12 augustus 2018: Bron: JAMA Otolaryngol Head Neck Surg. Published online August 2, 2018

Recreatief gebruik van marihuana - cannabis sativa verbetert sterk de kwaliteit van leven bij patiënten met een nieuwe diagnose van mond- en keelkanker in vergelijking met geen gebruik. Dit blijkt uit een gerandomiseerde studie bij totaal 148 patiënten (74 versus 74) met een nieuwe diagnose van mond- en keelkanker.

cannabis sativa Source foto:

De patiënten werden gerandomiseerd geworven voor de studie in de periode van 1 januari 2011 tot 1 Januari 2015. Er waren geen verschillen tussen de karakteristieken van de patiënten tussen beide groepen.

74 patiënten gingen vanaf de diagnose marihuana - cannabis sativa gebruiken direct nadat de diagnose was vastgesteld. En werden vergeleken op een aantal punten aan de hand van de ESAS quality of life vragenlijst met 74 patiënten die geen marihuana - cannabis sativa gebruikten.

In de maand november 2017 werd de analyse gemaakt.

Gebruikers van marihuana hadden minder pijn, waren minder moe, waren minder depressief, waren minder angstig, hadden meer eetlust, waren minder slaperig en hadden beter algemeen welzijn volgens de ESAS. Een Wilcoxon ranglijsttest bevestigde een statistisch significante verbetering in ESAS-scores binnen de scores van angst (z-score, -10,04), pijn (z-score, -2.36), vermoeidheid (z-score, -5.02), depressie (z-score, - 5.96), slaperigheid (z-score, -5.51), eetlust (z-score, -4.17) en algemeen welbevinden (z-score, -4.43).

Het studierapport: Association of Marijuana Use With Psychosocial and Quality of Life Outcomes Among Patients With Head and Neck Cancer is tegen betaling in te zien.

Hier het abstract van de studie uit JAMA

This prospective case-matched study suggests that there may be significant QOL benefits, including decreased anxiety, pain, and depression and increased appetite and generalized feelings of well-being, associated with marijuana use among patients with newly diagnosed HNC.

Original Investigation

From the American Head and Neck Society

August 2, 2018

Association of Marijuana Use With Psychosocial and Quality of Life Outcomes Among Patients With Head and Neck Cancer

Han Zhang, MD, FRCSC¹; Michael Xie, BSc²; Stuart D. Archibald, MD, FRCSC²; et al B. Stanley Jackson, MD, FRCSC¹; Michael K. Gupta, MD, MSc, FRCSC¹

Author Affiliations

JAMA Otolaryngol Head Neck Surg. Published online August 2, 2018. doi:10.1001/jamaoto.2018.0486

Full Text

Key Points

Question Is there a difference in quality of life and psychosocial outcomes between marijuana users and nonusers who have newly diagnosed head and neck cancer?

Findings In this case-matched cohort study, 74 patients with newly diagnosed head and neck cancer who were marijuana users appeared to have quality of life differences compared with 74 who did not use marijuana, including decreased anxiety, pain, and depression and increased appetite and generalized feelings of well-being on the Edmonton Symptom Assessment System and the EuroQol-5D questionnaires.

Meaning Recreational marijuana use potentially improves quality of life and psychosocial symptoms among patients with newly diagnosed head and neck cancer.

Abstract

Importance Cannabis sativa, the most widely used illicit substance in Canada, has a unique ability to facilitate relaxation and relieve anxiety while reducing pain. However, no study to date has examined quality of life (QOL) and psychosocial issues in relation to the use of this drug among patients with newly diagnosed head and neck cancer (HNC).

Objective To examine the differences in QOL and psychosocial outcomes between marijuana users and nonusers with newly diagnosed HNC.

Design, Setting, and Participants This prospective cohort study was conducted at a tertiary care cancer center. Patients were enrolled consecutively and prospectively at the time of HNC diagnosis from January 1, 2011, to January 1, 2015. Seventy-four patients who were current marijuana users were case matched to 74 nonusers in a 1:1 scheme based on age, sex, and tumor subsite. All patient demographic and QOL data were collected prospectively, and data analysis was conducted from November 1 to December 1, 2017.

Main Outcomes and Measure The QOL outcome was assessed using the EuroQol-5D (EQ5D) and the Edmonton Symptom Assessment System (ESAS) questionnaires.

Results A total of 148 patients were included in this study: 74 in the marijuana user group (mean age, 62.3 [10.3] years; male sex, 61 patients [82%]) and 74 in the marijuana nonuser group (mean age, 62.2 years; male sex, 63 patients [85%]). There was no statistically significant difference in age, sex, tumor subsite, clinical TNM staging, treatment modality, or mean Karnofsky score between the 2 groups. On univariate analysis, there was no statistically significant difference in the mobility, self-care, and usual activities domains of the EQ5D. Marijuana users had significantly lower scores in the anxiety/depression (difference, 0.74; 95% CI, 0.557-0.930) and pain/discomfort (difference, 0.29; 95% CI, 0.037-1.541) domains. Wilcoxon rank sum test confirmed the results of the EQ5D with improvements in the pain/discomfort (z score, −2.60) and anxiety/depression (z score, −6.71) domains. Marijuana users had less pain, were less tired, were less depressed, were less anxious, had more appetite, were less drowsy, and had better general well-being according to the ESAS. A Wilcoxon rank sum test confirmed a statistically significant improvement in ESAS scores within the domains of anxiety (z score, −10.04), pain (z score, −2.36), tiredness (z score, −5.02), depression (z score, −5.96), drowsiness (z score, −5.51), appetite (z score, −4.17), and general well-being (z score, −4.43).

Conclusions and Relevance This prospective case-matched study suggests that there may be significant QOL benefits, including decreased anxiety, pain, and depression and increased appetite and generalized feelings of well-being, associated with marijuana use among patients with newly diagnosed HNC.

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