Medical cannabis for refractory cancer-related pain in a specialised clinical service: a cross-sectional study
Haggai Sharon 1 2 3 4, Yara Agbaria 2 4, Silviu Brill 1 3, Jesus de Santiago 5, Uri Hochberg 6 3
- 1Institute of Pain Medicine, Department of Anesthesia and Critical Care Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
- 2Sagol Brain Institute, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel aviv, Israel.
- 3Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- 4Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
- 5Department of Anesthesia and Chronic Pain Unit, Hospital Quirónsalud de Tenerife, Palmones, Spain.
- 6Institute of Pain Medicine, Department of Anesthesia and Critical Care Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel urihochberg@hotmail.com.
Affiliationer
Background and objectives: Cancer-related pain management in advanced stages presents a significant challenge that often requires a multidisciplinary approach. Although advancements in pharmacological and interventional therapies, a considerable number of patients still suffer from refractory pain, leading to unmet clinical needs. This study shares our experience with medical cannabis (MC) as a potential therapy for this specific population of patients with cancer-related refractory pain.
Methods: In a cross-sectional study, 252 consecutive refractory cancer-related pain patients (mean age=61.71, SD=14.02, 47.6% males) filled out detailed self-report questionnaires. Of these, 126 patients (55%) were treated with MC and 105 patients (45%) were not.
Results: Most patients received pain management from their oncologist, not a pain specialist. MC was mainly started for pain relief, sleep difficulties and anorexia. About 70% of patients reported subjective improvement from MC, with almost 40% reporting a significant improvement in coping with their illness. Side effects were generally mild, with fatigue and dizziness being the most common (21.78% and 23.46%, respectively). No patient required dedicated medical care for side effects. Of non-users, 65% had tried MC before and stopped due to lack of effectiveness or side effects (39.7% and 34.6%, respectively).
Conclusion: Refractory cancer pain necessitates innovative approaches. This registry highlights that MC can effectively improve symptoms in non-responsive patients, with favourable safety profiles for this vulnerable population.
Keywords: pain; symptoms and symptom management.
