CBD May Reduce Early Nerve Damage Symptoms from Chemotherapy | Research

The takeaway

Cancer patients taking 300 mg daily CBD before and during chemotherapy showed reduced early signs of peripheral neuropathy compared to untreated controls, with no major safety concerns.

Oncologists and cancer patients interested in neuropathy prevention; researchers studying CBD in supportive cancer care.

-1.76 vibrometry Z-score improvement at 250 Hz in Carbo-Tax patients

What the researchers found

CBD-treated patients receiving CAPOX or Carbo-Tax chemotherapy showed significantly better high-frequency vibrometry scores compared to controls. CAPOX patients on CBD also reported less cold sensitivity and throat discomfort.

Why it matters

Chemotherapy-induced peripheral neuropathy (CIPN) affects up to a third of cancer patients and has no well-established preventive treatment. If CBD can reduce early neuropathy symptoms, it could improve quality of life during cancer treatment.

The numbers in context

54 patients recruited. CBD dose: 300 mg/day. Carbo-Tax patients showed the largest vibrometry improvement at 250 Hz (difference: -1.76, 95% CI -2.52 to -1.02). CAPOX patients had lower cold sensitivity (-2.08), discomfort swallowing cold liquids (-2.06), and throat discomfort (-1.81) scores. Side effects: grades 1-2 stomach pain in CAPOX patients.

How the study worked

Prospective study of 54 cancer patients scheduled for oxaliplatin- or paclitaxel-based chemotherapy. Patients received 150 mg CBD oil twice daily (300 mg/day) for 8 days starting 1 day before chemotherapy. Neuropathy was measured by multi-frequency vibrometry and 10 patient-reported outcome measures. Controls came from a similar untreated cohort.

What this study cannot tell us

This was not randomized. CBD-treated patients were significantly older than controls, which could confound results. The sample size of 54 is small. Only early symptoms (first cycle) were measured; long-term follow-up is ongoing.

How to read the evidence

Preliminary: non-randomized prospective study with 54 patients and historical controls.

When this study was published

Published in 2022, with long-term follow-up ongoing.

The bigger picture

CIPN prevention is an unmet need in oncology. This is among the first prospective studies testing CBD specifically for CIPN prevention rather than general cancer pain. The results are promising enough to justify the randomized trial that the authors recommend.

Questions still open

Will the neuropathy prevention effect persist across multiple chemotherapy cycles? Would a randomized, placebo-controlled design confirm these findings? Is 300 mg/day the optimal CBD dose for CIPN prevention?

Common questions

Can cancer patients take CBD during chemotherapy?

In this study, 300 mg/day CBD appeared safe with only mild stomach pain as a side effect. However, CBD can interact with certain medications, so any use during chemotherapy should involve the treatment team.

Does CBD prevent nerve damage or just reduce symptoms?

The vibrometry improvements suggest CBD may have a protective effect on nerve function, not just symptom relief. However, this needs confirmation in a larger randomized study.

Read the original research

Oral cannabidiol for prevention of acute and transient chemotherapy-induced peripheral neuropathy.

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 30(11), 9441-9451

View on PubMed ↗Publisher’s paper ↗

Citation

Nielsen, Sebastian W; Hasselsteen, Simone Dyring; Dominiak, Helena Sylow Heilmann; Labudovic, Dejan; Reiter, Lars; Dalton, Susanne Oksbjerg; Herrstedt, Jørn. (2022). Oral cannabidiol for prevention of acute and transient chemotherapy-induced peripheral neuropathy.. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 30(11), 9441-9451. https://doi.org/10.1007/s00520-022-07312-y