Even the fear of pain is a heavy burden for many cancer patients, as this study from the School of Psychology at the University of Ottawa discovered.
Of course, beyond the fear of pain is the actual pain, which can have a massive impact on the quality of life of cancer patients. This is why there has been, and still is, a lot of research being conducted into treatments for cancer pain management. A part of that research has focused on cannabinoids – the compounds found in the cannabis plant – and how they might be able to help cancer patients improve their quality of life.
While research into the effects of cannabinoids on the pain related to cancer is still relatively young, there are already studies that suggest they may help with pain management in cancer patients. One 2020 study from the Manipal Academy of Higher Education in India found that cannabinoids potentially produce an analgesic effect by activating certain receptors present in the central nervous system and nerve terminals. The findings of the researchers propose that cannabinoids may block the production of pain and inflammatory mediators, which could be a key to pain reduction and management in cancer patients.
So far, all very encouraging, so let’s look at what cannabinoids are, and how they interact with the receptors in our bodies.
What are cannabinoids?
As mentioned above, cannabinoids are chemical compounds found in cannabis plants, and also produced by our own bodies. Cannabinoids are split into two main groups.
- Endocannabinoids – These are the cannabinoids produced by our own bodies that can help interact with the endocannabinoid system, producing a range of effects such as pain relief, sleep regulation and mood elevation.
- Phytocannabinoids - These are the cannabinoids found in plants, cannabis and hemp included.
The main phytocannabinoids in cannabis plants are tetrahydrocannabinol (THC) and cannabidiol (CBD), which interact with the endocannabinoid system in the human body. This system contains the body’s naturally-produced cannabinoids, and consists of a complex of cannabinoid receptors, chemical signals and molecules called endogenous ligands.
The full scope of interactions between cannabinoids and the endocannabinoid system is wide-ranging, and they can impact a variety of bodily functions. However, both THC and CBD have different properties which have differing impacts, so here’s a quick explanation of the differences between THC and CBD and how they might help with cancer pain management.
THC and CBD for cancer pain management
Different types of cannabis contain varying amounts of both THC and CBD (and also other cannabinoids and terpenes), which is one of the primary reasons there are so many strains cultivated by legal growers.
THC is the intoxicating, psychoactive cannabinoid and is what offers the ‘high’ feeling when administered. The psychoactive element can affect how the brain works, enhancing or outright altering your mood and disposition.
CBD is a non-intoxicating cannabinoid that studies show may reduce inflammation, relieve pain by exerting analgesic effects, and decrease anxiety, as this study first published in the Cannabis and Cannabinoid Research journal reported.
As for how these cannabinoids can help with cancer pain, another study from 2020 found that “a large body of observational evidence points to the potential efficacy of cannabinoids for cancer pain management”.
Current approaches to cancer pain management
Conventional treatment for cancer pain is administered by health professionals such as doctors and nurses specialising in cancer care. Treatments can also come from anaesthetists, pharmacists, physiotherapists and occupational therapists. Psychologists and counsellors also help with the mental aspect of cancer pain management.
When it comes to conventional pain management for cancer patients, opioids are the go to. Opioid medication for mild to moderate cancer pain is most often codeine, while strong opioids for severe pain include morphine, oxycodone, tramadol and methadone.
Another medical option is non-steroidal anti-inflammatory drugs (NSAIDs), although research on their therapeutic effects is limited and often considered ‘low quality’ according to the research itself.
There are also adjuvant therapies in the form of drugs or substances that are used to increase the efficacy or potency of other drugs used to treat cancer pain. These include antidepressants, anticonvulsants and local anaesthetics, as well as topical agents, steroids and bisphosphonates.
Mechanisms of action of cannabinoids in cancer pain management
As mentioned above, cannabinoids interact with the endocannabinoid system in our bodies. The mechanisms of action during these interactions help our bodies to regulate pain, as well as our moods, emotions, and appetite.
The process involves a group of molecules derived from host tissues or cells called endogenous ligands, which bind with cannabinoid receptors through chemical signals to activate them. This binding has been shown to send instructional signals to the brain and body on how to respond to certain stimuli such as pain, hunger, and anxiety.
The potential mechanisms of action of cannabinoids in managing cancer pain primarily revolve around their analgesic, anti-inflammatory, and antianxiety effects. This multi-pronged impact has the potential to reduce physical pain while reducing the anxiety caused by the fear of pain.
The studies linked in this article among others have demonstrated how a cannabinoid treatment targeted towards the receptors in our endocannabinoid systems may release cytokines. These signalling proteins help control inflammation in the body and enable the immune system to fight off the likes of germs, infections, and viruses.
Different forms of cannabinoids for cancer pain
There are different forms of cannabinoids that can be administered for potential cancer pain management, including pharmaceutical cannabinoids, medical cannabis, and cannabinoid-based products.
Pharmaceutical cannabinoids
Cannabis commodities produced at a 'research-class' facility under laboratory conditions in a contained environment are known as pharmaceutical cannabinoids, or medical-grade cannabis.
Medical cannabis
Medical cannabis is not necessarily medical-grade cannabis, though the latter is technically included as part of the former. Medical cannabis is simply cannabis cultivated for medical purposes instead of recreational.
Cannabinoid-based products
Products containing THC or CBD can be described as cannabinoid-based products. These include oils and tinctures, skin creams, and edible products like gummies and tablets. To make such products, the cannabinoids are extracted from the original plant and infused with the product’s base ingredient.
Cannabinoid-based products may be especially useful for treating medical issues such as cancer pain, as the dosage can be easily adjusted to find the ideal amount. The amount of cannabinoid ingredients will usually be marked in milligrams on the product, so the patient knows exactly how much they are taking with each dose.
Which type of cannabinoid-based product is most suitable will be determined by the patients preference and the advice from the prescribing doctor, though some routes of administration such as the inhalation and sublingually administered tinctures are faster-acting due to the quicker absorption.
Benefits of cannabinoids for cancer pain
Further studies into the benefits of cannabinoids for cancer pain management are ongoing, but there is already plenty of research that suggests that cannabinoids can help with pain relief and improve sleep, and ultimately improve the quality of life for cancer patients.
Conclusion
As the results of more research is published, we will learn more and more about the benefits of cannabinoids for cancer pain management. So far, the majority of studies are reporting encouraging results, with cannabinoids continuing to grow in popularity as a treatment for cancer pain management.
Releaf is committed to helping you access the benefits of a medical cannabis service. Our monthly packages are tailored to your cannabis prescription, and we offer specialist consultations for medical cannabis and a unique medical cannabis card for protection.
