Effectiveness of Medicinal Cannabis for Cancer Patients

Medicinal Cannabis
21 mn read

Introduction

Cannabis is among one of the most famous plants as it is used in many different settings especially because of the recreational use of its derivatives (Li, 1974). Its products are called weed, marijuana, cannabis, hash, hashish, pot and many other names. Most of the time it is considered to be a symbol of weed which is a smoke-able substance made of cannabis Sativa (Freeman, 2015). However, despite being a drug as it is commonly known to be cannabis has various types, and almost all types have quite significant medicinal properties (Arata, 2004). Even some people are referred to smoke weed to deal with their issues like anxiety and in some cases glaucoma and other such permanent conditions by their doctors. It is also talked a great deal about in terms of a cure for cancer by many habitual users of different strands of Marijuana in unofficial settings as well as many doctors and physicians discuss it in their conversation as a cure. So, medical marijuana is a topic that is under a lot of discussion in various circles including the medical ones.

The discussions relating to the usage of cannabis for treatment are very inconclusive, and people supporting different sides of the discussion are radically against the opposing view. This is a reason that the current study finds it of great importance to reach the truth of medical efficacy or inefficacy thereof in case it does not do much to help (Mangot, 2013). The research seeks to produce an in-depth analysis of the use of cannabis in the field of medicine and a cost-benefit analysis for cancer patients. Being a recreational drug as well the negatives and benefits will be examined to see a clear picture of what cannabis can do for the patients without hurting them in key ways.

The use of Marijuana, its different strands or the chemicals in cannabis plants for medicinal purposes can be defined as medical marijuana or medical cannabis. It is in many cases the same stuff that is used for recreational purposes but the motivation behind the use is for the treatment of some symptoms, and that is why it is considered medical. The different strands of the cannabis plant contain more than 100 different chemicals in various proportions and these chemicals are called cannabinoids (Uchiyama et al., 2010). Each one of these compounds and chemicals has different effects on the body. For example, Delta-9-tetrahydrocannabinol ordinarily referred to for instance THC is the main component that gives the ‘high’ and cannabidiol commonly called CBD counteracts the very effect of the THC which balances the effect of marijuana. These are also the two main components that are used for their medicinal properties (Fada et al., 2004).

Medicinal marijuana has attained a lot of attention recently because of the controversies relating to societal, ethical and legal issues associated with its use, or the packaging, dispensing, safe administration and adverse effects for health and sometimes even death related to marijuana intoxication (Philipson, 2014). The therapeutic indications also are a controversial subject themselves as it is based on limited research on the topic which is in some cases due to the restrictions in attaining the substance that hinders the research. So, to say the least, the subject of Marijuana use for medication is quite complex and it is full of contradictions and controversies which makes it harder to study as well. The use of Marijuana or cannabis under medical supervision is also under a great deal of controversy as there are many legal limitations which do not approve of it as a medicinal substance. It is until now, given the status of Schedule I substance under the MHRA and has only been opened for use as a medication in November of 2018. The move was made with the passage of the Comprehensive Drug Abuse Prevention and Control Act. So, even though, under different regulations, the UK has made the usage of cannabis legal for treatment but due to the familiar legal practices, many doctors still stay away from prescribing the substance for medicinal use. However, in the UK, most of the byproducts of the cannabis plant were illegal and weren’t allowed for use in any domain i.e. recreational or medical (Potter, 2006).

WHO reports put marijuana among the most universally cultivated, smuggled and misused prohibited medicine in the world. Nearly 147 million people in the world partake in marijuana use which makes up 2.5% of the global population. Circa 22.2 million of the subjects of the research over the age of 12 testified that they had used some form of the drug in 2014 and among the surveyed populations around 8.4% reported using it in the last month (Wang and Post, 2019). However, according to the public opinion polls, ballot measures and legislative activities show that in the UK the general use of marijuana for medicinal and recreational usage has garnered some legitimacy, and the laws have opened up the debate on legalization. A 2016 survey by Gallup about whether the substance should be legalized showed that among the people surveyed, about 60% were in favour of the move. Another recent study by Quinnipiac University found that about 54% of the population surveyed was in favour of legalizing marijuana without any constraints, while 81% were only in favour of legalizing it for medicinal use, which shows that the public opinion on the matter has changed quite a lot recently (McCarthy, 2016).

Health care providers may also consider going the route of this therapy in certain circumstances but there is a limited study which suggests that. Use of marijuana is illegal in the UK, and that is why getting the products can be harder for even the researcher. Even after the legalization there still are many stoppages to getting the substance in circumstances. More and more nations and states are opening their doors to some forms of marijuana and that is the reason that it is being legalized more and more as well the doors for the research on the substance are also opening up (Mead, 2017).

The authorities like FDA in the US much MHRA in the UK, have deliberated on how they would determine the uses of curative marijuana while also taking into account the public security and abuse of the substance to unprecedented amounts. Other countries’ authorities are also opening up their ideas and thinking about the use of this drug for medicinal needs (Miller and Oberbarnschiedt, 2017). With the new arenas opening up for use of cannabis there is a promising future of research in pharmacology and pharmacokinetics. The use of the products of cannabis would also have implications for the ways to be used at hospitals and how that would change the dynamic of health care institutions and practices.

The origin of the use of cannabis as a botanical or plant-based product goes back to the ancient world. The use of Marijuana can be traced back to 5,000 years back when it was used in the region now Romania. The first use of medicinal marijuana in the shape of Delta Tetrahydrocannabinol (THC) has been medicinally used around 400 BCE (Paice, 2017). All through the nineteenth and twentieth centuries, products of marijuana plant were widely used as a legal medicine around the world which is described in detail in the United States Pharmacopoeia in 1850. It was legal up until 1928 and was later added as addendum to the 1920’s Dangerous Drug Act. After the act of 1928 cannabis became illegal and was thrown under strong repercussions for the people for having even small amounts of the plant or the products. The punishments for possession became stricter in 1950s with the enactment of different constitutional Acts. These laws and criminalization under these acts not only made possession for recreational purposes hard but it also impeded the possibilities of research on cannabis (Friedman and Sirven, 2017). The Acts made acquiring cannabis for academic purposes which is the main reason that there still is a great debate on the benefits of marijuana but limited research in that department.

The UK considered cannabis a perfectly harmful drug with no possible uses. However, some states of the US like California permitted access to cannabis legally in 1996 for medicinal use only under general practitioner’s supervision after the presentation of Act of compassionate use. As mentioned earlier that many states since decriminalized marijuana and its products and others have legalized it completely and allowed for people to possess it in small amounts. This will allow more and more people to attain it for the purpose of research and hence the knowledge about the medicinal use of marijuana will become more comprehensive with time on a relatively faster pace than it has been till now. Additionally, the move made in the UK in the same spirit of legalizing using marijuana and its products for medicinal use would change the situation of research on the substance in the UK as well.

Research Motivation

The topic especially piqued the interest of the researcher because of the recent hype that the legalization of Marijuana in the UK and overall legal debate on the matter in the media has created. The media pundits in many countries and states have stated various beneficial sides of the use of marijuana as well which added to the curiosity of the researcher. Along with all the hype media created the researcher has also experienced learning about people first hand who have had positive results after using cannabis. All of these are the reasons that got the researcher interested in the topic, so it can be argued that the motivation for this research is a mix of both intrinsic and extrinsic. The researcher is also keen to learn everything about this important topic as it would be beneficial in the future professional setting as well. So, the evidence-based knowledge of the benefits of cannabis would be a good addition to the researcher’s knowledge. Even though, the UK legislation regarding the medicinal use of marijuana is behind many other nations and might take a longer time for legalization but knowledge of the subjects of future importance is quite important for the medical practitioners and for that purpose the researcher would gain a lot by learning through in-depth analysis of the topic. The Literature review for the research topic seeks to gather the available data and research on the topic of the medicinal use of cannabis for cancer. It will also lead the way into making new suggestions based on the previously available knowledge on the topic.

The medicinal value of cannabis for cancer should be researched upon in detail as it can be of a great help to the cancer patients.

Benefits of medicinal Cannabis

Even though in the modern medicine cannabinoids agents and cannabis itself is used for the alleviation of various symptoms and to treat certain diseases but the effectiveness of these is not well established according to the scientific research. There are however many studies that indicate that the cannabis and its products do help in relieving pain related to different conditions. For example, a study that included 18 cases with pain conditions resulting from fibromyalgia, rheumatoid arthritis, mixed chronic pain and neuropathic pain showed that after the taking cannabis-based medications the levels of pain in 15 cases were relieved to a greater extent by these products than placebo (Campbell et al., 2018). The cannabis-based medicine used in the trials were oromucosal extracts like dronabinol, nabilone, a novel THC analogue and smoked cannabis as well. The study also found out the adverse effects of the cannabinoids were mild to moderate and in most cases, they were tolerated easily. The research study concluded that the use of cannabis outweighs the adverse implications, in that it is moderately expedient for relief of neuropathic pain with primary evidence suggesting that it is safe and effective for fibromyalgia.

There is not enough data to suggest routine use of cannabis for the alleviation of sickness which comes as side effects of chemotherapy researched by international or national cancer societies. “At the same time, however, some of the derivatives of cannabis like dronabinol have been approved to be used as antiemetic in many countries including the UK.” These derivatives are in use in the medical practice in many places but there is a lack of understanding of how effective they are. It remained an unsearched field for a long time but recently cannabis-based medicines have been researched on for their use for the management of vomiting and nausea due to chemotherapy. In some other studies, THC products have shown some promise for the treatment of dementia-related behavioural symptom management and also a good treatment for anorexia (Shelef et al., 2016). However, sedation like symptoms still remains as a side effect of the cannabinoids.

Even though the evidence of the efficiency of marijuana and cannabis products for the treatment of various symptoms but there is still legislation in various states that has allowed the use of cannabis for medicinal use. Cannabis is commonly referred to for medication for symptoms like glaucoma, cancer, acquired immunodeficiency / human immunodeficiency Syndrome and multiple sclerosis.

Side Effects of Pharmaceutical Cannabis

Much of the understanding of the bad effects of marijuana emanates from the studies done on the people using cannabis for recreational purposes. For example, the use of marijuana for a short term in heavy doses leads to short term memory impairment, motor coordination impairment, paranoia, psychosis and altered judgement. Heavy use of cannabis for the long term is even more dangerous especially in cases where it is used since adolescence where it can lead to addiction, brain development patterns alteration, diminished vigour and life satisfaction and lower outcomes in the educational and professional life. Chronic bronchitis ad increase risk of chronic psychosis and related diseases are also connected to long term excessive use of marijuana. Psychosis related health disorders can range up to schizophrenia, different types of depression especially in people who are predisposed to such disorders (Oliveira et al.,2017). Use of cannabis can also lead to stroke, myocardial infarction and heart attacks as well. Marijuana used for the management of neurodegenerative diseases like Alzheimer’s, Parkinson’s and MS can also lead to impaired cognition in the patients. Negative symptoms related to the use of cannabis also include impaired coordination, anxiety, hyperemesis syndrome, suicidal thoughts, psychosis etc. Prolonged symptoms can be mood disturbances, further worsening of various psychological syndromes and disorders like withdrawal syndrome, neurocognitive impairments as well as respiratory and cardiovascular illnesses (Subramaniam et al., 2019). However, there still is a need for comprehensive long-term clinical studies to assess the risks and rewards of the use of cannabis for a protracted period of time.

Legal limitations for research on cannabis

There are severe limitations on acquiring cannabis of its derivative products almost everywhere in the world and that is the reason that there are limited chances for conclusive research in many places as well. In the UK marijuana for recreational purposes is prohibited and is classified as a ‘class B drug’ which means there are strict penalties on possession of the substance (Wright, 2019). According to a law in 2004 it was declared a class C drug which limited the severity of the penalties on cannabis possession but later in 2009, the rule was changed back to the original verdict of making it a class B drug. Medicinal use of marijuana or cannabis was legalized in 2018 only if a registered specialist prescribes it to the patient.

Cannabis is used as an illegal drug all over the UK however, some derivatives of cannabis like hemp have been traditionally used for the creation of fibre, seeds and oils. Cannabis has remained restricted in the United Kingdom since 1928 and even stricter terms were implemented in 1971 after the products of cannabis found popularity among the general public. The policymakers saw it as a threat and the restrictions of the substance became stricter.

Even though marijuana and its products are illegal in the UK and are only allowed to be used in special medical situations but still the United Kingdom is among the largest exporters of legal cannabis. GW pharmaceuticals that deal in medicinal cannabis and are the largest producer of medicinal cannabis products like Epidiolex and Sativex is also located in the United Kingdom (Ruben, 2018).

A literature search was conducted using the databases EMBASE, PubMed Central (PMC), UpToDate, BNI, PubMed, Cinhal, Medline, Cochrane Library, Web Science and Google Scholar. The keywords used for the search for primary and secondary data included Cannabis, cannabinoid, THC, CBD, cannabis and cancer, THC for cancer, medical marijuana, medical cannabis, medicinal properties of cannabis, cancer and oncology, cannabis and oncology, chemotherapy-related sickness, chemotherapy and nausea or vomiting etc. A vast number of peer-reviewed articles and research papers were found for the research through this search strategy and a further in-depth review of the papers found will be the next step in the research. Gathering the information and knowledge for the research in this way will lead to a comprehensive understanding of the topic at hand and make the researcher able to deal with it accordingly.

The filter used for the search was a timeline from 2014 to present which narrowed down the search area as well as allowed the researcher to gather the most recent and up-to-date data concerning the partaking in cannabis products for the management of vomiting and nausea prompted by chemotherapy. Another step for ease of the researcher was taken and that was to include only the articles and papers that are published in the English language. Papers from countries like the US, Italy and Canada were also included in the research to gather more data as these countries have extensive research on the topic and can aid with the research quite a lot. The liberal legal policies of these nations or at least of states within them made it easier for the researcher to understand the legal limitations in the UK as well. The research will utilize the relevant links from the papers collected to further the research towards the attainment of goals.

In their research paper ‘Cannabis use in cancer: a survey of the current state at Cancer before recreational legalization in Canada’, Hawley and Gobbo (2019) surveyed patients suffering from cancer about the use of cannabis whether they use it or would like to use it or not. As the cancer patients suffer from many different symptoms during their illness and need some help for easy management of those symptoms. So, a lot of people are reported to take cannabis to manage their cancer-related illnesses and sometimes even to cure cancer. The research focused on finding out the effectiveness and risks related to cannabis use in cancer patients. The original sample population of 2998 patients was the cancer patients who visited any of the 6 cancer centres on the day of the survey. They were sent survey questionnaires and only 821 responded and were added to the study. The analysis, therefore, included 821 (27.4% of the intended number) patients. Of the total respondent, 23% were using the cannabis-derived products for their medicinal properties and 28% had used marijuana in the past mostly for recreational purposes. The current users of cannabis were using the substance to help with insomnia, nausea, pain and anxiety i.e. symptoms related to cancer treatment and some of them hoped for anti-cancerous effects of the products as well. The study concluded that a major part of the respondents was in favour of using cannabis if their doctors and physicians helped them for management of symptoms. The study also added to the conclusion that there is a need for further detailed study into the cannabis use and its effects so that the physician can suggest the use of the product for their patients.

The study is suggestive that the use of marijuana and its products actually help alleviate some of the symptoms related to cancer and therefore there is a need for further research into the matter. This is a point that not only this study but many more make because the effectiveness of cannabis can be a key factor in the management of symptoms of cancer patients which can actually better their circumstance during the treatment and also allow them to live a better life with the debilitating disease i.e. cancer.

Abrams (2016) in his paper, “Integrating cannabis into clinical cancer care” outlines the basic methods and analyses the possibilities of utilization of cannabis for cancer. He argues that various species of cannabis have remained in use for medicinal purposes for a long time in history and illegalization only occurred after the 1940s. It has still been used for medicinal purposes but was not available as much as it did before. In the recent past, however, there have been moves that have made it easier again to access the products for medicinal purposes again in many states and countries in the world. Cannabis has a number of possible benefits for cancer patients as it can help them manage certain conditions they fall ill too because of cancer. Cannabis can help to fight against anorexia and can also benefit in the management of symptoms induced by chemotherapy like insomnia, pain, vomiting and nausea and depression. Some patient believes that cannabis might be weaker in action then other antiemetics but for some patient, it is the only thing that works. It is also a good product to increase appetite which gives them energy. Cannabis can also help with neuropathy that results as a side-effect from chemotherapy. A study on pharmacokinetic interaction of vaporized cannabis suggested that it works better than many other plasma opiates and increases in the pain relief benefits.

Some laboratory and animal trial studies also suggest that not only does cannabis alleviate sickness related symptoms but it can also possibly work as a cure for cancer itself. For example, there are studies that point to the effectiveness of cannabinoids in various ways like apoptosis of the cancer cells. It also inhibits metastasis and there are possibilities of angiogenesis. Even though clinical trials on these studies have not been done, there are still many reports are circulating that many patients have responded well to the cannabis use especially in concentrated oral forms in terms of its positive anti-cancer properties. So, as there is quite a lot of evidence, so, human trials must be done to understand the efficacy of human subjects. The questions put forward by these studies must be answered and the clinical trials on humans are the only way according to Abrams.

In “A selective review of medical cannabis in cancer pain management” Blake et al., suggest that if the neuropathic and chronic pain in cancer patients if not treated can cause the worsening quality of life which increases the problems for the patient (2017). Among the cancer patients, pain management medicine mostly used in conventional settings are the opioid analgesics. These analgesics can, however, in some cases exhibit severe side effects for certain patients and therefore need alternatives to analgesic for successful management of pain. The study reviewed a number of studies with the earliest from 1975 a small pilot study and the latest a double-blind-placebo-controlled trials. The studies reviewed were on the effectiveness of cannabidiol (CBD) and delta-tetrahydrocannabinol (THC) for relief in the pain of cancer patients. the literature review done in this study found some effectiveness in THC and CBD in controlling cancer-related pain. “THC oil capsules, THC and CBD oromucosal spray (nabiximols) and other THC derivatives are shown as possible therapies that can successfully reduce the severity of pain in melanoma patients.” The scholars in the paper show that the CBD and THC products of cannabis do show quite a lot of promise in relation to relieving pain for cancer patients but at the same time many of the studies involved in this particular project lacked a strong statistical backing. The study also points to some side effects of the use of these chemicals, which is in a way a needless hassle and mars the necessity or efficacy of the drugs. Mental clouding, drowsiness, vomiting and nausea and hypotension are among some of the side effects gathered through these studies. The researcher of the study also like many other researchers in the filed call for a more comprehensive study into the topic so that some clarity can be brought to the matter.

The study with the topic ‘What cancer patients actually know regarding medical cannabis: A cross-sectional survey with a critical analysis of the current attitudes’, by Cortellini et al., (2019) focuses on the medicinal use of cannabis. In Italy cannabis has maintained the status of a medication since 1998. Even though, it is not given the status of a therapy but it is considered to be an adequate treatment of symptoms like nausea, vomiting and chronic pain in a different patient including severe conditions like cancer. The researchers in the study took cancer patients of two cancer OPD centres and a home care service as subjects. Between February and April of 2018, 232 patients became part of the study. 210 patients among them were on active treatment. Among the patient, 81% had heard about the medicinal properties of cannabis but among all of the 81%, only 2% got the said information from their doctors and nurses. A greater number of the patients wanted to use marijuana for themselves to relieve one or more symptoms most of them focused on relieving pain. Even though, they believed it could help them but 18% among the patient was of the view that using marijuana could actually have negative implications for their already weak health. Patients who have upper scholastic levels knew more about cannabis than the patient with lower education. The cancer patients who were under treatment also knew more about cannabis use for medicine than the patients who were not under treatment at the moment. The study concluded that most of the patients in the subject institutions of Italy were aware of the medicinal use of marijuana and among them, a major portion wanted to use it themselves to treat one or more of their symptoms. But even though they have heard about the cannabis and its medicinal values they are still uninformed about its effectiveness and tend to not bring up the topic with their health care providers. So, their knowledge exists but is insufficient and not asking the medical professionals about it means that do not trust their knowledge about their condition. The recreational use of cannabis is the main reason that despite their knowledge the patients do not trust it enough to ask questions about it from their doctors.

An investigative report by Elisabeth Mahase (2019) titles, “Medical cannabis; patients turn to private clinics because of NHS void”, outlines the need of cannabis that some patients feel quite strongly about that they left their doctors who could not prescribe medical marijuana to them. The two main clinics in London, Sapphire Medical Clinic and medical Cannabis Clinic are still waiting to get permission to prescribe and provide cannabis for medicinal purposes. The clinics have long waiting lists of people who are there in hopes of getting the products they think will help them with their chronic pain, cancer and other such conditions.

Martell et al., (2018) in their study titled “Rates of cannabis use in patients with cancer” try to outline the patients’ thoughts about the use of cannabis for medicinal purposes. The method utilized for the study was to spread an anonymous survey among patients suffering from cancer over 18. The areas of research encapsulated a provincial health care jurisdiction in Canada. 1987 of the total returned survey were filled sufficiently enough for them to be used for analysis. Of the patients who answered enough questions, 812 which makes up 41% of the total surveys were less the 60 years of age. 55% of the patients were women and 45% men. 44% of the total population considered in the research had college and above degrees. Of the total respondents, 43% reported using cannabis all their lives. Most of the cannabis, however, almost 80% was acquired through friends and 10% through medical dispensaries and 6% from other sources. 81% of the patients who used cannabis used dried leaves of cannabis. Out of the patients, only18% of respondents had used cannabis in the last 6 months, and 36% of them were new users. They used cannabis to deal with nausea (34%), pain due to cancer (46%), non-cancer related (56%) and other symptoms (31%). The survey concluded that many people who were suffering from cancer had used the substance before their diagnosis. However, among all of the users of the substance 1 in 8 cited that the reason there were using it was to relieve from symptoms of cancer.

The literature reviewed here suggests that cannabis and its derivatives and products can have some positive effects on cancer patients. Some research studies even suggest that these compounds not only help in managing the symptoms related to cancer, but they can also act as anticancer agents and weaken and deteriorate cancer itself. This is a big claim which is quite important and significant to know more about. There is a need for research into the anti-cancer properties of cannabis and its products. The literature also points out that the use of cannabis is done almost in all of the courtiers used in the study, and that shows that medical practitioners believe it to be of some merit that is the reason that they suggest their patients use cannabis or don’t categorically stop them from use thereof. Literature, however, suggests that there is a huge gap in the knowledge about this important product and the medical industry and healthcare services should raise a voice for more research on the products along with the help and aid of the authorities in the respective countries and states.

The research background and literature suggest two main things. Firstly, the use of cannabis for medication for cancer is not a mere suggestion on weed lovers it is a way to manage the problems that are a part of cancer and make its treatment a little better. Secondly, there is still a great need for research into the matter of the use of cannabis and its effectiveness compared to the negative implications it might have on a person. From the perspective of any health care provider, it is a question that needs to be addressed in detail. The health services related to cancer care are especially under a lot of problems as the pain and other symptoms related to cancer are quite agitating and the drugs traditionally used for these symptoms do not always work and have the capability to create more complications as well. So if this age-old remedy comes in handy and is manageable without too many complications then it would be a good alternative to common analgesics and antiemetics as well.

Cannabis is considered an illegal drug, and possession of the drug can lead to jail or some penalties for a person. People who consider cannabis a way to relieve their cancer-related and other permanent conditions try to get it however they can. In a lot of cases, people have to resort to illegal means to gain access to the substance, which can lead to their arrest. This would not only cause the patients problems with their reputation with the law they would also be put under a lot of stress which is quite harmful in most of the cases the cannabis is used to manage in the first place. However, the harms of cannabis to the health of a cancer patient do not outweigh the benefits they may be getting be it psychological in the management of nausea, vomiting, pain and inflammation or actually curing cancer as suggested by some studies.

Some studies were undertaken before show that usage of cannabis has a positive effect in terms of curing cancer not only in managing the symptoms. In a study on mice for example, with tumours, surgically implanted on them and then after treatment with THC for 30 days their tumour size had become much smaller than the original size. Many more of the same type of studies into the matter suggested similar results, but the issue still remains under the rug because of the recreational users of cannabis.

Another study by Dr Manuel Guzman from University Madrid Spain managed to find similar results as the above-mentioned study. He also reported in another article in the journal of medicine that cannabinoids like THC have the capability to shrink tumours in mice and therefore there is a relative chance that it would work on humans too. The study suggested that further probing into the subject would enlighten the scientific community on the matter. THC has been considered a better alternative to common antiemetics by countless studies. So, in light of all of this knowledge about the positive impact of THC and CBD and cannabinoids on cancer patients must warrant an in-depth study into the subject. The studies cited throughout the current research are all suggestive of the fact that there is a need for learning more about cannabis. They also suggest that better administration methods for these drugs must be developed, and the strands of the cannabis must be understood and designed through bio-engineering that have more beneficial components and less of adverse effects as there are many.

Further studies and probes into the matter are the only ways forward and at the moment even though there are studies suggestive of the benefits of cannabis use for cancer and other diseases as well but there are also others that contradict their findings. This contradictory nature of the subject has created a controversy and an outcry in the scientific community about finding common scientific grounds on the matter. The scientific community cannot work like a social setting where people have different opinions. It has to come to the truth and there can only be one truth. Cannabis is either good or bad for cancer patients. or to put it smoothly its benefits might outweigh the adverse effect or it could be the other way around. Whatever the reality of the matter is that is a need to find the truth about this issue, and research needs to take place.

The research suggests that cannabis has proved to be quite useful according to most of the literature reviewed here and that is why a further probe into answering questions about the efficacy of cannabis would be a good idea. Cannabis, CBD and THC seem to have some positive effects in terms of managing pain, queasiness and nausea which happen because of cancer. Therefore, the use of cannabis is important, and knowledge about it is even more so. Cancer is among the diseases that have been around for a long time, but there are no perfect and effective ways to manage and cure the problem altogether. In many cases, even when cancer is cured, it still comes back and can cause a considerable amount of pain, and misery and also put a huge fiscal load on the healthcare services and the person. So, proper management strategies for such a disease need to be put on a higher list of importance.

The researcher would recommend that the subject of the medicinal use of cannabis for the management of symptoms related to cancer and cancer itself needs to be taken seriously by the authorities as well as the medical researchers. It should be considered as the research also suggests that there is a need to comprehend the pros and cons of the use of cannabis for medicinal purposes. The search for the current study showed that there is a limited number of studies that discuss the use of cannabis in terms of a cost-benefit analysis. So, there is an urgent need for such comprehensive studies that weigh the benefits and the adverse effects of cannabinoids and give out a conclusive verdict about the good or bad effects thereof.

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