Dronabinol treatment of refractory nausea and vomiting related to peritoneal carcinomatosis.
Nausea and vomiting are common and often highly distressing symptoms in advanced cancer and in hospice and palliative medicine practice. Nausea and vomiting generally respond well to correction of the underlying etiology (when possible) and appropriate selection of antiemetic medication, but up to 7% of patients will have refractory symptoms. Dronabinol is extensively studied for chemotherapy-related nausea and vomiting, but there are only a few case reports of its use in nausea and vomiting unrelated to chemotherapy. We report a patient with end-stage ovarian cancer with peritoneal carcinomatosis and refractory nausea and vomiting who responded dramatically to addition of dronabinol. Dronabinol is usually well tolerated and may have several novel mechanisms of antiemetic action; further study of its scope of efficacy is warranted.
University of South Florida College of Medicine, Tampa, FL, USA.
Sarah L
SL
Hernandez
University of South Florida College of Medicine, Tampa, FL, USA Hospice and Palliative Care Unit, James A. Haley VA Hospital, Tampa, FL, USA.
Inna
I
Sheyner
Hospice and Palliative Care Unit, James A. Haley VA Hospital, Tampa, FL, USA.
Karen T
KT
Stover
University of South Florida College of Medicine, Tampa, FL, USA Hospice and Palliative Care Unit, James A. Haley VA Hospital, Tampa, FL, USA jonathan.stewart1@va.gov.
Jonathan T
JT
Stewart
D000932:Antiemetics / Q000627:therapeutic use*; D002277:Carcinoma / Q000150:complications*; D013759:Dronabinol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009325:Nausea / Q000188:drug therapy* / Q000209:etiology; D010051:Ovarian Neoplasms / Q000150:complications / Q000473:pathology; D010534:Peritoneal Neoplasms / Q000150:complications*; D014839:Vomiting / Q000188:drug therapy* / Q000209:etiology
D000932:Antiemetics; D013759:Dronabinol
anandamide; dronabinol; endocannabinoids; nausea; ovarian cancer; peritoneal carcinomatosis; vomiting