University Hospital for Tumors, University Hospital Center Sestre milosrdnice
Abstract
Although today among oncology patients use of various preparations of complementary and alternative medicine is more and more frequent, there is unequivocal scientifi c base for their use. Among the often used preparations, especially in the treatment of cancer pain, is cannabis and its derivatives. Cannabinoids act on the endogenous cannabinoid system, with widespread receptors in the central nervous system and peripheral tissues. Although the pharmacology of the cannabinoids is still largely unknown, numerous of their eff ects were investigated. In oncology, studies have been conducted on the effect
of cannabinoids on nausea and vomiting during the oncological treatment, the cancer pain and neuropathy, on appetite and weight loss, and the impact on mood, depression and anxiety. It is also observed that some of the cannabinoids have antitumor, but also protumorous activity. There have been many diff erent side eff ects of cannabinoids detected, and in a smaller percentage also the development of addiction. Best known preparations nowadays are dronabinol, nabilon and nabiximol. At the moment, the evidence lack strenght, and large randomized clinical trials are required, which would confi rm predominatly positive results of the research.Iako je danas među onkološkim bolesnicima sve učestalija uporaba različitih pripravaka komplementarne i alternativne medicine, za njihovu uporabu nema nedvojbene znanstvene potvrde. Među češće primjenjivanim pripravcima, osobito u liječenju karcinomske boli, je i kanabis i njegovi derivati. Kanabinoidi djeluju u organizmu preko endokanabinoidnog sustava, s rasprostranjenim receptorima u središnjem živčanom sustavu i perifernim tkivima. Iako je farmakologija kanabinoida još uvijek uglavnom nepoznata, do sada su istraživani njihovi brojni učinci. U onkologiji su provedena istraživanja utjecaja na mučninu i povraćanje prilikom onkološkog liječenja, na karcinomsku bol te neuropatiju, na apetit i gubitak tjelesne mase te utjecaj na raspoloženje, depresiju i tjeskobu. Također je opažen antitumorski, ali i protumorski učinak nekih kanabinoida. Zabilježeni su brojni različiti neželjeni učinci kanabinoida, a u manjem postotku i razvoj ovisnosti. Najpoznatiji pripravci danas jesu dronabinol, nabilon i nabiksimol. Sveukupno, za sada nisu osigurani dovoljno snažni i nedvojbeni dokazi i potrebne su velike randomizirane kliničke studije, koje bi potvrdile do sada opažene pozitivne rezultate istraživanja
