People living with pancreatic cancer often manage several difficult symptoms at once, including pain, poor appetite, nausea, anxiety and poor sleep. Researchers are studying whether medical cannabis has a role alongside standard cancer care in managing these symptoms, but the evidence is still at an early stage.
A new analysis of the CANPAN trial, published in The Oncologist in 2026, looked at whether the daily dose of tetrahydrocannabinol (THC) people used was linked to changes in their symptoms.
Key Takeaways:
- The CANPAN trial included 32 adults in the US with newly diagnosed advanced pancreatic cancer who were starting chemotherapy and had not used cannabis before.
- Participants were randomly allocated to start medical cannabis straight away or after 8 weeks. The two groups used cannabis in very similar ways, which suggests this “waitlist” design is workable for future trials.
- In the 16 participants with complete data, a higher average daily THC dose was associated with greater improvement in anxiety and sleep problems (insomnia).
- Participants who used 10 mg of THC a day or more on average reported improvement in more symptoms (an average of 4 symptoms) than those using less (an average of 2.1 symptoms).
- No link with dose was seen for nausea, pain, appetite or fatigue.
- Only half of participants (16 of 32) had complete data by the end of the study. People were not randomly allocated to different doses. The authors describe the findings as exploratory and hypothesis-generating, not confirmation of that medical cannabis is suitable for all patients or a basis for dosing recommendations.
- What is pancreatic cancer?
Pancreatic cancer starts in the pancreas, an organ behind the stomach that helps with digestion and controls blood sugar. Around 11,500 people are diagnosed with pancreatic cancer in the UK each year, and it causes around 10,200 deaths a year. Fewer than 5 in 100 people survive 10 years or more after diagnosis, making it one of the hardest cancers to treat (Cancer Research UK).
Many people are diagnosed when the cancer is already locally advanced or has spread (metastatic). At this stage, chemotherapy aims to control the cancer and extend life. Managing symptoms and the side effects of treatment is a central part of care.
Can medical cannabis help with cancer symptoms?
Medical cannabis is not a treatment for cancer itself, and it should never be used in place of cancer treatment. Research is looking at whether it may have a role in managing some symptoms of cancer and the side effects of treatment, alongside standard care.
In the UK, the strongest guidance relates to nausea and vomiting caused by chemotherapy. The National Institute for Health and Care Excellence (NICE) recommends that doctors consider nabilone, a licensed synthetic cannabinoid, as an add-on treatment for adults whose chemotherapy-induced nausea and vomiting continues despite standard anti-sickness medicines (NICE guideline NG144). For other cancer-related symptoms, such as pain, appetite loss, anxiety and sleep problems, the evidence for cannabis-based medicines is still limited and comes mostly from small or observational studies.
What was the CANPAN trial?
CANPAN was a small, early-stage (phase II) randomised trial run in Minnesota, USA (trial registration NCT06605430). It was designed to test whether a trial of medical cannabis in people with advanced pancreatic cancer could be run successfully, and to gather early data on symptoms.
Who took part?
The trial enrolled 32 adults who:
- had been newly diagnosed with locally advanced or metastatic pancreatic cancer
- were starting standard chemotherapy
- had not used cannabis before (cannabis-naïve)
- had at least one qualifying symptom, which could be pain, nausea, vomiting, loss of appetite (anorexia) or weight and muscle loss (cachexia)
- lived in Minnesota and could join the state’s Medical Cannabis Program
The median age was 71 years and just over half (17 of 32, 53%) were women.
How was the trial run?
Participants were randomly allocated to one of two groups of 16:
- Early access: medical cannabis from the start of the trial (weeks 0 to 8)
- Delayed access: medical cannabis from week 9 (weeks 9 to 16)
This is called a waitlist-controlled design. Everyone could access medical cannabis at some point. During the first 8 weeks, the delayed group acted as a comparison for the early group.
Before starting, participants received education from the study team and specialist pharmacists. This covered how cannabis can be taken, possible side effects, how to adjust the dose gradually, and safety. They then collected individually chosen products from a licensed dispensary at no cost. Products could be taken by mouth, inhaled or applied to the skin. Doses followed a “start low, go slow” approach, adjusted by each participant with guidance from their care team. All participants continued their usual cancer care.
How were symptoms measured?
Participants reported their own symptoms online using validated questionnaires. The main one was the PRO-CTCAE, a questionnaire developed by the US National Cancer Institute to record symptoms during cancer treatment. It was adapted to cover cancer symptoms and possible cannabis side effects, including:
- anxiety, sadness and sleep problems (insomnia)
- pain, nausea, vomiting and appetite
- nerve pain or tingling (neuropathy) and fatigue
- dry mouth, dizziness and problems concentrating
Participants also reported which cannabis products they used, how much, how often and how. From this, the researchers calculated each person’s average daily dose of THC, the main cannabinoid used in the trial.
What did the new analysis find?
The main results from the first 8 weeks were published earlier in 2026. This new analysis looked at the full 16 weeks, how much cannabis people used, and whether THC dose was linked to changes in symptoms.
How many people used cannabis and completed the study?
Of the 32 participants, 23 (72%) used cannabis during their allocated 8 weeks. This was 12 of 16 in the early group and 11 of 16 in the delayed group. Complete symptom data before starting cannabis and 8 weeks after were available for 16 people (50%). These 16 people formed the group for the dose analysis.
People dropped out for reasons including becoming too unwell, going into hospice care, loss of contact with the study team, and, in one case, death. This reflects how quickly advanced pancreatic cancer can progress.
Did the two groups use cannabis in the same way?
Yes. The median daily THC dose was 10.0 mg in the early group and 9.3 mg in the delayed group. The number of people using cannabis and providing data was also similar in both groups. The authors describe this as reassuring for the waitlist design, because it suggests both groups received a comparable intervention.
Was THC dose linked to symptom changes?
In the 16 people analysed, a higher average daily THC dose was associated with greater change in:
- anxiety
- sleep problems (insomnia)
A similar pattern for sadness did not reach statistical significance. People in the comparison period who were not using cannabis showed little or no change in these symptoms.
No link with dose was seen for nausea, vomiting, pain, appetite, fatigue or neuropathy. The authors note that cannabis use overall, regardless of dose, had been associated with improvements in pain and appetite in their earlier report. Dry mouth, dizziness and concentration problems also showed no clear link with dose. With only 16 people, however, the study was too small to draw conclusions about side effects.
What do the findings mean?
The authors draw three main lessons for future research.
- Keeping people in studies is hard. Only half of participants had complete data at 16 weeks. Future trials in advanced pancreatic cancer will need to recruit more people to allow for this.
- The waitlist design appears workable. Both groups used cannabis in similar ways. This supports using the design to compare people with and without medical cannabis while still offering it to everyone.
- There may be a dose-response relationship for psychological symptoms. Higher THC doses were linked to greater improvement in anxiety and sleep. The authors suggest that lower doses might be enough for some physical symptoms, while psychological symptoms might need higher doses. This idea has not been tested directly.
What are the limitations of this study?
The authors are clear that these results are early and should be read with caution.
- Very small sample. The dose analysis included only 16 people. Small studies can produce chance findings.
- Dose was not randomised. Participants chose their own dose. People who felt early benefit or had fewer side effects may have gone on to use higher doses. This means a higher dose could be the result of improvement rather than its cause.
- No placebo. Participants knew they were using cannabis, which can influence how people report their symptoms.
- Limited dose data. Doses were based on what participants recalled, not on blood tests or detailed records of the cannabinoid mix over time.
- Other factors were not accounted for. Chemotherapy, its side effects and cancer progression all affect symptoms, and these were not adjusted for in the analysis.
- US setting. Participants accessed products through a US state cannabis programme. Products, access and regulation differ from the UK.
The authors state that the findings are “hypothesis-generating for future trial design rather than a basis for definitive clinical dosing recommendations”.
Support for people living with cancer
A diagnosis of pancreatic cancer affects every part of life, for patients and the people close to them. Your oncology team, specialist nurse, GP and palliative care team are the best people to talk to about managing symptoms and treatment side effects.
Charities such as Pancreatic Cancer UK, Macmillan Cancer Support and Marie Curie also offer free information and support.
If you are considering medical cannabis, speak to your oncology team first. Cannabis can interact with other medicines, and any decision should take your cancer treatment into account.
Curaleaf Clinic is a specialist medical cannabis clinic. To find out whether a consultation with one of our specialist doctors may be appropriate for your circumstances, you can complete our online eligibility check. Any treatment decisions are made by a specialist on an individual basis after a full assessment.
Frequently Asked Questions
Can medical cannabis help with cancer?
It is important to remember that medical cannabis cannot cure cancer. However, in some cases, it may help to alleviate some symptoms associated with the disease and its treatment. For example, NICE currently recommends considering nabilone (a synthetic cannabinoid) as an add-on treatment for adults with chemotherapy-induced nausea and vomiting.
Learn more about medical cannabis treatment for cancer on our conditions page.
Is medical cannabis suitable for palliative care?
Palliative care aims to improve quality of life for people with life-limiting illness by easing symptoms such as pain, anxiety and poor sleep. In the UK, a specialist doctor may consider prescribing a cannabis-based medicine when standard treatments have not given enough relief. The evidence in this area is still developing.
Is medical cannabis legal in the UK?
Yes. Since November 2018, specialist doctors in the UK have been able to prescribe cannabis-based medicines when other treatments have not worked well enough. Most of these medicines are unlicensed, and they are only available on prescription following a specialist assessment.