cannabis plant.
A meta-analysis of both synthetic cannabinoids and plant-based cannabis for medical use was published in JAMA in 2015. This analysis included more than 6,000 patients across 79 trials. During this analysis, data about chemotherapy-induced nausea and vomiting, and neuropathic and non-neuropathic cancer-related pain was analysed.
The article concludes that, because cannabis remains a schedule I drug, its future remains highly uncertain. However, the economic impact of cannabis continues to grow exponentially, and the US Food and Drug Administration (FDA) has now approved a plant-based cannabis product for medical use, which will fuel research and development of plant-based cannabis products, despite the existing barriers.
