Ian Olver, AM, MD, PhD

Though many case studies and anecdotal reports have touted the effectiveness of cannabinoids for cancer pain, in randomized studies, the areas in which they are effective are “fairly borderline,” according to Ian Olver, AM, MD, PhD, Immediate Past President of the Multinational Association of Supportive Care in Cancer (MASCC) and Director at the University of South Australia Cancer Research Institute in Adelaide. 

“In cancer pain, we’re not seeing the sort of effect you’d like to see if you were going to prescribe, but that doesn’t mean people aren’t using cannabinoids for these symptoms,” he said in a press conference at the 2018 MASCC/International Society of Oral Oncology (ISOO) Annual Meeting in Vienna. “If you compare their efficacy to their toxicity, which in some patients can be quite extreme, there can’t be a definitive recommendation—in almost any symptom—to use cannabinoids.”

And in some individuals, particularly older patients, significant side effects can occur. “There has been a link to a possible higher incidence of psychotic episodes later on in people who use cannabinoids long term,” he added. “We need proper randomized controlled trials before we can be definitive in our recommendations.” ■

DISCLOSURE: Dr. Olver is an investigator (receiving no funding) on a trial of a cannabinoid for refractory post-chemotherapy emesis funded by the New South Wales government, and has advised BOD Australia on early phase trial design for a cannabinoid (payment going directly to the University of South Australia).