Study Proves Cannabis Improves Quality For End of Life Care
70% of patients in ‘end of life care’ reported improved quality of life after six months treatment with cannabis.
Cancer is a major health problem that represents a significant financial cost to the patient, the family, and the entire health system of a country. It is estimated that there are 12. 7 million cancer cases in the U.S. alone. Many of these cases will, sadly, progress to a palliative phase. How can cannabis help cancer patients with end of life care?
Palliative treatment of cancer includes therapy to alleviate pain and nausea. As well, unrelieved pain plagues 70-90% of patients. Current pain relief treatments include opioids, which have 80-90% success rate. Some patients achieve less success than that. When you combine pain with the brutal side effects of chemotherapy, including nausea and vomiting, the stress for the patient can become unbearable.
Cannabis for Improving End of Life Care
In 2007, the Ministry of Health for Israel approved medical cannabis treatment for palliative cancer care. A study published in the European Journal of Internal Medicine looked at the general effectiveness of this treatment as reported by patients. At the time of the conclusion of the study (2018), 60% of medical cannabis patients were using cannabis to treat cancer symptoms.
During the period of the study (2015-2017), 3845 patients received a cannabis license and the researchers followed 2970 who consuming cannabis for cancer treatment. The Israeli medical cannabis license specifies two permissible methods of administration: oil and inflorescence (flowers, capsules and joints). Almost half of the patients (44%) have the license for the combination of oil and inflorescence. The mean age was 59.5 ±16.3 yrs.
After the cannabis treatment initiation, there was a 1 month follow up, 6 months, 1 year and 2 years (ongoing). The most commonly reported cancer-related side effects, after one month were: dizziness (0.6%), cough due to smoking (0.3%), tiredness (0.3%), nausea (0.3%), confusion and disorientation (0.3%).
After six months, 50.8% of patients reported significant improvement to their cancer symptoms and 45.1 % reported slight or moderate improvement. The most improved symptoms at this point were nausea and vomiting, sleep disorders, restlessness, anxiety, depression and headaches.
Most patients in the palliative category used cannabis to alleviate pain. These cancer patients reported their pain to to be 8 to 10 on a scale that ends at 10 (being the highest). After 6 months of cannabis treatment, less than 5% of patients reported these high levels of pain.
Quality of Life For Palliative Patients Improves With Cannabis
Cannabis treatment for the palliative cancer seems to be a safe, effective and well-tolerated option for patients to cope with the malignancy related symptoms. Initially, less than 20% of the patients in this group reported that they expected a good quality of life. Impressively, after 6 months of treatment, about 70% of patients indicated a significant improvement in quality of life.
Interestingly, 36% of patients taking the opioids stopped taking these altogether after the six months of treatment with the medical cannabis. It is very probable that the mechanism by which medical cannabis affects the common issues with cancer patients is very similar to the one by which opioids affect the same condition.
Cannabis Can Treat Multiple Symptoms
Cancer patients are an unique population characterized by multiple symptoms and the simultaneous use of different medications. Medical cannabis can reduce this list of medications by treating multiple symptoms at once. Therefore, it is recognized as a desirable therapeutic agent.
This study is impressive and statistically significant. There is a caveat, however, in that the data was collected by the company offering (selling) the medical cannabis in Israel. And the scientists leading the study are paid by the same company. This is a clear conflict of interest, that might be allowed in Israel, but certainly is not common practice in the North America. Scientists show bias if they are influenced by the goals of the company. This sways the results of the study for the benefit of the company. Ethically, this is a big problem.
An independent study would need to follow in order to remove the threat of bias.