Research study · Supportive Care in Cancer · 2025
Medicinal Cannabis for Symptom Control in Advanced Cancer: A Randomised, Placebo-Controlled Trial of 1:1 THC and CBD
A 2025 randomized controlled trial in Supportive Care in Cancer tested medicinal cannabis in cancer. Overall symptom distress improved in both groups by a similar amount, with no difference between them. An honest negative result on the headline question.
Study overview
A placebo-controlled trial asking whether a 1:1 THC:CBD oil eased the overall symptom burden of advanced cancer beyond what palliative care already provides.
Findings
Overall symptom distress improved in both groups by a similar amount, with no difference between them. Pain scores improved more on cannabis, but with more psychological side effects, and general wellbeing favoured placebo.
Why this matters
An honest negative result on the headline question. It is a useful corrective: people often arrive hoping cannabis will lift everything at once, and this trial says that is not what happened.
Abstract
144 patients with advanced cancer were randomised to a 10 mg/ml 1:1 THC:CBD oil or placebo, with the dose escalated over 14 days according to tolerance and continued to day 28. Symptoms were scored on the Edmonton Symptom Assessment Scale and summed into a total symptom distress score.
On the primary outcome - change in total symptom distress at day 14 - both arms improved and neither did better: -6.30 (SD 12.3) on cannabis versus -6.98 (SD 12.56) on placebo (P = 0.76). That both arms improved substantially is itself worth noting, and points at how much good palliative care and trial participation deliver on their own.
Among secondary outcomes, ESAS pain improved more on cannabis (-1.42 versus -0.46; P = 0.04), and both global impression of change and the pain component of quality of life favoured cannabis. The authors attribute the pain benefit to a cost: greater psychomimetic toxicity. General wellbeing improved more on placebo.
Citation
Hardy JR, Greer RM, Pelecanos AM, Huggett GE, Kearney AM, Gurgenci TH, et al. Medicinal Cannabis for Symptom Control in Advanced Cancer: A Randomised, Placebo-Controlled Trial of 1:1 THC and CBD. Supportive Care in Cancer (2025). PubMed 40705150 · DOI
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Condition: Cancer Topic: CBD Topic: Medical cannabis Topic: THC
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Reviewed by Dr. Caplan on September 17, 2026.
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