Dear Dr. Green:
I have been diagnosed with Stage 1 breast cancer and will begin chemotherapy four weeks from now. Some of my friends who have also battled this hideous disease have suggested I try marijuana to help with the side effects of chemo. What are your thoughts? — Melanie J., Pagosa Springs, Colo.
I am so sorry that you must deal with this dangerous disease. Fortunately, our chemotherapy regimens and anti-nausea medications have improved significantly over the past few decades. The severity of side effects from chemo varies greatly from person to person. Unfortunately there are, however, people who have significant side effects.
When considering any drug to manage side effects of chemotherapy, we have to realize that we do not have a single medication that will manage all side effects.
Some of the potential side effects of chemo for breast cancer include hair loss, nausea, a lack of desire to eat, constipation, diarrhea, chemo brain (with a difficulty to concentrate or focus).
One of the most bothersome side effects is hair loss. This is a painful reminder of the disease and the chemo. Fortunately these are support groups that help people through this. I do not feel the use of cannabis will affect hair loss. There are cooling caps that may decrease hair loss.
There are pharmaceuticals derived from cannabis for nausea already in use in the United States. These complement other pharmaceuticals. In studies we have found that the pharmaceutical agents are generally more effective than cannabis. However there is a group of patients for whom cannabis works better than standard medications. If these standard medications fail to improve your situation, I think it would be worthwhile to consider medical cannabis if you are in a state where this is legal.
A review of 30 studies showed significant improvement with oral cannabis. Inhaled cannabis was not within this review. There are animal studies that show cannabis improves appetite, decreases anxiety and improves sleep. From anecdotal reports we also see that this is true in humans.
There are people who suffer from chemo brain (decreased concentration and focus) while receiving chemo. We also know that some people using cannabis can have difficulty concentrating. In the same review of cannabis for nausea, some side effects were drowsiness, sedation, feeling high, euphoria and depression. All potential side effects need to be kept in mind when trying a new medication.
Since the cognitive side effects of cannabis may be similar to those of chemo, some practitioners advocate for trying cannabis prior to chemo so that the patient understands the effects of cannabis by itself. There are also preparations with higher percentages of CBD rather than THC, which may have less of an effect on concentration. You should discuss the types of preparations with your medical marijuana provider.
I wish you good luck with your chemo.
Credit to the National Cancer Institute
This information is intended only to complement, and not to replace or contradict, any health or medical advice or information provided by healthcare professionals. If you have any questions, please contact your doctor or other healthcare professional.