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Existential and Spiritual Suffering
In addition to symptom management, the implications of cannabinoids in oncologic care for mitigating existential and spiritual suffering have been demonstrated as well. This becomes especially significant for patients who may be nearing death and discover themselves addressing end-of-life issues. Cannabis can help abate anxiety and promote a sense of peace which is connected intrinsically to a patient’s experience of emotional integrity and spiritual wholeness.
Medical marijuana may also be of benefit to terminally-ill patients in enabling them to remain engaged in their loved ones lives before they die. In speaking about the use of cannabinoid integrative medicine, Dr Aggarwal writes, “…increased awareness of the moment, coupled with the increased introspection and meditation that cannabis can catalyze and for which it has been used in various spiritual traditions, might lead to spiritual growth and development, which can play a vital role in helping people to create a ‘good death’.”4
Additional Considerations
Some studies have indicated cannabis as an antitumor agent that operates in the induction of apoptosis and prevention of metastasis. “There is evidence that suggests that cannabis may be used as a potential chemotherapeutic treatment. In vivo and in vitro research proposes that cannabinoids can inhibit tumor growth via various mechanisms including increasing cellular apoptosis and suppressing cell proliferation.”1 Although the research is encouraging, patients should not misconstrue these findings as a “cure” and hence usurp conventional cancer therapy. The results are preliminary and have been focused primarily on animal studies.
Dr Abrams, writing with Manuel Guzman, of the Complutense University and Centro de Investigacion Biomedica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain, aptly cautions that “…although the in vitro and animal evidence is intriguing, there have not yet been any robust human studies investigating cannabis as an anticancer agent that would warrant advising patients to forego conventional therapy in favor of using a high-potency cannabis extract.”3
Conclusions
As legislative approval for the use of medical marijuana increases, studies continue to indicate the potential benefits of cannabinoid therapy for palliative and end-of-life care. The use of cannabis in oncology appears particularly promising as a viable treatment option in the alleviation of cancer related pain. Although further research is essential in determining the influence of cannabinoid integrative medicine on symptom management, caution should be exercised simultaneously, so as not to dissuade physicians from educating their patients on the potential benefits of medical marijuana.
Exploration and open communication between the patient and physician therefore, is crucial. “Integrating CIM into oncologic palliative care promises to improve overall health-related quality of life, to further relief from distressing symptoms and spiritual suffering, and to bring hope to patients and families facing terminal illness,” commented Dr Aggarwal.4 Physicians educated on the benefits of medical marijuana and trained in cannabinoid integrative medicine, can initiate the conversation and hence, work toward fostering and ensuing patients’ physical, emotional, and spiritual well-being and dignity.
Glenn Meuche is social work internship coordinator at CancerCare.
References
1. Wilkie G, Sakr B, Rizack T. Medical marijuana use in oncology: a review. JAMA Oncol. 2016 Mar 17. doi: 10.1001/jamaoncol.2016.0155 [Epub ahead of print]
2. Abrams DI. Integrating cannabis into clinical cancer care. Curr Oncol. 2016;23(2):S8-S14.
3. Abrams DI, Guzman M. Cannabis in cancer care. Clin Pharmacol Ther. 2015;97(6): 575-586.
4. Aggarwal SK. Use of cannabinoids in cancer care: palliative care. Curr Oncol. 2016;23(Suppl2):S33-S36.
