Medical Marijuana for Chemotherapy Side Effects – Nausea and Vomiting

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Patients with cancer report that nausea and vomiting are the most stressful side effects of chemotherapy treatment.  Mara of San Jose, CA is one of these patients. She was recently diagnosed with breast cancer and is experiencing nausea and vomiting from the chemotherapy treatments she’s going through.  Here’s what she writes…

Dr. Patel,

A couple months ago my doctor delivered the dreaded news that no one ever wants to hear.  I have breast cancer.

I’ve been going through rounds of chemotherapy treatments and it’s been wreaking havoc on my body.  Every round of chemotherapy treatment brings with it debilitating nausea and vomiting.

There are days when my stomach is so on edge that the slightest change in position makes me nauseous and results in vomiting.

The smell of food cooking get me nauseated. Sometimes even the sight of food makes me nauseous.  The times I do force myself to eat, it just comes right back up.

Most people feel better after throwing up.  It’s not the case when you’re going through chemotherapy treatment.  In fact, I feel even worse.

It’s painful knowing that I’ll have to go through this agony with every round of the chemotherapy treatment.  Sometimes I’m left wondering if the chemotherapy treatment is worse than the cancer itself.  I’ve lost count of the number of times I’ve thought of quitting the chemotherapy treatment.

To help with the nausea and vomiting, my doctor had me try Ativan, then Zofran, and then Zyprexa, which is actually a medication used to treat Schizophrenia and Bi-Polar Disorder.  They didn’t do anything.  The nausea and vomiting was the same before as it was after taking these medications.

I can’t believe I’m saying this, but at this point I’m so desperate that I’m even willing to try medical marijuana.  I’ll do whatever it takes to get rid of the torment of the nausea and vomiting.

But before I try it, I want to know if it actually works.  Will the medical marijuana help me to get rid of the nausea and vomiting that I’m having?

Sincerely,

Mara
San Jose, CA


Mara,

Thanks for writing in.

Feeling nauseous for a couple hours and vomiting even once leaves the average person feeling out of sorts, but feeling nauseous on a daily basis and vomiting multiple times I imagine leaves you feeling worn out.  I’m sure your frustration levels must be off the charts given that the what you’ve tried so far hasn’t worked at all.

I do have a good bit of information to share with you on using medical marijuana for nausea and vomiting, specifically as a side effect of chemotherapy treatment.

First, I’m going to talk about what the research shows and then I’ll tell you the sort of results I’ve seen in my own patients over the past couple years.  I’ll even go into why medical marijuana helps to ease nausea and vomiting.

Let’s get started.


Medical Marijuana for Chemotherapy Side Effects – Nausea and Vomiting: The Research

I want to start with what we already know.

We already know from about 30 clinical trials that synthetic cannabinoids are better at preventing nausea and vomiting associated with chemotherapy than prescription medications like Reglan, Compazine, Phenergan.

A synthetic cannabinoid is a chemical similar to that found in marijuana, but is created in a lab.  It doesn’t come from the marijuana plant.

Examples of the synthetic cannabinoids are prescription medications like Nabilone and Dronabinol.  Both Nabilone and Dronabinol are approved by the US Food and Drug Administration for use in chemotherapy-induced Nausea and Vomiting when conventional pharmaceutical drugs haven’t been effective.

We also know based on clinical trials that patients prefer to use marijuana over synthetic cannabinoids.  With a synthetic cannabinoid, patients are just getting the effect of that one cannabinoid.  With marijuana, research in animals suggests that some of the other cannabinoids in marijuana may be enhancing the effect of THC, one of the chemicals in marijuana, in preventing nausea and vomiting.

The study I’m going to discuss looks at the effect of the medication Sativex on chemotherapy-induced nausea and vomiting.

Sativex is a medication created using the marijuana plant.  Basically, it’s an extract of the chemicals in the marijuana plant.  It’s applied as a spray in the mouth.  If you live in a state in the United States where marijuana is medically or recreationally legal, then it’s very similar to the tinctures that you find at medical marijuana dispensaries.

The study specifically selected patients that were not doing well with standard anti-nausea/anti-vomiting treatments.  The standard treatment included medications like corticosteroids, Zofran, and Reglan.  So the researchers decided to add some marijuana to the mix to see if it would help any in relieving the nausea and vomiting. The patients received either

standard treatment + placebo (designed to appear, taste, and smell like Sativex without any cannabinoids in it)
OR
standard treatment + Sativex

In the end, here’s what they found

  • In the group that was given Sativex, 5 out of 7 patients, or 71.4%, reported having no vomiting and an average of 10 out of 100 level of nausea.
  • In the group that wasn’t given Sativex, 2 out of the 9, or 22.2%, reported having no vomiting and an average of 10 out of 100 level of nausea.

Medical Marijuana for Chemotherapy Side Effects – Nausea and Vomiting: The Why

It’s believed that marijuana prevents vomiting by activating the CB1 and CB2 receptors located in the part of the brain (the dorsal vagal complex) that controls the vomiting response.  CB1 and CB2 receptors are what interact with the chemicals in the marijuana plant.

Medical Marijuana for Chemotherapy


Medical Marijuana for Chemotherapy Side Effects – Nausea and Vomiting: The Results

Ok.  So, on to the results I’ve seen in the cancer patients I’ve treated.  These are specifically patients who experience nausea and vomiting from their chemotherapy treatments.

Most of my patients report that using medical marijuana both before and after the chemotherapy treatments helps to keep the nausea at bay.  In the vast majority of my cancer patients, the medical marijuana also helps to eliminate the vomiting.

My patients also report that the medical marijuana works better than the prescription medications they’ve tried.

In fact, they find that medical marijuana works better than Marinol, which is a synthetic version of THC.  It’s available by prescription in the United States.  It’s approved by the FDA (Food and Drug Administration) for nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional anti-nausea/anti-vomiting treatments.  Patients also find that they tend to get side effects from the Marinol, like dizziness for instance.

It’s important to know that when used excessively, medical marijuana can actually worsen your nausea and vomiting.  Doctors called this effect Cannabis Hyperemesis Syndrome. It’s important to ensure that you’re using appropriate amounts of medical marijuana.

So, Mara, I hope this information helps you to make an informed decision.  I wish you the best with your treatments.

With Gratitude,
Dr. Patel


Research Referenced:

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