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Prospective Analysis of Safety and Efficacy of Medical Cannabis in Large Unselected Population of Patients with Cancer

European Journal of Internal Medicine, 2018

Lihi Bar-Lev Schleidera,b, Raphael Mechoulamc, Violeta Ledermanb, Mario Hiloub, Ori Lencovskya, Oded Betzalelb, Liat Shbiroa, Victor Novacka

a Clinical Cannabis Research Institute, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er-Sheva, Israel; b Research Department, Tikun Olam LTD, Israel; c Institute for Drug Research, School of Pharmacy, the Hebrew University of Jerusalem, Israel

Cancer is a major public health problem as the leading cause of death. Opioids are currently the standard treatment for treating pain caused by cancer, with a success rate of 80-90%. However, for some patients treatment with opioids and other painkillers is not effective over time or causes serious side effects. The aim of this prospective study, conducted in collaboration with Soroka University Medical Center and Ben-Gurion University, was to examine the epidemiological characteristics, safety, efficacy and side effects of products and strains of Tikun Olam for palliative care of 2,970 cancer patients. Cannabis treatment as a palliative treatment for cancer patients seems to be an effective and safe option to help patients cope with the symptoms resulting from cancer.

STUDY POPULATION: 2970 cancer patients (1348 male, mean age 59.5 ± 16.3).

STUDY PRODUCT: Most patients consumed Alaska, Erez and Avidakel.


  • During the study period, 3845 subjects received a cannabis license under the cancer indication. Seventy-nine patients (2.1%) died before starting the treatment, 146 (3.7%) received the license but opted not to receive the treatment, one patient (0.2%) switched to a different cannabis supplier, and 3619 patients (94.1%) initiated the treatment. Out of these 2923 (80.7%) responded to the intake questionnaire.
  • Overall improvement – 95.9% reported an improvement in their condition, 45 patients (3.7%) reported no change and four patients (0.3%) reported deterioration in their medical condition.
  • Decreased nausea and vomiting – 91.0% reported a significant relief from nausea and vomiting.
  • Cannabis as a palliative treatment for cancer patients seems to be well tolerated, effective and safe option to help patients cope with the malignancy related symptoms.
  • Decrease in medication consumption – Before starting treatment, patients took an average of 3.9 different regular medications per patient. After half a year of cannabis treatment 35.1% of them reported a reduction in drug consumption. Opioids, for example, was the most prevalent drug consumed by 344 patients (33.9%) at intake, 36% of them stopped taking opioids, 9.9% decreased dose, 51.1% continue to take the same dose, 1.1 increased the dose and 32 patients that did not consumed opioids but started treatment with opioids during the six months of follow-up.
  • Significant decrease in pain intensity – Prior to treatment initiation 52.9% of patients reported their pain to be in the interval of 8 to 10 (in a scale from 1 to 10), while only 4.6% reported this intensity after six months of treatment.
  • Significant improvement in quality of life – only 18.7% of patients reported good quality of life prior to treatment initiation while 69.5% reported good quality of life at 6 months.
  • 362 patients (30.1% of the respondents) reported side effects. The most common side effects were dizziness, dry mouth, increased appetite, drowsiness, psychoactive effect, nausea, and weakness.
  • Cannabis treatment as a palliative treatment for cancer patients seems to be an effective and safe option to help patients cope with the symptoms resulting from cancer.


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