Cannabis is increasingly being explored as a supportive therapy in cancer care, particularly for managing symptoms and improving quality of life. In a recent webinar hosted by Goldstein Wellness, Realm of Caring Foundation and Leaf411, physician and pioneer Bonni Goldstein, MD, shared research and clinical insights into how cannabis interacts with the body and how it may support patients navigating cancer treatment.

 

Watch the full webinar here: https://youtu.be/MYfJ1pcnbLI

 

Why Target the Endocannabinoid System?

 

The rationale for using cannabis in cancer care centers on the endocannabinoid system (ECS), which is a biological system responsible for maintaining balance, or homeostasis, across many physiological processes.

 

The ECS regulates:

 

• Immune function
• Inflammation
• Pain signaling
• Appetite
• Mood
• Sleep
• Cell survival and cell death

 

These processes are directly relevant to cancer and cancer treatment.

 

Dr. Goldstein explains that the ECS acts as a signaling system that helps “dial back” excessive biological messages such as pain, nausea, anxiety, or inflammation. When these systems become dysregulated, as often occurs during serious illness, cannabinoids from the cannabis plant may help restore balance.

 

Importantly, many tumors themselves express cannabinoid receptors. This has led researchers to investigate whether cannabinoids may influence tumor behavior through mechanisms such as:

 

• Apoptosis (programmed cancer cell death)
• Anti-angiogenesis (blocking blood vessel growth to tumors)
• Reduced metastasis
• Modulation of immune responses

 

While these potential anti-cancer effects are still largely being studied in laboratory and animal models, the biological rationale continues to drive research interest.

 

What the Research Says About Symptom Relief

 

One of the strongest areas of evidence for cannabis in cancer care is symptom management.

A 2025 meta-analysis by Castle et al. reviewed more than 10,000 studies on medical cannabis and cancer, analyzing roughly 39,000 data points. The researchers found that the majority of published findings supported cannabis use for symptom relief, particularly:

 

• Pain
• Nausea and vomiting
• Appetite stimulation
• Cachexia (cancer-related wasting)

 

Despite this growing body of evidence, cannabis is still rarely introduced in clinical oncology conversations unless patients raise the topic themselves.

 

A Long History of Research on Nausea and Vomiting

 

Cannabis’ role in treating chemotherapy-induced nausea and vomiting (CINV) dates back decades.

 

A landmark 1975 study published in the New England Journal of Medicine found 70–80% efficacy of THC for controlling nausea and vomiting in chemotherapy patients.

 

Later research led to the development of synthetic THC medications, but many clinicians and patients still report better outcomes with whole-plant cannabis.

 

Dr. Goldstein referenced a statement from Harvard psychiatrist Dr. Lester Grinspoon, who observed that patients who tried both synthetic THC and natural cannabis overwhelmingly preferred the effects from the natural plant.

 

The reason likely lies in cannabis’ complex chemistry. Whole-plant cannabis contains hundreds of compounds to include cannabinoids and terpenes that may work together through what is often called the “entourage effect.”

 

A Fascinating Study on Delta-8 THC

 

Another notable example comes from a 1995 pediatric study led by Raphael Mechoulam, a pioneering cannabis researcher.

 

Researchers administered delta-8 THC to children aged 3–13 undergoing chemotherapy. Over 480 doses over an 8 month period, delta-8 completely eliminated vomiting without significant side effects. Today, delta-8 products often generate controversy, but the compound itself is not inherently dangerous. The primary safety concern is that most commercial delta-8 products are semi-synthetically converted from CBD, and poor manufacturing practices can introduce concerning contaminants.

 

In the original study, the delta-8 used was 99% pure and pharmaceutical-grade, highlighting how product quality and regulation play a critical role in safety.

 

Cannabis and Cancer Pain

 

Cancer pain remains one of the most difficult symptoms to manage.

 

Studies estimate 30–50% of cancer patients experience moderate to severe pain, which may include:

 

• Tumor-related tissue damage
• Nerve pain (neuropathy)
• Inflammation
• Mixed pain syndromes

 

While opioids remain the primary treatment, many patients remain undertreated.

 

A large 2018 report of nearly 3,000 cancer patients using medical cannabis found that 95.9% reported symptom improvement after six months, with significant reductions in pain scores.

 

Clinically, many practitioners report similar experiences: cannabis may help reduce pain severity, improve sleep, stimulate appetite, and ease anxiety during cancer treatment.

 

What We Still Don’t Know

 

Despite promising evidence, many important questions remain unanswered:

 

• Which cannabinoids work best for different cancers?
• What role do terpenes play?
• What doses are most effective?
• Which chemotherapy combinations work synergistically with cannabinoids?
• What drug interactions may occur?

 

Human clinical trials are still extremely limited.

 

For example, one small trial in recurrent glioblastoma suggested longer one-year survival when THC and CBD were combined with chemotherapy, compared with chemotherapy alone. But much larger studies are needed before firm conclusions can be drawn.

 

The Bottom Line

 

For many patients, cannabis is not a replacement for conventional cancer treatment but it may serve as a valuable complementary tool to support comfort, resilience, and quality of life during treatment.

 

As research continues, education and safe access remain essential.

 

Getting Started

 

If you’re interested in learning more about integrating cannabis into cancer care:

 

• Watch the full webinar on YouTube
• Realm of Caring: https://realmofcaring.org
• Goldstein Wellness: https://goldsteinwellness.com
• Leaf411 Nurse Guidance: https://leaf411.org

 

These organizations provide trusted education and patient guidance to help individuals make informed decisions about cannabis and health.

 

Webinar Q&A with Dr. Bonni Goldstein

 

During the webinar, attendees asked thoughtful questions about cannabis and cancer care. Below are several of those questions along with Dr. Goldstein’s responses in her own words.

 

Can you talk to us about inhaling flower – by vaping or other means?

My recommendation for inhaling flower in a patient with cancer depends on the situation. In general, I do not recommend smoking. Vaporization is preferred because it reduces exposure to combustion by-products that can irritate the lungs and impair local immune defenses. If a patient is immunocompromised from cancer treatment, especially if neutropenic (very low white blood cell count), inhalation should be avoided altogether due to potential infection risk. Most of my patients use inhaled cannabis only “as needed” for rapid symptom relief, such as nausea/vomiting or pain, while using oral formulations (tinctures/oils) for more consistent baseline dosing.

 

Is inhalation effective for tumor shrinking?

There are patient reports of this (for instance, the published case reports of two teenagers with residual brain tumors after surgery who smoked cannabis and their tumors resolved), but we have no scientific studies or data to support this as an effective method of administration for cancer-killing.

 

Are there specific temperatures to dial into for vaporization as to not compromise the lungs?

320-355°F: Light vapor, terpene rich, mild effects
356-390°F: Most commonly recommended range with balanced vaporization of THC/CBD/terpenes
391-410°F: Stronger effects, reported to release more cannabinoids from the flower
Over 440°F: Combustion occurs, recommended to stay below this temperature.

 

What should one look for in a dispensary if one wanted to vape for cancer killing?

This is difficult to answer as we don’t know which strain(s) will kill which cancer. My patients using cannabis for this indication are taking high doses that can only be achieved through oral ingestion, which also allows for effects to last longer ~ 8 hours. Inhalation can allow for transient high levels in the bloodstream, which can be very effective for pain, initiation of sleep, panic or anxiety and also appetite stimulation, but the effects only last for a few hours, which may not be ideal for cancer killing.