Medical marijuana for management of cancer pain: a narrative review.

BACKGROUND AND

OBJECTIVE

The increasing legalization of medical marijuana in the United States (US) has spurred ongoing interest in its clinical application for the management of cancer-related pain. Although medical marijuana is legal in 40 states and the District of Columbia, its effect on pain pathways and variability in patient responses remain key areas of investigation. The purpose of this narrative review was to examine the prevalence and efficacy of marijuana use in the treatment of cancer-related pain.

METHODS

A research librarian conducted a literature search in PubMed and EMBASE for articles published between January 01, 2018 and August 2025. Search terms included but were not exclusive to cancer Cannabis AND cancer pain; Marijuana AND cancer pain management; Cannabinoids AND cancer-related pain; Medical cannabis AND oncology pain; THC CBD AND cancer pain relief. Twenty articles were identified and three database reviewers (A.M.M., A.N., and L.R.K.) independently screened titles and abstracts for relevance. Full-text articles were then reviewed with full consensus for final inclusion.

KEY CONTENT AND FINDINGS: This narrative review examines the current understanding of the mechanisms of action and clinical efficacy of medical marijuana for cancer pain. We explore the pharmacological mechanisms underlying its analgesic properties, including its interaction with cannabinoid receptors and modulation of pain-related pathways. We also review and synthesize existing clinical evidence on the effectiveness of medical marijuana in reducing pain, improving quality of life, and minimizing opioid use in cancer patients.

CONCLUSIONS

Overall, there continues to be limited evidence to support the use of medical cannabis for treatment of cancer-related pain. While significant progress has been made in this domain of pain management research, current federal regulations classifying marijuana as a Schedule I substance continue to limit large research studies. As the legal landscape evolves, an emphasis on future randomized controlled trial studies focused on the challenges related to medical marijuana dosing, side effects, and long-term safety will help advance the field and future cancer patients.