Chemotherapy Induced Nausea and Vomiting (CINV)
Understanding CINV
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What is chemotherapy-induced nausea?
Chemotherapy-induced nausea and vomiting (CINV) is a common and distressing side effect of cancer treatment. It can occur immediately after chemotherapy or can be delayed for several days.
CINV can negatively impact a person’s quality of life and ability to stick to their cancer treatment plan. Therefore, effective management of CINV is crucial to improve patient outcomes and quality of life.
The causes of CINV
Chemotherapy-induced nausea and vomiting (CINV) are caused by the use of chemotherapy drugs to treat cancer.
These drugs are designed to kill rapidly dividing cancer cells. In doing so, they can also affect healthy cells in the body, including those in the gastrointestinal tract and the brain.
Chemotherapy treatment can lead to irritation and inflammation in the gastrointestinal tract, triggering the vomiting centre in the brain and causing nausea and vomiting.
Symptoms of CINV
The symptoms of chemotherapy-induced nausea and vomiting (CINV) can range from mild to severe and may include nausea, retching, and vomiting. Some people may also experience:
- Loss of appetite
- Stomach cramps
- Feelings of anxiety or depression
The severity and duration of CINV can vary depending on the type and dose of chemotherapy medication used, as well as individual factors such as age, gender, and overall health.
Treatment for chemotherapy-induced nausea and vomiting
Traditional treatment options
Treatment for chemotherapy-induced nausea and vomiting typically involves a combination of medications and non-pharmacological interventions.
The most common treatments often include:
- Anti-nausea medications, such as ondansetron, metoclopramide, and dexamethasone
- Other medications, such as corticosteroids, benzodiazepines, and cannabinoids
Alternative treatment options
In addition to traditional treatment options, non-pharmacological interventions may also be helpful in managing chemotherapy-induced nausea and vomiting.
These alternative treatment options may include:
- Acupuncture
- Relaxation techniques
- Ginger supplementation
- Medicinal cannabis
Using medicinal cannabis may benefit patients looking for relief from nausea and vomiting, chronic pain, and anxiety or depression symptoms [1]. While some potential risks and side effects are associated with cannabis use, other patients have found it a safe and effective treatment option.
How medicinal cannabis works
Before diving into the pros and cons of using medicinal cannabis, it’s helpful to understand how cannabis works in the body.
The human body has an endocannabinoid system (ECS) that regulates various physiological processes, including pain, mood, appetite, and sleep. The ECS consists of a network of receptors and enzymes that interact with endocannabinoids, which are naturally occurring compounds in the body that are similar to the cannabinoids found in cannabis.
When cannabis is consumed, the THC and CBD in the plant interact with the ECS in the body. THC binds to cannabinoid receptors in the brain and body, producing various effects, including pain relief, relaxation, and altered perception. Conversely, CBD does not bind to cannabinoid receptors but instead interacts with other body receptors involved in inflammation, pain, and mood regulation.
Potential benefits of medical cannabis for chemotherapy-induced nausea
Reduce nausea during treatment
The primary potential benefits of using medicinal cannabis for CINV is reducing both the severity and frequency of nausea and vomiting.
One study in the British Journal of Clinical Pharmacology found that a standardised cannabis extract, administered orally, was more effective than placebo in reducing nausea and vomiting in patients undergoing chemotherapy [5].
Delay nausea and vomiting post chemotherapy
While some patients experience the most severe symptoms at the time of their treatment, it is not uncommon for other patients to experience nausea and vomiting after chemotherapy treatment.
Another study found that dronabinol, a synthetic form of THC, was more effective than placebo in reducing delayed chemotherapy-induced nausea and vomiting, and that the combination of dronabinol and ondansetron (an anti-nausea medication) was more effective than ondansetron alone [1].
Alleviate pain
Many people undergoing chemotherapy treatment often suffer from high levels of pain and discomfort.
The cannabinoids in cannabis interact with the body’s endocannabinoid system, which plays a role in regulating pain perception. For some, cannabis is effective in reducing pain, particularly chronic pain. In a 2015 study published in the Journal of Pain, researchers found that cannabis use was associated with significantly reduced pain and stiffness in patients [7].
*The above studies highlight the potential benefits of medicinal cannabis, but do have some limitations that need to be considered. These limitations may include: a relatively small sample size, use of self-reported data rather than objective measures, and not measuring the long-term effects of cannabis use or exploring the different strains/types of cannabis used, which may have an impact on the observed effects.
Potential side effects
Like any medication, medicinal cannabis can have side effects. While medicinal cannabis may benefit some patients, it is vital to understand the potential risks and side effects. Common side effects of cannabis use include dry mouth, dizziness, and increased heart rate. Some people may also experience anxiety or paranoia. It is also important to note that medicinal cannabis can interact with other medications, so it is essential to talk to your doctor before using cannabis.
Finding the right dose
When using medicinal cannabis, finding the correct dose that provides maximum benefits with minimal side effects is essential. Everyone’s tolerance and sensitivity to cannabis are different, so finding the right dose may take some trial and error.
Working with a healthcare provider who specialises in medicinal cannabis can be helpful in finding the correct dose and product for your specific needs.
The legal status of medicinal cannabis in Australia
In Australia, the use of medicinal cannabis is legal under certain circumstances. In 2021, the Australian government amended its Narcotics Drugs Act to allow for the cultivation and manufacture of medicinal cannabis products for therapeutic use [1].
To access medicinal cannabis in Australia, patients must have a valid prescription from a healthcare provider and obtain their medication from a licensed medicinal supplier. Medicinal cannabis is unavailable over the counter and cannot be legally grown or produced by patients for personal use.
While the legal framework for medicinal cannabis in Australia is still relatively new, there is growing awareness of its therapeutic potential for various medical conditions, including fibromyalgia.
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Research suggests that medicinal cannabis may benefit chemotherapy patients looking for relief from nausea and vomiting.
The above studies provide some evidence for the potential benefits of using medicinal cannabis, including THC and synthetic cannabinoids, to alleviate nausea related to chemotherapy. It’s important to note, however, that more research is needed to fully understand the effects and potential risks of medicinal cannabis.
If you’re considering using medicinal cannabis for fibromyalgia, it’s essential to work with a healthcare provider, to better understand your options and to determine if you are a suitable candidate for medical cannabis treatment.
Other medical conditions
Non-chemotherapy-induced nausea
Non-CINV
Neuropathic Pain
Neuropathic Pain
Anxiety Disorders
Anxiety Disorders
Chronic Inflammation
Chronic Inflammation
Migraines and Headaches
Migraines and Headaches
Other medical conditions
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