Impact of cannabinoids on the Quality of Life in Oncology: Prospective Observational Study

Abstract

Background: In Italy, the use of derivatives of Cannabis in oncology is being inserted in clinical practice. In particular, the mention of these substances is oriented within relieving emesis and pain, and their prescription is presenting various aspects that deserve to be explored. Patients and methods: The aim of our study was to evaluate the efficacy in clinical practice of inflorescences of cannabis for pain control and emesis in cancer patients. The secondary endpoints are the appetite, quality of life and toxicity. From January 2014 to now, we enrolled 18 patients with different oncological diseases who have started treatment with cannabinoids for pain and / or chemotherapy induced nausea and / or vomiting. Efficacy data are collected every three weeks of treatment through NRS scale to quantify pain and emesis. The evaluation of appetite is measured through a NRS scale, too; for measuring the quality of life is used QoL Index and the test for the toxicity psychiatric PROD-Screen. The anamnestic interview and physical examination were practiced in all cases. Results: All patients received inflorescences of cannabis with THC to 19%, in the form of an infusion, one or two times a day, at doses ranging from 14 to 264 mg per day. The control of the emetic symptomatology was achieved in all cases. The pain was not controlled significantly. Patients enrollment showed appetite or sleeping hours decreased or anxious or depressive symptoms have reported clinical improvement. QoL Index score rose for all patients. There were neither significant changes in the PROD-Screen nor any relevant toxicity except mild epigastralgia in three cases during the administration of the infusion. Conclusions: From obtained data, the use of inflorescences of cannabis in cancer patients appears to be useful for the control of emesis, while it seems insufficient to relieve pain. The formulation in infusion appears to have a high compliance. The ability of the derivatives of Cannabis in improving the quality of life through better control of the anxious / depressive symptoms and an increased appetite and hours of sleep should best be studied in a larger number of cases.