October is a month that usually draws attention to "Breast Cancer Awareness Month" and the importance of breast cancer prevention. But it is also an invitation to reflect on something equally essential: the care for those who are already on the front line of the fight against the disease. In oncology palliative care, the focus goes beyond curing; it is about quality of life, relief of suffering, and dignity.

In this context, medicinal cannabis has proven to be an important complementary tool, especially in controlling symptoms that conventional treatment may not always alleviate.

What are palliative care and why talk about it in October

Palliative care aims to alleviate physical, emotional, and spiritual symptoms of people with serious illnesses, seeking comfort and autonomy. It is not about giving up but about respecting life in all its stages.

According to palliative care physician Silvia Seligmann Soares, from Salvador/BA, “in oncology palliative care, medicinal cannabis can be a valuable complementary tool. It does not replace conventional treatments, but it can enhance the control of difficult symptoms, especially when the response to usual therapies is unsatisfactory".

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She also explains that cannabinoids, especially THC and CBD, act on endocannabinoid system receptors, which modulate pain, nausea, appetite, sleep, and mood, symptoms that often significantly impact patients' quality of life.

“Furthermore, the rational use of medicinal cannabis can reduce the need for opioids and antiemetics, decreasing cumulative side effects. All of this translates into something essential in palliative care: relief of global suffering and preservation of patient autonomy and dignity,” she emphasizes.

Benefits of cannabis in oncology palliative care

National and international studies have pointed out that the benefits of medicinal cannabis in palliative care range from pain control to improved appetite, sleep, and emotional well-being.

Among the main observed effects:

• Control of nausea and vomiting caused by chemotherapy;
• Increased appetite and improved nutritional status;
• Reduction of chronic pain and the need for opioids;
• Improvement in anxiety, sleep, and mood;
• Greater sense of well-being and disposition.

The physician also emphasizes that when used under professional supervision, medicinal cannabis can represent a significant change in the oncology patient's experience. “It is a resource that helps restore comfort, sleep, appetite, and even the desire to talk, to connect. All of this has a direct impact on how the person faces treatment and life itself,” she states.

Challenges and Resistance Still Faced

Despite the growing number of studies and promising clinical results, the use of medicinal cannabis still faces resistance within the medical community. Silvia explains that this resistance has several causes. “From a scientific point of view, we still lack robust and standardized clinical trials because cannabis is a complex substance, with over a hundred phytocannabinoids and multiple mechanisms of action in the body. In addition, variations in formulation, dosage, and administration routes make it difficult to produce comparable evidence".

She also points out ethical and formative factors. “There is a historical prejudice. For a long time, cannabis was associated with recreational use and a negative stigma. And even after the discovery of the endocannabinoid system in the 1990s, it has not been structurally included in medical education. This greatly hinders breaking down barriers," she reflects.

In Brazil, access to medicinal cannabis can be done through patient associations, importation by individuals, and direct purchase at pharmacies, but access is still limited for a large part of the population, mainly due to cost and the absence of products in the public healthcare system.

“I believe that broader incorporation involves continuous medical education, inclusive public policies, and encouragement of research,” Silvia concludes.

The Emotional and Spiritual Dimension of Care

Caring for those facing cancer is also about embracing the invisible: fear, anxiety, loneliness. Palliative medicine understands that human suffering is multifaceted, and relief is only complete when it considers body, mind, and spirit.

According to Silvia, palliative care is, above all, a person-centered practice and not just disease-centered. “Medicinal cannabis can significantly act in this more subjective dimension of suffering. If we bring the concept of Total Pain, created by Cicely Saunders, we will understand that proper relief requires addressing psychic, spiritual, and social dimensions”.

Silvia summarizes the role of cannabis in this context with sensitivity: “Cannabis is not just a molecule; it is a tool within a context of compassionate care. If used with discernment and empathy, it can be a formidable ally in restoring wholeness and dignity,” she concludes.