Cannabis & Palliative Care
A plain-language guide to help you understand how medicinal cannabis may ease pain, nausea, sleep problems and other distressing symptoms during cancer treatment and palliative care — and how to use it safely.
This sheet is for you. Prepared by your MedWest pharmacist to help you understand your prescription in plain English. The science is kept honest and the language kept simple. If anything is unclear, please ask us — no question is too small.
THC & CBD — what they each do
Your prescription contains one or both of these compounds. They work differently in your body, and your doctor has chosen the right combination for your specific symptoms.
THC is the compound that can produce a 'high' feeling. At prescribed doses, it works with your body's own pain system to reduce discomfort, settle nausea and stimulate appetite. Think of it as turning down the volume on pain and distress signals.
- Reduces cancer-related pain — including pain that hasn't responded to opioids 1,2
- Settles nausea and vomiting from chemotherapy — one of the best-supported uses 3
- Stimulates appetite and may help reverse unwanted weight loss 3,4
- Can ease anxiety and distress — particularly at lower doses 2
- May improve sleep quality in palliative patients 2
CBD has no 'high' effect. It works on inflammation, nerve pain and anxiety through different pathways in your body. Many patients find it calming and helpful for managing day-to-day discomfort alongside other treatments.
- Calms inflammation — helps settle the body's overactive pain response 5
- May ease nerve pain from chemotherapy (the tingling or burning called CIPN) 5
- Well-studied calming effect on anxiety — without sedation 4
- Works better alongside THC — they produce stronger relief together 4,5
- A 2023 Australian trial (MedCan1-CBD) found significant improvements in fatigue and sleep 5
Your body already has a cannabis system
THC and CBD work by connecting with a natural network in your body called the endocannabinoid system (ECS). Understanding this helps explain why cannabis can help with so many different symptoms at once.
Your body has a built-in cannabinoid network — the ECS — that regulates pain, mood, appetite, and sleep. THC and CBD bind to its receptors (CB1 & CB2), mimicking your natural endocannabinoids to restore balance. 1
Because the ECS is involved in so many processes, cannabis medicines can ease pain, reduce nausea, improve appetite and calm anxiety all at once — rather than needing a separate pill for each symptom. 2
Many patients find a combination of THC and CBD works best. CBD takes the edge off THC's psychoactive effects and may reduce morning grogginess. Your pharmacist will help you find the right ratio for your situation. 4,5
What symptoms can it help with?
Medicinal cannabis is prescribed alongside — not instead of — your other medications. It works best as part of a broader palliative care plan.
Evidence from clinical trials
All of the information below is drawn from published, peer-reviewed research. Your pharmacist can walk you through what's most relevant to your situation.
Yes, for many patients. A landmark clinical trial found a THC+CBD mouth spray reduced cancer pain significantly better than placebo in patients whose pain couldn't be controlled with strong opioids.
This is one of the strongest areas of evidence. THC-based medicines outperformed standard anti-nausea drugs in multiple clinical trials — making it one of the most well-supported uses in oncology.
Possibly, yes. A 2023 Australian trial of CBD oil in advanced cancer patients found meaningful improvements in sleep quality and fatigue — two of the most distressing palliative symptoms.
THC has a well-known appetite-stimulating effect. It may also help with changes in how food tastes or smells during treatment — a common reason patients stop eating, contributing to weight loss.
CBD has well-researched calming effects. In palliative populations, where anxiety is very common, THC+CBD combinations have shown improvements in validated mood and quality-of-life scores.
Early evidence suggests it might. Some patients on medicinal cannabis have reduced their opioid dose — which can mean fewer opioid side effects like constipation and drowsiness. Research is still growing.
When to take it & how much to start with
Your pharmacist will tailor this to your specific medicine. These are general starting guidelines — always follow your personalised instructions first.
What starting treatment looks like
Here's a typical experience for a palliative patient starting oral medicinal cannabis for the first time.
Start with the lowest suggested dose. Oils and capsules need time to absorb — this is completely normal. Starting with a low THC:CBD ratio (1:1 or 1:2) is a gentle way to begin.
Most patients notice reduced anxiety, a quieter mind, and some easing of pain or nausea around this time. The effect may be subtle at first — this is expected at low doses. 1,2
If your symptoms aren't improving enough, your pharmacist will suggest a small dose increase. It can take 2–4 weeks to find the optimal dose. Don't increase on your own — let us guide you through it.
Once your dose is established, most patients experience consistent relief. Contact your MedWest pharmacist at any point if your symptoms change or if you have any concerns about your medicine. 2,4
Please read — what to watch for
Medicinal cannabis affects everyone differently. Most people tolerate it well at low doses. If any of the following apply to you, make sure you've discussed it with your prescribing doctor before starting. If you experience unexpected side effects, contact your MedWest pharmacist straight away.
- What ratio of THC to CBD is right for my condition?
- Will this interact with my other medications or chemotherapy?
- How do I know if my dose needs adjusting?
- What should I do if I feel dizzy or unwell?
- Can I take this if I need to drive?
- Is it safe to take this alongside my opioids?
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All evidence in this guide is based on peer-reviewed research and current Australian clinical guidelines. References are provided for transparency — you don't need to read them, but they're here if you'd like to learn more. Vancouver format.
- 1. Johnson JR, Burnell-Nugent M, Lossignol D, Ganae-Motan ED, Potts R, Fallon MT. Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain. J Pain Symptom Manage. 2010;39(2):167–79. doi:10.1016/j.jpainsymman.2009.06.008
- 2. Doppen M, Kung S, Maijers I, John M, Dunphy H, Townsley H, et al. Cannabis in palliative care: a systematic review of current evidence. J Pain Symptom Manage. 2022;64(5):e260–84. doi:10.1016/j.jpainsymman.2022.06.002
- 3. Oliveira ASMF, Gama AMC, Correa LVC, Sousa MB, Mello TF. Effects of cannabinoids on pain control, quality of life and opioid-sparing in cancer patients: systematic review. Braz J Pain. 2023;6:e20230061. doi:10.5935/2595-0118.20230061
- 4. Macedo LT, Carvalho FA, Vitória C, Rodrigues CM. Review of the use of medicinal cannabis products in palliative care. Cancers (Basel). 2024;16(7):1412. doi:10.3390/cancers16071412
- 5. Hardy J, Greer R, Huggett G, Kearney A, Gurgenci T, Good P. Phase IIb randomized, placebo-controlled, dose-escalating, double-blind study of cannabidiol oil for the relief of symptoms in advanced cancer (MedCan1-CBD). J Clin Oncol. 2023;41(7):1444–52. doi:10.1200/JCO.22.01632
- 6. Nielsen S, Picco L, Murnion B, Winters B, Matheson J, Graham M, et al. Opioid-sparing effect of cannabinoids for analgesia: an updated systematic review and meta-analysis of preclinical and clinical studies. Neuropsychopharmacology. 2022;47(7):1315–30. doi:10.1038/s41386-022-01282-9