At the 2018 Annual Meeting’s Parallel Session on Cannabinoids for Symptom Management, MariaLuisa Vigano delivered a paper on cannabis-based treatments for improving appetite in cancer patients and others with nonmalignant chronic diseases.1
MariaLuisa is 17 years old and, this month, begins her last year of high school (Grade 12) in the International Baccalaureate Program at Lower Canada College in Montreal, Quebec, Canada. This program requires each student to write a 4,000-word research paper. MariaLuisa chose the topic of cannabinoids and their effects on appetite and weight. She was already interested in complementary medicine, and the research project gave her an opportunity to pursue the topic. MariaLuisa told us: “I picked the topic of medical cannabis because over the past three years, I have witnessed, through my father’s work, 2 the revolution it is creating in the field of medicine around the world and particularly in Canada. I was intrigued by its therapeutic potential, as well as its potential to help improve appetite and weight in patients with chronic diseases. I already knew that nonmedical cannabis can give the people “the munchies,” making them want to eat. But I was baffled, at first, by the lack and/or weakness of clinical data on the effects of medical cannabis on appetite and weight.”
MariaLuisa worked with colleagues at McGill University and Santé Cannabis, a medical cannabis clinic in Montreal, Canada, and the only such clinic in the province of Quebec. The team conducted a retrospective chart review of all adult patients assessed at Santé Cannabis Clinic between August 2016 and October 2017 who had “increase of appetite” as a treatment goal. The “lack of appetite” item (0 = no lack of appetite to 10 = complete lack of appetite) from the revised Edmonton Symptom Assessment System (r-ESAS), and weight (kg), were considered as primary outcomes.
Fifty-four patients with disease-related anorexia (43% with cancer and 57% with nonmalignant disease) were studied. The r-ESAS score for lack of appetite significantly improved between baseline (5.07 ± 3.21) and follow-up (3.56 ± 3.15) (p = 0.0026), while weight remained stable between baseline (70.74 ± 14.63) and follow-up (71.02 ± 14.76). The use of nabilone (p= 0.0521) along with type of administration (inhaled and oral plus inhaled vs. oral) (p= 0.0142) had an effect on the difference in appetite. In addition, 18.5% of the patients reported only mild side effects, such as anxiety, fatigue, dizziness, and dry mouth. The results support the conclusion that administration of cannabis-based medicines within an individualized and supportive monitoring program may safely improve appetite and weight maintenance in patients who experience anorexia from cancer or nonmalignant chronic diseases.
After completing her research project, MariaLuisa showed the results to her father, MASCC member Antonio Vigano, who encouraged her to submit an abstract to MASCC’s Annual Meeting. Says the author, “Having the opportunity to present my work at a conference as notable as MASCC was simply surreal.”
MariaLuisa plans to pursue a career in medicine and medical research. She is certainly off to a good start and we wish her much success in the future!
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1Vigano M, Arboleda MF, Prosk E, Drozd Y, Xuecheng L, Dworkind M, Kasvis P. Cannabis-based Medicines Show More Promise for Improving Appetite in Chronic Diseases.
2MASCC member Antonio Vigano, MD, is an Associate Professor in the Department of Oncology, McGill University and is the Director of the Cancer Rehabilitation Program and the Cannabis Pilot Project in the Supportive and Palliative Program at the McGill University Health Centre.
