Supporting gut health with medicinal cannabis in people with advanced cancer: potential benefits and challenges
Hannah R Wardill 1 2, Luke T Wooley 3, Olivia M Bellas 3 4, Katrina Cao 4 5, Courtney B Cross 3 4, Madele van Dyk 6, Ganessan Kichenadasse 6 7, Joanne M Bowen 3, Andrew C W Zannettino 3, Sepehr Shakib 3, Gregory B Crawford 7 8, Jaroslav Boublik 9, Mellar M Davis 10, Scott D Smid 3, Timothy J Price 8 11
- 1The School of Biomedicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia. hannah.wardill@adelaide.edu.au.
- 2Supportive Oncology Research Group, Precision Cancer Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia. hannah.wardill@adelaide.edu.au.
- 3The School of Biomedicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia.
- 4Supportive Oncology Research Group, Precision Cancer Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia.
- 5School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia.
- 6Flinders Centre for Innovation in Cancer, Flinders Medical Centre/Flinders University, SA Health, Adelaide, SA, Australia.
- 7Northern Adelaide Local Health Network South Australia, SA Health, Adelaide, SA, Australia.
- 8Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia.
- 9LeafCann Group Pty Ltd, Coolum Beach, QLD, Australia.
- 10The Geisinger Commonwealth School of Medicine, Scranton, PA, USA.
- 11Queen Elizabeth Hospital, Adelaide, SA, Australia.
Affiliationer
The side effects of cancer therapy continue to cause significant health and cost burden to the patient, their friends and family, and governments. A major barrier in the way in which these side effects are managed is the highly siloed mentality that results in a fragmented approach to symptom control. Increasingly, it is appreciated that many symptoms are manifestations of common underlying pathobiology, with changes in the gastrointestinal environment a key driver for many symptom sequelae. Breakdown of the mucosal barrier (mucositis) is a common and early side effect of many anti-cancer agents, known to contribute (in part) to a range of highly burdensome symptoms such as diarrhoea, nausea, vomiting, infection, malnutrition, fatigue, depression, and insomnia. Here, we outline a rationale for how, based on its already documented effects on the gastrointestinal microenvironment, medicinal cannabis could be used to control mucositis and prevent the constellation of symptoms with which it is associated. We will provide a brief update on the current state of evidence on medicinal cannabis in cancer care and outline the potential benefits (and challenges) of using medicinal cannabis during active cancer therapy.
