The Use of Cannabinoids for Cancer-Related Pain Management: A Systematic Review

Abstract

Introduction: Cancer-related pain is often severe and can be refractory to conventional opioid analgesics. Cannabinoids have been proposed as an alternative or adjunct therapy for pain management. This review evaluates the clinical evidence for the use of cannabinoids in treating cancer pain.

Methods: A search of MEDLINE and CENTRAL was conducted for RCTs comparing any type of cannabinoid (including herbal cannabis and pharmaceutical preparations) to placebo or other analgesics for cancer-related pain.

Results: Ten RCTs were included. The results were mixed. While some studies using nabiximols (a 1:1 THC:CBD extract) showed a modest but statistically significant improvement in pain scores compared to placebo in patients with opioid-refractory pain, studies of smoked cannabis or other preparations were less conclusive.

Discussion: The evidence for cannabinoids in cancer pain is still developing. Nabiximols may offer a benefit for a subset of patients who do not respond adequately to opioids, but their overall effect size is small. More research is needed to identify optimal formulations and patient populations.

Conclusion: Certain cannabinoid preparations may provide modest relief for cancer pain refractory to opioids, but evidence is not uniformly strong.