nabilone and Carcinoma--Squamous-Cell

We present the case of a 56-year-old man who developed chronic pain following the excision of a facial cancer that was poorly controlled despite multiple analgesic medications. Following the starting of nabilone (a synthetic cannabinoid) his pain control was greatly improved and this had a huge impact on his quality of life. We also managed to significantly reduce his doses of opioid analgesia and ketamine. We review the current literature regarding the medicinal use of cannabinoids, with an emphasis on chronic pain, in an attempt to clarify their role and how to select patients who may benefit from this treatment.

Topics: Analgesics; Carcinoma, Squamous Cell; Chronic Pain; Dronabinol; Humans; Lip Neoplasms; Male; Middle Aged; Pain, Postoperative; Submandibular Gland Neoplasms

Patients treated for head and neck carcinomas experience a significant deterioration of their quality of life during treatments because of severe side effects. Nabilone has many properties that could alleviate symptoms caused by radiotherapy and improve patients' quality of life. The aim of the present study was to compare the effects of nabilone versus placebo on the quality of life and side effects during radiotherapy for head and neck carcinomas.. Fifty-six patients were randomized to nabilone or placebo. Patients filled the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and the EORTC QLQ-H&N35; three independent questionnaires assessing appetite, nausea, and toxicity; and a visual analog scale for pain. These data were collected before radiotherapy, each week during radiotherapy, and 4 weeks after radiotherapy. Patients were weighed every week.. Nabilone did not lengthen the time necessary for a 15% deterioration of quality of life (P = .4279), and it was not better than placebo for relieving symptoms like pain (P = .6048), nausea (P = .7105), loss of appetite (P = .3295), weight (P = .1454), mood (P = .3214), and sleep (P = .4438).. At the dosage used, nabilone was not potent enough to improve the patients' quality of life over placebo.

Topics: Affect; Antiemetics; Appetite; Body Weight; Carcinoma, Squamous Cell; Chemoradiotherapy; Double-Blind Method; Dronabinol; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Nausea; Pain; Pain Measurement; Quality of Life; Radiotherapy; Sleep; Squamous Cell Carcinoma of Head and Neck