Cannabis in cancer care: what works, what might work, and what we don't know yet

Sufficient evidence supports cannabis for palliative indications in oncology, including chemotherapy-induced nausea and vomiting, cancer-related pain, anorexia, insomnia, and anxiety. Preclinical data show potent antineoplastic (antitumor) activity through immunological and direct mechanisms. However, no clinical trials have confirmed antitumor effects in humans. Concepts like synergism with conventional treatments, dosing sequence, and molecular cross-talk remain largely unexplored.

Narrative review classifying cannabinoids by natural and synthetic subtypes, examining mechanisms of action, clinical evidence for palliative indications, and preclinical evidence for antitumor activity.

Cancer patients are among the most common medical cannabis users, but there is a large gap between what preclinical research suggests about antitumor effects and what has been proven in humans.

The palliative evidence is solid enough to guide clinical decisions, but the more exciting antitumor potential remains in early stages. The danger is that patients may rely on cannabis instead of proven treatments based on premature conclusions.

Narrative review. No meta-analysis of palliative outcomes. Antitumor evidence is entirely preclinical. Regulatory barriers limit clinical trial design and conduct.