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Cannabinoids in Treating Chemotherapy-Induced Nausea and Vomiting, Cancer-Associated Pain, and Tumor Growth

Cannabinoids have been found to affect tumors of the brain, prostate, colon and rectum, breast, uterus, cervix, thyroid, skin, pancreas, and lymph. However, the full potential of cannabinoids is yet to be understood. This review discusses current knowledge on the promising applications of cannabinoids in treating three different side effects of cancer—chemotherapy-induced nausea and vomiting, cancer-associated pain, and tumor development. The findings suggest that cannabinoids can be used to address some side effects of cancer and to limit the growth of tumors, though a lack of supporting clinical trials presents a challenge for use on actual patients. An additional challenge will be examining whether any of the over one hundred naturally occurring cannabinoids or dozens of synthetic compounds also exhibit useful clinical properties.

Shower power: a case report of cannabinoid hyperemesis syndrome

Cannabis use is becoming more common globally, making it important for physicians to be aware of cannabinoid hyperemesis syndrome (CHS). CHS presents in chronic cannabis users, typically under the age of 50, and entails a severe cyclic nausea and vomiting pattern with abdominal pain but normal bowel habits. Symptoms typically predominate in the morning, are relieved by hot baths or showers, and resolve with discontinuation of cannabis use. This report details a case of a 32-year-old woman who presented to the emergency department at a large Canadian hospital with severe nausea, vomiting and a history of regular use of marijuana cigarettes. In an attempt to alleviate her symptoms she reported taking frequent hot baths and using as many as five marijuana cigarettes per day. The patient’s clinical presentation, chronic daily use of marijuana and relief of symptoms with hot baths led to the diagnosis of CHS. The antiemetic properties of cannabis are widely known in the community, meaning patients may not associate marijuana use with their symptoms. Additionally, cyclic vomiting syndrome is present in many different conditions, making physician awareness of this syndrome crucial. Recognition and diagnosis of this condition can prevent unnecessary, costly diagnostic tests, and provide an opportunity to initiate counselling on cessation.

Cannabinoid Hyperemesis Syndrome: A Review of Potential Mechanisms

Authors: Marieka V. DeVuono, Linda A. Parker Published in Mary Ann Liebert, Inc Publishers June 2020 Abstract Introduction Cannabinoids have long been known for their ability to treat nausea and vomiting….

Use of cannabinoids in cancer patients: A Society of Gynecologic Oncology (SGO) clinical practice statement.

Authors: B. Whitcomb, C. Lutman, M. Pearl, E. Medlin, E. Prendergast, K. Robison, W. Burke
Gynecologic Oncology, 10 January 2020

Tetrahydrocannabinol (THC), cannabidiol (CBD) and cannabinol (CBN) affect the human endocannabinoid system. Cannabinoids reduce chemotherapy induced nausea or vomiting (CINV) and neuropathic pain. Each state has its own regulations for medical and recreational cannabis use. Ef…

Cannabinoid hyperemesis syndrome: a review of the literature.

Authors: Eleonore Deceuninck, Denis Jacques
Psychiatria Danubina, September 2019

BACKGROUND: Cannabinoid Hyperemesis Syndrome (CHS) is characterized by cyclic vomiting and compulsive need to take hot showers in the context of chronic cannabis use. Physicians’ lack of knowledge of CHS often results in a diagnostic delay of several years. The purpose of this…

Should Oncologists Recommend Cannabis?

Authors: Donald I. Abrams
Current Treatment Options in Oncology, 3 June 2019

Cannabis is a useful botanical with a wide range of therapeutic potential. Global prohibition over the past century has impeded the ability to study the plant as medicine. However, delta-9-tetrahydrocannabinol (THC) has been developed as a stand-alone pharmaceutical initially …

Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome.

Authors: Thangam Venkatesan, David J. Levinthal, B U. K. Li, Sally E. Tarbell, Kathleen A. Adams, et al
Neurogastroenterology and Motility, June 2019

Cannabis is commonly used in cyclic vomiting syndrome (CVS) due to its antiemetic and anxiolytic properties. Paradoxically, chronic cannabis use in the context of cyclic vomiting has led to the recognition of a putative new disorder called cannabinoid hyperemesis syndrome (CHS…

Cannabinoid hyperemesis syndrome: An unrecognized cause of nausea and vomiting.

Authors: Tiffany N. Smith, Anne Walsh, Christopher P. Forest
Journal of the American Academy of Physician Assistants, April 2019

Cannabis has long been used for medical and recreational purposes because of its antiemetic, analgesic, and mood effects. Ironically, chronic use of cannabis can result in paradoxical effects, including a condition known as cannabinoid hyperemesis syndrome. Patients with this …

Practical Perspectives in the Treatment of Nausea and Vomiting.

Authors: David J. Cangemi, Braden Kuo
Journal of Clinical Gastroenterology, March 2019

Nausea and vomiting result from complex interactions between afferent and efferent pathways of the gastrointestinal tract, central nervous system, and autonomic nervous system. Afferent pathways from the vagus nerve, vestibular system, and chemoreceptor trigger zone project to…

Patient Counseling Guidelines for the Use of Cannabis for the Treatment of Chemotherapy-Induced Nausea/Vomiting and Chronic Pain.

Authors: Patrick Makary, Jayesh R. Parmar, Natalie Mims, Nile M. Khanfar, Robert A. Freeman
Journal of Pain and Palliative Care Pharmacotherapy, December 2018

The use of cannabis medications has grown in recent years for the symptomatic relief of chemotherapy-induced nausea/vomiting (CINV) and chronic pain (cancer-related and non-cancer-related). As states legalize the use of cannabis, it is important for pharmacists and other healt…

Oral cannabinoid-rich THC/CBD cannabis extract for secondary prevention of chemotherapy-induced nausea and vomiting: a study protocol for a pilot and definitive randomised double-blind placebo-controlled trial (CannabisCINV).

Authors: Antony J. Mersiades, Annette Tognela, Paul S. Haber, Martin Stockler, Nicholas Lintzeris, et al
BMJ open, 12 September 2018

INTRODUCTION: Chemotherapy-induced nausea and vomiting (CINV) remains an important issue for patients receiving chemotherapy despite guideline-consistent antiemetic therapy. Trials using delta-9-tetrahydrocannabinol-rich (THC) products demonstrate limited antiemetic effect, si…

Using Medical Cannabis in an Oncology Practice

Authors: Donald I. Abrams
Oncology, May 2016

As oncologists, we treat patients who have devastating diagnoses with potent therapies. Hence, we demand solid evidence before recommending any intervention. Unfortunately, when it comes to supporting the use of cannabis in clinical situations, we are frustrated by a dearth of…