DOES MEDICINAL CANNABIS SUPPORT THE MENTAL HEALTH OF CANCER SURVIVORS? A SYSTEMATIC REVIEW AND META-ANALYSIS OF INTERVENTION STUDIES

Skye Marshall, Megan Crichton, Thusharika Dissanayka, Wolfgang Marx, Elizabeth Gamage, Nikolaj Travica, Alison Bowers, Elisabeth Isenring, Patsy Yates

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Abstract

Introduction:
Medicinal cannabis may have a role in supporting the mental health
of cancer survivors. This study aimed to synthesize evidence on the
safety and efficacy of medicinal cannabis, compared to any control, on
depression, anxiety, and stress in cancer survivors.
Methods:
A systematic review with meta-analysis searched five databases to
October 2022. Any type of intervention study, medicinal cannabis,
comparator, cancer type/stage, and participant age were included.
Depression, anxiety, and stress were primary outcomes. Secondary
outcomes were mood, cognition, pain, sleep, fatigue, quality of life,
appetite, nutrition status, and gastrointestinal symptoms. Data were
pooled using RevMan. Evidence was appraised using the Cochrane
RoB-2 or ROBINS-I tool and GRADE.
Results:
Sixteen studies (n=9 RCTs, n=5 controlled trials; n=2 uncontrolled trials)
of 18 interventions and 1898 adults were included. Compared to
control, medicinal cannabis (THC with or without CBD) had no overall
effect on anxiety (n=9 studies reported no effect) nor depression (n=5
studies reported no effect). However, the likelihood of anxiety was
increased by 100% with high dose THC compared to low dose (OR:2.0;
95%CI:1.42-2.90; n=2 interventions; GRADE: Low). One study found
severity of anxiety, depression, and stress was reduced with THC/CBD
(GRADE: Very low). Medicinal cannabis improved sleep and appetite
but had no effect on pain, fatigue, confusion, appetite loss, constipation,
dry mouth, and adverse events (asthenia, anaemia, hallucinations, feeling
‘high’, neoplasm progression). Medicinal cannabis increased likelihood
of nausea, vomiting, drowsiness, headache, disorientation, and
dizziness. Confidence in findings was limited by most studies having
high or unclear risk of bias, small samples, heterogenous interventions,
unvalidated primary outcome measures, and inadequate data reported
for meta-analysis.
Conclusions:
There was insufficient evidence to determine if medicinal cannabis
has a role in supporting the mental health of cancer survivors. Future
well-powered trials using validated outcome measures and full data
reporting are warranted to confirm efficacy and safety.
Original languageEnglish
Pages (from-to)261-261
Number of pages1
JournalSupportive Care in Cancer
Volume31
Publication statusPublished - 17 Jun 2023
EventMASCC/ISOO Annual Meeting on Supportive Care in Cancer : MASCC/JASCC/ISOO Annual Meeting 2023 - Nara, Japan
Duration: 22 Jun 202324 Jun 2023
https://mascc.org/save-the-date-for-the-mascc-jascc-isoo-2023-annual-meeting/

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