Cannabidiol (CBD), widely recognized for its potential therapeutic properties, has gained attention for its ability to alleviate anxiety. In a groundbreaking clinical trial recently published in JAMA Network Open, researchers examined the effect of CBD on anxiety levels in women with advanced breast cancer during the high-stress period preceding tumor assessment scans.

Anxiety in Cancer Care: An Overlooked Challenge

Anxiety is a common yet under-addressed issue among cancer patients, with 20-25% experiencing clinical anxiety during treatment. Despite this prevalence, effective pharmaceutical options remain limited. Benzodiazepines, the most commonly prescribed anxiety medications, come with significant drawbacks, including confusion, amnesia, and potential addiction, making them less desirable in oncology care. As a result, only a small percentage of adult cancer patients receive these drugs.

CBD offers a potential alternative. Early research suggests it may reduce anxiety safely without impacting mental or neurological health. However, most studies have excluded cancer patients, leaving a gap in the evidence that this trial aimed to address.

Anxiety Before Scans: A Critical Target

Tumor assessment scans are a major source of anxiety for cancer patients, driven by fears of discomfort, disease progression, or the unknown. This anxiety peaks just before the scan, affecting up to 81% of patients. Recognizing this, the study focused on the pre-scan period to assess CBD’s potential impact.

The Study: CBD vs. Placebo

The phase II trial involved 50 women with advanced breast cancer, most of whom had mild to moderate anxiety. Participants were randomly assigned to receive either a single 400 mg dose of oral CBD or a placebo before their scans. Anxiety was measured using the “afraid” component of the Visual Analog Mood Scale (VAMS) both before and 2-4 hours after ingestion.

Key aspects of the study:

• No benzodiazepines or other cannabinoids were permitted on the day of the study.
• The CBD used was of regulatory-grade quality, suitable for broader application if proven effective.

Findings: Mixed Results with Promising Signals

The results showed no statistically significant difference in anxiety reduction between the CBD and placebo groups. The mean change in the “afraid” scores was -19 for the CBD group and -15 for the placebo group, falling below the threshold for reliability.

However, those with higher baseline anxiety showed the greatest reductions, and the CBD group had numerically lower anxiety scores 2-4 hours after ingestion compared to the placebo group (51.5 vs. 58). Importantly, no significant adverse effects were reported, highlighting CBD’s safety.

Implications and Future Research

While the study did not achieve statistical significance, the findings suggest that CBD may have an anxiety-reducing effect, particularly in patients with higher initial anxiety levels. The safety profile of CBD makes it an appealing option for cancer patients and their healthcare providers.

Researchers recommend further studies focusing on cancer patients with moderate to severe anxiety. Longitudinal trials incorporating both subjective and objective anxiety measures, such as the Patient Global Impressions Scale, are suggested to better understand CBD’s efficacy.

Conclusion: A Promising Step Forward

This trial marks an important step in exploring CBD as a treatment for anxiety in oncology patients. Despite mixed results, the study highlights CBD’s potential as a safe and tolerable option for managing cancer-related anxiety. As researchers continue to investigate, CBD could emerge as a valuable tool in supporting the mental health of cancer patients during their treatment journey.