A review found that the endocannabinoid system is involved in several otolaryngic conditions, with potential therapeutic benefits for pain, inflammation, and head/neck cancers, alongside known risks from cannabis use.
Read this if you use cannabis and have ear, nose, throat, or head/neck conditions and want to understand the medical implications.
Potential anti-cancer effects demonstrated in oral, thyroid, and skin cancer research
What the researchers found
Researchers reviewed the endocannabinoid signaling system in the context of ear, nose, and throat medicine. Cannabis is the most widely used illicit substance worldwide, and otolaryngologists encounter its effects and potential benefits across multiple conditions.
The review identified potential therapeutic roles in several domains. For pain management, cannabinoids showed promise for chronic head and neck pain. For inflammation, endocannabinoid system modulation could address various inflammatory conditions in the head and neck. Research has demonstrated potential antineoplastic benefits in oral, thyroid, and skin cancers.
On the risk side, the review documented adverse effects of cannabis use relevant to otolaryngology, including effects on the oral mucosa, throat irritation from smoking, and potential interactions with surgical anesthesia. Two synthetic cannabinoids (dronabinol and nabilone) were FDA-approved at the time of publication for chemotherapy-related nausea/vomiting, cachexia, and appetite loss.
The authors emphasized that with increasing use and changing legislation, otolaryngologists need to be aware of both the adverse manifestations and potential therapeutic benefits when discussing cannabis with patients.
Why it matters
Otolaryngologists see patients for conditions ranging from head/neck cancer to chronic pain to sleep disorders, many of which involve the endocannabinoid system. As more patients use or ask about cannabis, these specialists need to understand both the risks and potential benefits specific to their field.
The numbers in context
Two FDA-approved synthetic cannabinoids at time of publication. Approved indications: chemotherapy-related nausea/vomiting, cachexia, appetite loss. Research showing potential anti-cancer effects in oral, thyroid, and skin cancers.
How the study worked
This was a narrative review of the current literature on cannabis use, the endocannabinoid signaling system, and their relevance to otolaryngology practice, including regulatory status and clinical implications.
What this study cannot tell us
This is a broad narrative review covering many topics at a general level. Much of the therapeutic evidence is preclinical. The review does not provide specific dosing or clinical guidance for using cannabinoids in otolaryngic conditions. The regulatory landscape has evolved since publication.
How to read the evidence
This is a specialty-specific narrative review covering a broad range of evidence levels, from preclinical to clinical.
When this study was published
Published in 2018. Cannabinoid research in otolaryngology continues to develop.
The bigger picture
This review reflects a growing trend of specialty-specific cannabis reviews, as physicians in every field encounter patients who use cannabis. The otolaryngology perspective is particularly relevant because the head and neck are both sites of cannabis exposure (via smoking) and potential therapeutic targets.
Questions still open
- Could cannabinoid-based treatments be developed specifically for head/neck cancers? How should otolaryngologists counsel patients who smoke cannabis about the effects on their airway and oral mucosa? What role might cannabinoids play in post-surgical pain management for head/neck procedures?
Common questions
Can cannabis help with head and neck cancer?
Does smoking cannabis affect the throat?
Read the original research
Therapeutic Cannabis and Endocannabinoid Signaling System Modulator Use in Otolaryngology Patients.
Laryngoscope investigative otolaryngology, 3(3), 169-177
Citation
Bryant, Lucas M; Daniels, Kelly E; Cognetti, David M; Tassone, Patrick; Luginbuhl, Adam J; Curry, Joseph M. (2018). Therapeutic Cannabis and Endocannabinoid Signaling System Modulator Use in Otolaryngology Patients.. Laryngoscope investigative otolaryngology, 3(3), 169-177. https://doi.org/10.1002/lio2.154
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