Therapeutic application of cannabis in medicine and its relevance to thoracic surgery

Background: Cannabis is the most commonly used illicit substance in the United States. As cannabis use rises in popularity and its legalization continues to expand, the scientific community must address the controversy between beneficial and adverse effects of cannabis consumption.

Methods: We have performed a comprehensive literature review to study the medicinal and pathological effects of cannabis use, with emphasis on its association with cancer pathophysiology and thoracic surgery.

Results: We found evidence that cannabis products often contain carcinogenic materials, and their use is associated with development of certain head and neck cancers, but not lung cancer. Indeed several in vitro and in vivo studies have demonstrated that cannabis may have a therapeutic role in cancer given the antiproliferative effects of its active compounds such as delta-9-tetrahydrocannabinol. Cannabis-derived products have also been shown to be effective treatments for chronic pain, neuropathy, spasticity, and as anti-emetics.

Conclusions: We acknowledge that additional studies are required to elucidate the long-term effects of cannabis products, and that many potential biases and limitations exist in the literature due to self-reporting and limited survey studies. Appropriate stewardship over cannabis use amongst our patient population will likely determine its full implications in terms of both oncologic and perioperative outcomes.