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medical testimonies database contains 7 testimonies from cannabis users with cancer
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cannabis-related medications have been tested for their effects on nausea caused
by chemotherapy, including delta-9-THC, delta-8-THC, Nabilone, Levonantradol and
BRL-4664, as well as 'natural' cannabis
was almost always found to produce significant antiemetic properties. One of the
first studies was by Sallan et al (1975). The study compared oil-based capsules
containing THC given to 20 patients both before and after chemotherapy treatment.
Fourteen of the patients found THC to be an effective antiemetic. Chang et al
(1979) found that THC was an effective antiemetic to counteract the nauseous effects
of the methotrexate medication used in chemotherapy, with 14 out of 15 patients
reporting some relief of nausea and vomiting. Two years later Chang et al found
that it was also effective in patients undergoing treatment with anthracyclines
(which produce a higher level of emetic behaviour) albeit to a limited extent.
Lucas et al (1980) gave THC to 53 patients to whom other treatments were unsatisfactory.
10 suffered no vomiting after chemotherapeutic treatment. Another 28 had more
than a 50% reduction in vomiting.
by Frytak et al (1979), Orr et al (1980) and Sallan et al (1980) showed a comparison
between patients receiving the antiemetic drug prochlorperazine and THC. Typically
oral THC was found to be of a similar efficiacy to prochlorperazine. Whilst comparing
THC to metoclopramide, Gralla et al (1984) found that THC completely stopped vomiting
in 13% of patients, and almost eliminated it in another 27%.
regard to the lesser-studied variants of THC, McCarthy et al (1984) found that
a metabolite of THC, 11-OH-THC was less effective as an antiemetic than THC. Razden
(1986) however found that delta-8-THC completely prevented any emesis in 8 children
undergoing chemotherapy. Moreover, delta-8-THC is significantly less psychoactive
than delta-9-THC and very few side-effects were reported.
stated, the synthetic cannabinoids Nabilone and Levonantradol have also been investigated
(Steele et al 1980 and Tyson et al 1985 respectively). These produced similarly
effective antiemetic results to THC. Herman et al (1979) found that medicating
with Nabilone was significantly more effective that treatment with the standard
et al (1981) investigated another THC homologue known as BRL-4664. This too showed
some antiemetic effect.
et al (1988) found that 78% of 56 patients with nausea who were resistant to standard
drugs became symptom free through inhaling cannabis. All of these found that cannabis
was either a 'moderately effective' or 'highly effective' form of therapy.
method of administration for medicinal cannabis can be of importance. Firstly,
patients suffering severe vomitting may not be able to keep orally-given cannabis
down long enough to have effect. Inhalation, whether by smoking or other means,
removes this obstacle, and studies such as Ohlsson's (1980) have shown that the
effects of inhaled cannabis start much sooner (almost immediately) than if it
is taken orally.
et al (1984) compared chemotherapy patients given either oral THC or smoked cannabis.
Both appeared to have similar antiemetic effectiveness, with about 25% of each
group gaining total control of emesis. In a post-treatment survey, 35% of patients
slightly preferred receiving oral THC, 20% preferred smoking cannabis and 45%
had no preference.
the other hand, Chang et al (1979) found that smoking cannabis rather than taking
it orally seemed more effective. In addition, a report published by the Board
of Pharmacy in Tennessee (1983) found a 23% higher success rate in those patients
who smoked cannabis rather than those who took oral THC. McNeill (1983) found
the same overall result. 75% of patients who took any form of THC showed a significant
improvement in their condition. When routes of administration were taken into
account it was found that 90% of those who inhaled cannabis showed and improvement,
compared to 60% of those who took it orally. Likewise Vincigeurra et al's (1988)
study also found inhaled cannabis to have advantages over THC taken orally.
seems to be no definite answer as to whether or not the psychoactive effects of
cannabis play a part in its antiemetic effectiveness. Gralla et al (1984) reported
no correlation between the psychoactive effects (in terms of euphoria or dysphoria)
and the effectiveness of the antiemetic properties. Sallan et al (1980) reported
a less pharmacological note, Doblin and Kleiman (1991) sent a questionnaire to
US oncologists (cancer specialists). 44% of the respondents had recommended illegal
use of cannabis and half of them would prescribe it if it were legal.
Institute of Medicine's report (1999) concluded that after reviewing the most
valid trials, 'the evidence indicated that cannabinoids reduce emesis in about
one quarter of patients receiving cancer chemotherapy' and that 'the side effects
associated with cannabinoid use are generally tolerable'. Likewise, in a review
of the research conducted by Hall et al (1994), it was concluded that '...THC
is superior to placebo, and equivalent in effectiveness to other widely-used anti-emetic
drugs...' when used to medicate these symptoms.
Annual Report (1983): Evaluation of Marijuana and Tetrahydrocannabinol in Treatment
of Nausea and/or Vomiting Associated with Cancer Chemotherapy Unresponsive to
Conventional Anti-Emetic Therapy: Efficacy and Toxicity, Board of Pharmacy,
State of Tennessee 5;
et al., (1979) Delta-9-THC as an Antiemetic in Cancer Patients Receiving High
Dose methotrexate. Ann. Internal Med. 91 819-824
AK, Shiling DJ, Stillman RC, Goldberg NH, Seipp CA, Barofsky I, Rosenberg SA.
(1981) A prospective evaluation of delta-9-tetrahydrocannabinol as an antiemetic
in patients receiving adriamycin and cytoxan chemotherapy. Cancer 47:1746-51.
and Kleiman, (1991) Marihuna as Anti-emetic medicine: A Survey of Oncologists'
Attitudes and Experiences. J. Cli. Oncology 9 1275-1280
S. Moertel CG, O'Fallon J. et al. (1979) Delta-9-tetrahydrocannabinol as an antiemetic
in patients treated with cancer chemotherapy: a double comparison with prochloperazine
and a placebo. Annals of Internal Medicine 91 :825-830.
RJ, Tyson LB, Borden LB, et al. (1984) Antiemetic therapy a review of recent studies
and a report of a random assignment trial comparing metoclopramide with delta-9-tetrahydrocannabinol.
Cancer Treatment Reports 68:163-172.
Hall, et al. (1994) The Health and Psychological Consequences of Cannabis Use,
Canberra, Australian Government Publishing Service 189.
T.S., Einhorn, L.H., Jones, S.E., Nagy, C., Chester, A.B., Dean, J.C., Furnas,
B., Williams, S.D., Leigh, S.A., Dorr, R.T., and Moon, T.E. (1979) Superiority
of nabilone over prochlorperazine as an antiemetic in patients receiving cancer
chemotherapy. N. Engl. J. Med. 300: 12951298.
of Lords Select Committee on Science and Technology (1998) Science and Technology
- Ninth report. Science and Technology Committee Publications, UK.
of Medicine (1999) Marijuana and medicine: Assessing the science base.
National Academy Press
M, Faiman C, Hawks R. et al. (1984) Randomized double-blind comparison of delta-9-
THC and marijuana as chemotherapy antiemetics. Proceedings of the American
Society for Clinical Oncology 3:91.
V.S.,Jr., and Laszlo, J. (1980) Delta9tetrahydrocannabinol for refractor
vomiting induced by cancer chemotherapy. J. Am. Med. Assoc. 243:
LE, Flora KP, Vishnuvajjala BR. (1984) Antiemetic properties and plasma concentrations
of delta-9-tetrahydrocannabinol against cisplatin vomiting in cats. In: Agurell
S. Dewey WL, Willette RE, Editors The Cannabinoids: Chemical, Pharmacologic
and Therapeutic Aspects. Orlando, FL: Academic Press. Pp. 859- 870.
R. (1983), The Lynn Pierson Therapeutic Research Program: A Report on Progress
to Date, Behavioral Health Services Division, Health and Environment Department,
State of New Mexico, 4;
A, Lindgren J-E, Wahlen A, Agurell S. Hollister L E, Gillespie HK. (1980) Plasma
delta-9-tetrahydrocannabinol concentrations and clinical effects after oral and
intravenous administration and smoking. Clinical Pharmacology and Therapeutics
LE, McKernan JF, Bloome B. (1980). Antiemetic effect of Tetrahydrocannabinol.
Compared with placebo and prochlorperazine in chemotherapy-associated nausea and
emesis. Archives of Internal Medicine 140:1431 -3.
RK. (1986) Structure-activity relationships in cannabinoids. Pharmacology Review
S.E., Zinberg, N.E., and Frei, E. (1975) Antiemetic effect of delta9tetrahydrocannabinol
in patients receiving cancer chemotherapy. N. Engl. J. Med. 293:
SE, Cronin CM, Zelen M, et al. (1980) Antiemetics in patients receiving chemotherapy
for cancer: a randomized comparison of delta-9-tetrahydrocannabinol and prochlorperazine.
New England Journal of Medicine 302: 135 - 138.
M., Bron, D., Rosencweig, M., and Kenis, Y. (1981) Clinical studies with a THC
homolog (BRL4664) in prevention of cisplatininduced vomiting. J.
Clin. Pharmacol. 21: 60S63S.
N. Gralla RJ, Braun DW, Jr. (1980) Double-blind comparison of the antiemetic effects
of nabilone and prochlorperazine on chemotherapy-induced emesis. Cancer Treatments
LB, Gralla RJ, Clark RA, et al. (1985) Phase I trial of levonantradol in chemotherapy-
induced emesis. American Journal of Clinical Oncology 8:528-532.
Vincigeurra, Moore and Brenan, (1988) Inhalation Marijuana as an Anti-emetic for
Cancer Chemotherapy. NY State J. Med. 88 525-527.
a large collection of research materials, see our research
Youngs ruling - Docket 86-22
The US Drug Enforcement Agency held hearings
in 1987 to determine whether cannabis should be allowed as medicine. Doctors,
nurses, patients and academics testified that they had witnessed people using
cannabis as a medicine sucessfully. A large part of the report is concerned with
cancer chemotheraphy, and it makes astonishing reading.
Online Information Sources FAQ has a large number of links to sites which
may hold more information of relevance.