Cannabis sativa L. (cannabaceae): alternativa para o tratamento da dor oncológica

Viviane Gomes da Silva; Kelvyn Kennedy de Figueiredo Silva; Bruna Braga Dantas

doi:10.32712/2446-4775.2022.1384

Cannabis sativa L. (cannabaceae): alternativa para o tratamento da dor oncológica

v. 17 n. 1 (2023)
119-127
01/12/2021
31/03/2023
https://doi.org/10.32712/2446-4775.2022.1384

Viviane Gomes da Silva
Kelvyn Kennedy de Figueiredo Silva
Bruna Braga Dantas

Palavras-chave

Resumo

A dor oncológica configura-se como uma problemática atual de alta prevalência e difícil manejo. Logo, na busca por novas perspectivas para o alívio dos níveis álgicos de pacientes oncológicos, o uso da Cannabis surge como uma alternativa terapêutica. Diante disso, objetivou-se destacar, neste estudo, o potencial farmacológico da planta Cannabis sativa L. (cannabaceae) no tratamento da dor oncológica. Assim, realizou-se uma revisão da literatura através das bases de dados: SciELO, LILACS, Science direct e PubMed, considerando trabalhos publicados entre 2007 e 2020. Após a aplicação dos critérios de inclusão e exclusão, 25 artigos foram selecionados. Observa-se que a potencialidade farmacológica da Cannabis sativa está ligada ao grande número de substâncias químicas presentes em sua composição, sendo a principal classe denominada canabinoides. Tais compostos possuem inúmeras propriedades biológicas, como atividade antiemética, neuroprotetora, anti-inflamatória e anticâncer, podendo ser benéfica no tratamento da dor oncológica e distúrbios psíquicos. Atualmente, há um medicamento em uso clínico derivado dos canabinoides, sendo utilizado para aliviar algias oncológicas, porém encontra-se limitado ao Canadá.

Referências

Rangel O, Telles C. Tratamento da dor oncológica em cuidados paliativos. Rev Hosp Univers Pedro Ernesto. 2012; 11(2): 32-7. [https://www.e-publicacoes.uerj.br/index.php/revistahupe/article/view/8928].
Silva LJ, Mendanha DM, Gomes PP. The use of opioids in the treatment of oncologic pain in the elderly. Braz J Pain. 2020; 3(1): 63-72 [https://doi.org/10.5935/2595-0118.20200014].
Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Braz J Pain. 2020; 161(9): 1976-82. [https://doi.org/10.1097/j.pain.0000000000001939] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7680716/].
Costa JLGP, Maia LO, Orlandi-Mattos P, Villares JC, Esteves MAF. Neurobiologia da Cannabis: do sistema endocanabinoide aos transtornos por uso de Cannabis. J Bras Psiq. 2011; 60(2): 111-22. [https://doi.org/10.1590/S0047-20852011000200006].
Benevenuto SGM. Efeitos da fumaça da Cannabis sativa e de compostos Canabinoides: uma avaliação in vivo e in vitro. São Paulo. 2020. 198 f. Tese de Doutorado. [em Ciências – Programa de Pós-Graduação em Anatomia dos Animais Domésticos e Silvestres, Faculdade de Medicina Veterinária e Zootecnia] - Universidade de São Paulo, USP, São Paulo. 2020. [https://www.teses.usp.br/teses/disponiveis/10/10132/tde-28012021-211715/en.php].
Blake A, Wan BA, Malek L, De Angelis C, Diaz P, Lao N et al. A selective review of medical cannabis in cancer pain management. Annals Palliat Med. 2017; 6(S2): S215-22. [https://doi.org/10.21037/apm.2017.08.05] [https://pubmed.ncbi.nlm.nih.gov/28866904/].
Fallon M, Giusti R, Aielli F, Hoskin P, Rolke R, Sharma M, et al. Management of cancer pain in adult patients: ESMO Clinical Practice Guidelines. Annals Oncol. 2018; 29(4): 166-91. [https://doi.org/10.1093/annonc/mdy152] [https://pubmed.ncbi.nlm.nih.gov/30052758/].
Nersesyan H, Slavin KV. Current aproach to cancer pain management: Availability and implications of different treatment options. Therap Clin Risk Manag. 2007; 3(3): 381-400. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2386360/].
Grotenhermen F, MÃ¼ller-Vahl K. The therapeutic potential of Cannabis and cannabinoids. Dtsch Arztebl Int. 2012; 109(29-30): 495-501. [https://dx.doi.org/10.3238%2Farztebl.2012.0495] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3442177/].
Kisková T, Mungenast F, Suváková M, Jäger W, Thalhammer T. Future aspects for cannabinoids in breast cancer therapy. Inter J Molec Sci. 2019; 20(7): 1673. [https://doi.org/10.3390/ijms20071673] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6479799/].
Baron EP, Lucas P, Eades J, Hogue O. Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort. The J Headache Pain. 2018; 19(1): 37. [https://doi.org/10.1186/s10194-018-0862-2] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968020/].
Darkovska-Serafimovska M, Serafimovska T, Arsova-Sarafinovska Z, Stefanoski S, Keskovski Z, Balkanov T. Pharmacotherapeutic considerations for use of cannabinoids to relieve pain in patients with malignant diseases. J Pain Res. 2018; 11: 837-42. [https://doi.org/10.2147/JPR.S160556] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5922297/].
Pellati F, Borgonetti V, Brighenti V, Biagi M, Benvenuti S, Corsi L. Cannabis sativa L. and nonpsychoactive cannabinoids: their chemistry and role against oxidative stress, inflammation, and cancer. BioMed Res Inter. 2018; 2018: 1691428. [https://doi.org/10.1155/2018/1691428] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304621/].
Baron EP. Comprehensive review of medicinal Marijuana, Cannabinoids, and therapeutic implications in medicine and headache: what a long strange trip it’s been headache. The J Head Face Pain. 2015; 55(6): 885-916. [https://doi.org/10.1111/head.12570 ] [ https://pubmed.ncbi.nlm.nih.gov/26015168/].
Bonfá L, Vinagre RCO, Figueiredo NV. Uso de canabinóides na dor crônica e em cuidados paliativos. Rev Bras Anestesiol. 2008; 58(3): 267-79. [https://doi.org/10.1590/S0034-70942008000300010].
Lessa MA, Cavalcanti IL, Figueiredo NV. Cannabinoid derivatives and the pharmacological management of pain. Rev Dor. 2016; 17(1): 47-51. [https://doi.org/10.5935/1806-0013.20160012].
McAllister SD, Soroceanu L, Desprez P-Y. The antitumor activity of plant-derived non-psychoactive cannabinoids. J Neuroimmune Pharmacol. 2015; 10(2): 255-67. [https://dx.doi.org/10.1007%2Fs11481-015-9608-y] [https://www.ncbi.nlm.nih.gov/pubmed/25916739].
Turcotte D, Doupe M, Torabi M, Gomori A, Ethans K, Esfahani F et al. Nabilone as an adjunctive to gabapentin for multiple sclerosis-induced neuropathic pain: a randomized controlled trial. Pain Medic. 2015; 16(1): 149-59. [https://doi.org/10.1111/pme.12569] [https://pubmed.ncbi.nlm.nih.gov/25288189/].
Pamplona FA. Quais são e pra que servem os medicamentos à base de Cannabis? Rev Biol. 2014; 13(1): 28–35. [https://doi.org/10.7594/revbio.13.01.05].
Correia-da-Silva G, Fonseca BM, Soares A, Teixeira N. Cannabis e canabinoides para fins medicinais. Rev Portug Farmacoter. 2019; 11(1): 21-31. [https://doi.org/10.25756/rpf.v11i1.210].
Kahan M, Srivastava A, Spithoff S, Bromley L. Prescribing smoked cannabis for chronic noncancer pain: Preliminary recommendations. Canadian Family Physician. 2014; 60(12): 1083-90. [https://www.cfp.ca/content/60/12/1083.short].
Cebulski FS, Martins CAF. Uso da Cannabis sativa no Tratamento de Doenças Neoplásicas: Uma Visão Biomédica. Rev Eletr Biociên Biotecnol Saúde. 2016; 7(16): 20-30. [https://interin.utp.br/index.php/GR1/article/view/1583].
Volkow ND, Baler RD, Compton WM, Weiss SRB. Adverse Health Effects of Marijuana Use. New England J Med. 2014; 370(23): 2219-27. [https://doi.org/10.1056/NEJMra1402309] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4827335/].
Caffarel MM, Andradas C, Pérez-Gómez E, Guzmán M, Sánchez C. Cannabinoids: a new hope for breast cancer therapy? Cancer Treat Rev. 2012; 38(7): 911–8. [https://doi.org/10.1016/j.ctrv.2012.06.005] [https://pubmed.ncbi.nlm.nih.gov/22776349/].
Borrelli F, Pagano E, Romano B, Panzera S, Maiello F, Coppola D et al. Colon carcinogenesis is inhibited by the TRPM8 antagonist cannabigerol, a Cannabis-derived non-psychotropic cannabinoid. Carcinogenesis. 2014; 35(12): 2787-97. [https://doi.org/10.1093/carcin/bgu205] [https://pubmed.ncbi.nlm.nih.gov/25269802/].
Namdar D, Koltai H. Medical Cannabis for the Treatment of Inflammation. Nat Prod Communic. 2018 Mar; 13(3): 249-54. [https://doi.org/10.1177%2F1934578X1801300304].
Farinhas GV, Wendling MI, Dellazzana-Zanon LL. Impacto psicológico do diagnóstico de câncer na família: um estudo de caso a partir da percepção do cuidador. Pens Famíl. 2013; 17(2): 111–29. [http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1679-494X2013000200009].
Oliveira AD, Bernardo CE, Lima LV. Cannabis sativa: política proibicionista e o direito à saúde. Cad Pesq Interdisc Psicol: Fund Teór Hist Epistemol. 2018; 1(1): 59-69. [https://portal.unisepe.com.br/univr/wp-content/uploads/sites/10004/2018/03/Caderno-de-Pesquisa-Interdisciplinar-em-Psicologia-Vol.-1-20181-Artigo-6.pdf].
Ascenção MD, Lustosa VR, Silva LJ. Canabinoides no tratamento da dor crônica. Rev Med Saúde Brasília. 2016; 5(3): 255-63. [https://portalrevistas.ucb.br/index.php/rmsbr/article/view/7009].
Fine PG, Rosenfeld MJ. The Endocannabinoid System, Cannabinoids, and Pain. Rambam Maimon Med J. 2013; 4(4): e0022. [https://doi.org/10.5041/RMMJ.10129] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3820295/].

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Autor(es)

Viviane Gomes da Silva
Universidade Federal de Campina Grande (UFCG), Campus Cuité. Sítio Olho D'água da Bica, Zona Rural, CEP 58175-000, Cuité, PB, Brasil.
https://orcid.org/0000-0002-1391-1917
Kelvyn Kennedy de Figueiredo Silva
Universidade Federal de Campina Grande (UFCG), Campus Cuité. Sítio Olho D'água da Bica, Zona Rural, CEP 58175-000, Cuité, PB, Brasil.
https://orcid.org/0000-0001-7693-7420
Bruna Braga Dantas
Universidade Federal de Campina Grande (UFCG), Campus Cuité. Sítio Olho D'água da Bica, Zona Rural, CEP 58175-000, Cuité, PB, Brasil.
https://orcid.org/0000-0001-8807-1601

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Cannabis sativa L. (cannabaceae): alternativa para o tratamento da dor oncológica. Rev Fitos [Internet]. 31º de março de 2023 [citado 1º de fevereiro de 2025];17(1):119-27. Disponível em: https://revistafitos.far.fiocruz.br/index.php/revista-fitos/article/view/1384

Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.

[1] Rangel O, Telles C. Tratamento da dor oncológica em cuidados paliativos. Rev Hosp Univers Pedro Ernesto. 2012; 11(2): 32-7. [https://www.e-publicacoes.uerj.br/index.php/revistahupe/article/view/8928].

[2] Silva LJ, Mendanha DM, Gomes PP. The use of opioids in the treatment of oncologic pain in the elderly. Braz J Pain. 2020; 3(1): 63-72 [https://doi.org/10.5935/2595-0118.20200014].

[3] Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Braz J Pain. 2020; 161(9): 1976-82. [https://doi.org/10.1097/j.pain.0000000000001939] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7680716/].

[4] Costa JLGP, Maia LO, Orlandi-Mattos P, Villares JC, Esteves MAF. Neurobiologia da Cannabis: do sistema endocanabinoide aos transtornos por uso de Cannabis. J Bras Psiq. 2011; 60(2): 111-22. [https://doi.org/10.1590/S0047-20852011000200006].

[5] Benevenuto SGM. Efeitos da fumaça da Cannabis sativa e de compostos Canabinoides: uma avaliação in vivo e in vitro. São Paulo. 2020. 198 f. Tese de Doutorado. [em Ciências – Programa de Pós-Graduação em Anatomia dos Animais Domésticos e Silvestres, Faculdade de Medicina Veterinária e Zootecnia] - Universidade de São Paulo, USP, São Paulo. 2020. [https://www.teses.usp.br/teses/disponiveis/10/10132/tde-28012021-211715/en.php].

[6] Blake A, Wan BA, Malek L, De Angelis C, Diaz P, Lao N et al. A selective review of medical cannabis in cancer pain management. Annals Palliat Med. 2017; 6(S2): S215-22. [https://doi.org/10.21037/apm.2017.08.05] [https://pubmed.ncbi.nlm.nih.gov/28866904/].

[7] Fallon M, Giusti R, Aielli F, Hoskin P, Rolke R, Sharma M, et al. Management of cancer pain in adult patients: ESMO Clinical Practice Guidelines. Annals Oncol. 2018; 29(4): 166-91. [https://doi.org/10.1093/annonc/mdy152] [https://pubmed.ncbi.nlm.nih.gov/30052758/].

[8] Nersesyan H, Slavin KV. Current aproach to cancer pain management: Availability and implications of different treatment options. Therap Clin Risk Manag. 2007; 3(3): 381-400. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2386360/].

[9] Grotenhermen F, MÃ¼ller-Vahl K. The therapeutic potential of Cannabis and cannabinoids. Dtsch Arztebl Int. 2012; 109(29-30): 495-501. [https://dx.doi.org/10.3238%2Farztebl.2012.0495] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3442177/].

[10] Kisková T, Mungenast F, Suváková M, Jäger W, Thalhammer T. Future aspects for cannabinoids in breast cancer therapy. Inter J Molec Sci. 2019; 20(7): 1673. [https://doi.org/10.3390/ijms20071673] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6479799/].

[11] Baron EP, Lucas P, Eades J, Hogue O. Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort. The J Headache Pain. 2018; 19(1): 37. [https://doi.org/10.1186/s10194-018-0862-2] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968020/].

[12] Darkovska-Serafimovska M, Serafimovska T, Arsova-Sarafinovska Z, Stefanoski S, Keskovski Z, Balkanov T. Pharmacotherapeutic considerations for use of cannabinoids to relieve pain in patients with malignant diseases. J Pain Res. 2018; 11: 837-42. [https://doi.org/10.2147/JPR.S160556] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5922297/].

[13] Pellati F, Borgonetti V, Brighenti V, Biagi M, Benvenuti S, Corsi L. Cannabis sativa L. and nonpsychoactive cannabinoids: their chemistry and role against oxidative stress, inflammation, and cancer. BioMed Res Inter. 2018; 2018: 1691428. [https://doi.org/10.1155/2018/1691428] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304621/].

[14] Baron EP. Comprehensive review of medicinal Marijuana, Cannabinoids, and therapeutic implications in medicine and headache: what a long strange trip it’s been headache. The J Head Face Pain. 2015; 55(6): 885-916. [https://doi.org/10.1111/head.12570 ] [ https://pubmed.ncbi.nlm.nih.gov/26015168/].

[15] Bonfá L, Vinagre RCO, Figueiredo NV. Uso de canabinóides na dor crônica e em cuidados paliativos. Rev Bras Anestesiol. 2008; 58(3): 267-79. [https://doi.org/10.1590/S0034-70942008000300010].

[16] Lessa MA, Cavalcanti IL, Figueiredo NV. Cannabinoid derivatives and the pharmacological management of pain. Rev Dor. 2016; 17(1): 47-51. [https://doi.org/10.5935/1806-0013.20160012].

[17] McAllister SD, Soroceanu L, Desprez P-Y. The antitumor activity of plant-derived non-psychoactive cannabinoids. J Neuroimmune Pharmacol. 2015; 10(2): 255-67. [https://dx.doi.org/10.1007%2Fs11481-015-9608-y] [https://www.ncbi.nlm.nih.gov/pubmed/25916739].

[18] Turcotte D, Doupe M, Torabi M, Gomori A, Ethans K, Esfahani F et al. Nabilone as an adjunctive to gabapentin for multiple sclerosis-induced neuropathic pain: a randomized controlled trial. Pain Medic. 2015; 16(1): 149-59. [https://doi.org/10.1111/pme.12569] [https://pubmed.ncbi.nlm.nih.gov/25288189/].

[19] Pamplona FA. Quais são e pra que servem os medicamentos à base de Cannabis? Rev Biol. 2014; 13(1): 28–35. [https://doi.org/10.7594/revbio.13.01.05].

[20] Correia-da-Silva G, Fonseca BM, Soares A, Teixeira N. Cannabis e canabinoides para fins medicinais. Rev Portug Farmacoter. 2019; 11(1): 21-31. [https://doi.org/10.25756/rpf.v11i1.210].

[21] Kahan M, Srivastava A, Spithoff S, Bromley L. Prescribing smoked cannabis for chronic noncancer pain: Preliminary recommendations. Canadian Family Physician. 2014; 60(12): 1083-90. [https://www.cfp.ca/content/60/12/1083.short].

[22] Cebulski FS, Martins CAF. Uso da Cannabis sativa no Tratamento de Doenças Neoplásicas: Uma Visão Biomédica. Rev Eletr Biociên Biotecnol Saúde. 2016; 7(16): 20-30. [https://interin.utp.br/index.php/GR1/article/view/1583].

[23] Volkow ND, Baler RD, Compton WM, Weiss SRB. Adverse Health Effects of Marijuana Use. New England J Med. 2014; 370(23): 2219-27. [https://doi.org/10.1056/NEJMra1402309] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4827335/].

[24] Caffarel MM, Andradas C, Pérez-Gómez E, Guzmán M, Sánchez C. Cannabinoids: a new hope for breast cancer therapy? Cancer Treat Rev. 2012; 38(7): 911–8. [https://doi.org/10.1016/j.ctrv.2012.06.005] [https://pubmed.ncbi.nlm.nih.gov/22776349/].

[25] Borrelli F, Pagano E, Romano B, Panzera S, Maiello F, Coppola D et al. Colon carcinogenesis is inhibited by the TRPM8 antagonist cannabigerol, a Cannabis-derived non-psychotropic cannabinoid. Carcinogenesis. 2014; 35(12): 2787-97. [https://doi.org/10.1093/carcin/bgu205] [https://pubmed.ncbi.nlm.nih.gov/25269802/].

[26] Namdar D, Koltai H. Medical Cannabis for the Treatment of Inflammation. Nat Prod Communic. 2018 Mar; 13(3): 249-54. [https://doi.org/10.1177%2F1934578X1801300304].

[27] Farinhas GV, Wendling MI, Dellazzana-Zanon LL. Impacto psicológico do diagnóstico de câncer na família: um estudo de caso a partir da percepção do cuidador. Pens Famíl. 2013; 17(2): 111–29. [http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1679-494X2013000200009].

[28] Oliveira AD, Bernardo CE, Lima LV. Cannabis sativa: política proibicionista e o direito à saúde. Cad Pesq Interdisc Psicol: Fund Teór Hist Epistemol. 2018; 1(1): 59-69. [https://portal.unisepe.com.br/univr/wp-content/uploads/sites/10004/2018/03/Caderno-de-Pesquisa-Interdisciplinar-em-Psicologia-Vol.-1-20181-Artigo-6.pdf].

[29] Ascenção MD, Lustosa VR, Silva LJ. Canabinoides no tratamento da dor crônica. Rev Med Saúde Brasília. 2016; 5(3): 255-63. [https://portalrevistas.ucb.br/index.php/rmsbr/article/view/7009].

[30] Fine PG, Rosenfeld MJ. The Endocannabinoid System, Cannabinoids, and Pain. Rambam Maimon Med J. 2013; 4(4): e0022. [https://doi.org/10.5041/RMMJ.10129] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3820295/].