• Nausea from chemotherapy: Strong for prescription THC (see Cancer). Evidence is insufficient for nausea from advanced cancer itself, according to the Multinational Association of Supportive Care in Cancer (MASCC 2022).
• Appetite and weight loss: Moderate in HIV; not established in cancer. A review of palliative trials found weight and appetite gains in HIV but no convincing benefit in cancer, where megestrol worked better in a trial of 469 patients (Mücke 2018).
• Pain, mood, sleep, and overall comfort: Not established. Cancer pain trials found no benefit over placebo (see Cancer).

Compared with standard treatment: Standard palliative medicines remain first-line for each symptom.

Good to know: In hospice care, comfort and patient goals guide the decision. Watch for confusion, dizziness, and falls, and check interactions with the many medicines patients often take. Tinctures, topicals, and suppositories work for people who cannot swallow.

What to ask for: Choose by symptom: prescription THC or a THC-containing oral product for chemotherapy nausea; a low evening THC dose if sleep is the goal; an under-the-tongue tincture when swallowing is hard. Coordinate with the hospice or palliative team.