Marijuana Use in Supportive Care for Cancer Patients Posted: 01-28-08 18:27pm
Cancer, and cancer therapies and their
side effects, may cause a variety of
problems for cancer patients.
Chemotherapy-induced nausea and vomiting,
and anorexia and cachexia are conditions
that affect many individuals with cancer.
Nausea and Vomiting
Some anticancer drugs cause nausea and
vomiting because they affect parts of the
brain that control vomiting and/or
irritate the stomach lining. The severity
of these symptoms depends on several
factors, including the chemotherapeutic
agent(s) used, the dose, the schedule, and
the patient's reaction to the drug(s). The
management of nausea and vomiting caused
by chemotherapy is an important part of
care for cancer patients whenever it
occurs. Although patients usually receive
antiemetics, drugs that help control
nausea and vomiting, there is no single
best approach to reducing these symptoms
in all patients. Doctors must tailor
antiemetic therapy to meet each
individual's needs, taking into account
the type of anticancer drugs being
administered; the patient's general
condition, age, and related factors; and,
of course, the extent to which the
antiemetic is helpful. There has been much
interest in the use of marijuana to treat
a number of medical problems, including
chemotherapy-induced nausea and vomiting
in cancer patients. Two forms of marijuana
have been used: compounds related to the
active chemical constituent of marijuana
taken by mouth and marijuana cigarettes.
Dronabinol (Marinol�), a synthetic form
of the active marijuana constituent
delta-9-tetrahydrocannabinol (THC), is
available by prescription for use as an
antiemetic. In 1985, the U.S. Food and
Drug Administration approved its use for
the treatment of nausea and vomiting
associated with cancer chemotherapy in
patients who had not responded to the
standard antiemetic drugs.
National Cancer Institute (NCI) scientists
feel that other antiemetic drugs or
combinations of antiemetic drugs have been
shown to be more effective than synthetic
THC as %u201Cfirst-line therapy%u201D for
nausea and vomiting caused by anticancer
drugs. Examples include drugs called
serotonin antagonists, including
ondansetron (Zofran�) and granisetron
(Kytril�), used alone or combined with
dexamethasone (a steroid hormone);
metoclopramide (Reglan�) combined with
diphenhydramine and dexamethasone; high
doses of methylprednisolone (a steroid
hormone) combined with droperidol
(Inapsine�); and prochlorperazine
(Compazine�). Continued research with
other agents and combinations of these
agents is under way to determine their
usefulness in controlling
chemotherapy-induced nausea and vomiting.
However, NCI scientists believe that
synthetic THC may be appropriate for some
cancer patients who have
chemotherapy-induced nausea and vomiting
that cannot be controlled by other
antiemetic agents. The expected side
effects of this compound must be weighed
against the possible benefits. Dronabinol
often causes a %u201Chigh%u201D (loss of
control or sensation of unreality), which
is associated with its effectiveness;
however, this sensation may be unpleasant
for some individuals.
Marijuana cigarettes have been used to
treat chemotherapy-induced nausea and
vomiting, and research has shown that THC
is more quickly absorbed from marijuana
smoke than from an oral preparation.
However, any antiemetic effects of smoking
marijuana may not be consistent because of
varying potency, depending on the source
of the marijuana contained in the
cigarette.
To address issues surrounding the medical
uses of marijuana, the National Institutes
of Health convened a meeting in February
1997 to review the scientific data
concerning its potential therapeutic uses
and explore the need for additional
research. The group of experts concluded
that more and better studies are needed to
fully evaluate the potential use of
marijuana as supportive care for cancer
patients.
Anorexia and Cachexia
Anorexia, the loss of appetite or desire
to eat, is the most common symptom in
cancer patients. It may occur early in the
disease process or later, in cases where
the cancer progresses. Cachexia is a
wasting condition in which the patient has
weakness and a marked and progressive loss
of body weight, fat, and muscle. Anorexia
and cachexia frequently occur together,
but cachexia may occur in patients who are
eating an adequate diet but have
malabsorption of nutrients. Maintenance of
body weight and adequate nutritional
status can help patients feel and look
better, and maintain or improve their
performance status. It may also help them
better tolerate cancer therapy.
There are a variety of options for
supportive nutritional care of cancer
patients, including changes in diet and
consumption of foods, enteral or
parenteral feeding (delivery of nutrients
by tube), and the use of drugs. An
NCI-supported study to evaluate the
effects of THC and megestrol acetate (a
synthetic female hormone) used alone and
in combination for treatment-related and
cancer-related anorexia and cachexia
completed patient accrual earlier this
year. Researchers will compare the
appetite, weight, and rate of weight
change among patients treated with THC to
patients treated with megestrol acetate or
with both therapies. Researchers will also
evaluate the effects of the drugs alone or
in combination on nausea and vomiting,
assess for toxic effects of the drugs, and
evaluate differences in quality of life
among those patients who were treated with
THC.
The Institute of Medicine (IOM), part of
the National Academy of Sciences, has
published a report assessing the
scientific knowledge of health effects and
possible medical uses of marijuana. The
IOM project was funded by the White House
Office of National Drug Control Policy.
The IOM released its report on March 17,
1999.
National Cancer Institute (NCI) Resources
Cancer Information Service (toll-free)
Telephone:
1%u2013800%u20134%u2013CANCER
(1%u2013800%u2013422%u20136237)
TTY: 1%u2013800%u2013332%u20138615
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bobbette
Experienced User , Rather EHEALTHy
Joined: 07 Jan 2008 Posts: 122 Location: ,
Thanks: 21
Thanked:3
Posted: 01-29-08 15:00pm
nothing wrong with this-- another good
argument for the legalization of medicinal
marijuana.
My Brother's Beloved Wife Posted: 05-31-08 00:58am
lay dying of cancer. You could not even
sit on the side of her bed she was in so
much pain. She had the benefit of
marijuana there for awhile and it greatly
helped her. But, getting it was quite
impossible and I have to question why that
was. She could have gone down and
purchased alchohol, cigarettes but no, she
didn't. She died a miserable death. 30
years old, leaving a son 6 years old and a
little girl 2 years old.
This is not about marijuana. It is about
keeping marijuana away from the people who
will benefit from it. We are not talking
about major drug addicts here. We are
talking about the big boys in the
pharmaucetical companies running the show.
The money show.
Well, what is new?
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homerx
Supporter
Joined: 03 Jan 2008 Posts: 3236 Location: , USA
Thanks: 370
Thanked:1125
Posted: 05-31-08 10:12am
Bobbie, that is so true...its all about
$$$$ and that is so sad..plus it makes
innocent ill people who need the marijuana
into criminals. That is because the
religious right wing republicans are so
anti marijuana that they don't care if it
works for us, they have an ax to grind and
its all about being a right fighter
instead of doing the right thing..
