THC:CBD oil reduced chemo-induced nausea in a crossover trial of gynecologic cancer patients | Research

The takeaway

In a randomized, double-blind crossover trial, a 1:1 THC:CBD oil significantly reduced nausea scores compared to placebo in gynecologic cancer patients receiving emetogenic chemotherapy.

Oncologists, palliative care providers, cancer patients experiencing chemotherapy-induced nausea, and cannabinoid therapy researchers.

Nausea scores: 2.11 (THC:CBD) vs. 2.99 (placebo), p<0.05

What the researchers found

Nausea scores were significantly lower in the THC:CBD extract group (2.11) compared to placebo (2.99). Over half of participants experienced dizziness and sedation as side effects.

Why it matters

Chemotherapy-induced nausea remains a major quality-of-life issue despite standard antiemetics. This trial provides controlled evidence that cannabinoid supplementation can provide additional relief.

The numbers in context

54 patients completed the trial (60 recruited). Mean age 54.4 years, mean BMI 26.5. 59% had advanced cancer. Nausea scores: THC:CBD 2.11 vs. placebo 2.99 (p<0.05). 36/54 reported dizziness and sedation.

How the study worked

Randomized, double-blind, placebo-controlled crossover trial. 54 gynecologic cancer patients received THC:CBD extract oil (1:1) before one chemotherapy cycle and placebo before another. Both groups received standard antiemetic medication. Nausea scores and side effects recorded.

What this study cannot tell us

Relatively small sample (54 patients). Single-center trial in Thailand. Crossover design means each patient served as their own control, which is a strength, but carry-over effects are possible. High rate of dizziness/sedation may limit practical use.

How to read the evidence

Double-blind, placebo-controlled crossover RCT. Small sample and single center limit generalizability, but the design is rigorous.

When this study was published

Published 2023. Trial conducted August-November 2022.

The bigger picture

Cannabinoids for chemotherapy-induced nausea have a long history, but most evidence comes from older trials with synthetic THC. This trial tests a whole-plant extract with both THC and CBD, reflecting what patients increasingly seek out on their own.

Questions still open

Would different THC:CBD ratios produce better nausea control with fewer side effects? How does this compare to synthetic cannabinoids like dronabinol or nabilone?

Common questions

Can cannabis help with chemo nausea?

This trial found that a 1:1 THC:CBD oil significantly reduced nausea in gynecologic cancer patients receiving moderate-to-high emetogenic chemotherapy, when added to standard anti-nausea medications. The benefit was statistically significant but came with frequent dizziness and sedation.

What side effects did patients experience?

Over half (36 of 54) reported dizziness and sedation. Dry mouth, confusion, anxiety, and palpitations were also reported but at similar rates between the cannabinoid and placebo groups.

Read the original research

Oral Tetrahydrocannabinol (THC):Cannabinoid (CBD) Cannabis Extract Adjuvant for Reducing Chemotherapy-Induced Nausea and Vomiting (CINV): A Randomized, Double-Blinded, Placebo-Controlled, Crossover Trial.

International journal of women's health, 15, 1345-1352

View on PubMed ↗Publisher’s paper ↗

Citation

Sukpiriyagul, Apichaya; Chartchaiyarerk, Ratiporn; Tabtipwon, Paluekpon; Smanchat, Buppa; Prommas, Sinart; Bhamarapravatana, Kornkarn; Suwannarurk, Komsun. (2023). Oral Tetrahydrocannabinol (THC):Cannabinoid (CBD) Cannabis Extract Adjuvant for Reducing Chemotherapy-Induced Nausea and Vomiting (CINV): A Randomized, Double-Blinded, Placebo-Controlled, Crossover Trial.. International journal of women's health, 15, 1345-1352. https://doi.org/10.2147/IJWH.S401938