Cannabis Effective at Reducing Symptoms in Children With Cancer, but More Research Needed

Children with cancer who suffer from multiple symptoms related to the disease and its treatment can benefit from the use of cannabis, but more research needs to be done on correct dosing and safety, according to a recent study published in the journal Cancer.¹

Survival rates in childhood cancer have significantly improved thanks to the development of advanced diagnostic, surgical, and radiation techniques. However, these new technologies have come with numerous treatment-related side effects, including nausea, vomiting, pain, and anorexia, which are often uncontrolled.

Cannabis products have gained popularity over the last decade to manage these symptoms in children with cancer, but little is currently known about its safety, efficacy, and dosing in this patient population.

“Pediatric oncologists are understandably reluctant to authorize cannabis because of a lack of evidence supporting the safety and efficacy of its use in children with cancer,” the authors of the study wrote.¹ “There is a strong need to map the evidence on the current use of cannabinoids in children with cancer to inform the development of clinical trials evaluating the safety, dosing, and efficacy of various cannabis products in children with cancer.”

Investigators from the University of Manitoba conducted a systematic review and meta-analysis to assess the literature on the use of medical cannabis for symptom management in children with cancer. Data was gathered from 4 different databases: MEDLINE, Embase, PsycINFO, and the Cochrane Library.

A total of 34611 total citations were identified based on types of cannabis products, doses, formulations, frequencies, routes of administration, indications, clinical and demographic details, reported efficacy outcomes, and adverse events. Of those, 19 studies consisting of 1927 participants were included in the study.

Investigators found that the studies reported various cannabis products for the management of different symptoms, the most common of which was chemotherapy-induced nausea and vomiting. Adverse events associated with the use of cannabis products included somnolence, dizziness, and dry mouth.

Additionally, there were no serious adverse events related to the use of cannabis for the management of cancer-related symptoms in children across all of the studies that were included.

“It was difficult to measure benefit across studies, given a range of different outcomes and study designs; however, in interventional studies with active control groups, cannabinoids performed better in managing nausea and vomiting,” Lauren E. Kelly, PhD, lead author on the study, said in a release.² “Data are lacking on cannabinoids’ effects on pain, mood, sleep, and health-related quality of life.”

Study limitations include number of studies included in the review, lack of uniformity in the outcomes of the included studies, inability to conduct quantitative synthesis of outcome data due to a high variability in reporting of data, and no included case-controlled or cohort studies in the review.

“Given that some children report benefits and some children experience adverse events, it is critical that more rigorous studies evaluating the effects of cannabinoids on children with cancer are conducted and shared with parents, patients, and the health care community,” Kelly said.

References

1. Chhabra, M, Ben-Eltriki, M, Paul, A, et al. Cannabinoids for symptom management in children with cancer: a systematic review and meta-analysis. Cancer. 2023; 1-15. doi:10.1002/cncr.34920

2. Are cannabis products safe and effective for reducing symptoms in children with cancer? News Release. University of Manitoba. August 28, 2023. Accessed August 28, 2023. https://news.umanitoba.ca/are-cannabis-products-safe-and-effective-for-reducing-symptoms-in-children-with-cancer/