Cancer patients' experiences with medicinal cannabis–related care

Braun, Ilana M.; Nayak, Manan M.; Revette, Anna; Wright, Alexi A.; Chai, Peter R.; Yusufov, Miryam; Pirl, William F.; Tulsky, James A.

doi:10.1002/cncr.33202

Cited by 40 publications

(51 citation statements)

References 18 publications

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“…Similar to our findings, other studies have also identified anxiety and sleep problems as primary symptoms managed by cancer patients using medicinal cannabis [ 25 , 26 , 27 , 28 ].…”

Section: Discussionsupporting

confidence: 92%

Cannabis Use among Cancer Survivors amid the COVID-19 Pandemic: Results from the COVID-19 Cannabis Health Study

Camacho-Rivera

Islam

Rodriguez

et al. 2021

Cancers

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Clinical indications for medicinal cannabis use include those with cancer, a subgroup advised to avoid exposure to COVID-19. This study aims to identify changes to cannabis use, methods of cannabis delivery, and coping strategies among cancer survivors since the pandemic by cancer status. Chi-squared tests were used for univariate comparisons of demographic characteristics, cannabis use patterns, COVID-19 symptoms, and coping behaviors by cancer survivor status. Data included 158 responses between 21 March 2020 and 23 March 2021, from medicinal cannabis users, categorized as cancer survivors (n = 79) along with age-matched medicinal cannabis users without a history of cancer (n = 79). Compared to adults without a history of cancer, cancer survivors were more likely to report use of cannabis as a way of managing nausea/vomiting (40.5% versus 20.3%, p = 0.006), headaches or migraines (35.4% versus 19.0%, p = 0.020), seizures (8.9% versus 1.3%, p = 0.029), and sleep problems (70.9% versus 54.4%, p = 0.033), or as an appetite stimulant (39.2% versus 17.7%, p = 0.003). Nearly 23% of cancer survivors reported an advanced cannabis supply of more than 3 months compared to 14.3% of adults without a history of cancer (p = 0.002); though the majority of cancer survivors reported less than a one-month supply. No statistically significant differences were observed by cancer survivor status by cannabis dose, delivery, or sharing of electronic vaping devices, joints, or blunts. Cancer survivors were more likely to report a fear of being diagnosed with COVID-19 compared to adults without a history of cancer (58.2% versus 40.5%, p = 0.026). Given the frequency of mental and physical health symptoms reported among cancer survivors, clinicians should consider conversations about cannabis use with their patients, in particular among cancer survivors.

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“…Similar to our findings, other studies have also identified anxiety and sleep problems as primary symptoms managed by cancer patients using medicinal cannabis [ 25 , 26 , 27 , 28 ].…”

Section: Discussionsupporting

confidence: 92%

Cannabis Use among Cancer Survivors amid the COVID-19 Pandemic: Results from the COVID-19 Cannabis Health Study

Camacho-Rivera

Islam

Rodriguez

et al. 2021

Cancers

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“…Approximately half of individuals with cancer noted that they had spoken with their doctor. We have no evidence as to the amount of education that individuals might have received in setting of these conversations, but others have noted that little advice is given by providers when Cannabis use is revealed [20]. Available data suggest that much patient education on Cannabis comes from outside of the medical community [20].…”

Section: Plos Onementioning

confidence: 96%

Differences between cancer patients and others who use medicinal Cannabis

et al. 2021

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Background Cancer patients have been at the forefront of policy discussions leading to legalization of medical Cannabis (marijuana). Unfortunately, Cannabis use among those with cancer is poorly understood. Methods A diverse group of patients seeking certification for medical Cannabis in the state of Michigan were surveyed at the time of their presentation to medical dispensaries. The survey assessed demographics, employment/disability, pain, physical functioning, mental health, mode of Cannabis use, and frequency/amount of Cannabis use. Chi-square and t-tests were performed to compare those who did and did not endorse cancer diagnosis. Results Analysis of data from 1485 adults pursuing medical Cannabis certification, including 72 (4.8%) reporting a cancer diagnosis, indicated that those with cancer were older [mean age 53.4 years (SD = 10.5) vs. 44.7 years (SD = 13.0); p<0.001] than those without cancer. They also differed regarding employment status (p<0.001; working: 20.8% vs. 46.2%; disabled: 44.4% vs. 26.5% for those with vs. those without cancer, respectively). Those with cancer used less Cannabis (p = 0.033 for quantity used) and used Cannabis less often (p = 0.032 for frequency of use); they less frequently endorsed smoking Cannabis (80% vs 91%; p = 0.015). There was a non-significant trend to increased edible use in those with cancer (57% vs. 44%; p = 0.052). Conclusions Patients with cancer who are seeking medical Cannabis are different from those seeking medical Cannabis without cancer, and they report using Cannabis differently. Further research to characterize the patterns and consequences of Cannabis use in cancer patients is needed.

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“…This report by Braun et al 3 focuses on patients using cannabis as part of their cancer treatment. The authors conducted telephone interviews to survey participants across the country (United States) about their cannabis use and about interactions between the patients and their medical staff with respect to this use.…”

mentioning

confidence: 99%

Education and communication are critical to effectively incorporating cannabis into cancer treatment

Hughes

Casarett

2020

Cancer

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As cannabis becomes legalized more widely, its use is increasing both recreationally and medicinally. 1,2 In virtually all states that have legalized medical cannabis, its use requires a prescription or certification from an authorized provider. 2 The use of medical cannabis is initiated at the suggestion of the provider or often by request of the patient, and it is used to treat a variety of conditions. Cancer is widely accepted as a condition that justifies the prescription of medical cannabis, and it is a common motivation for those seeking cannabis for medicinal purposes. However, in cancer, as in most conditions treated with medical cannabis, there is a lack of clinical evidence to support its use. For instance, there are few controlled clinical studies assessing its efficacy in managing cancer-related symptoms, and there is very little information on dosing. This report by Braun et al 3 focuses on patients using cannabis as part of their cancer treatment. The authors conducted telephone interviews to survey participants across the country (United States) about their cannabis use and about interactions between the patients and their medical staff with respect to this use. This survey found that patients typically obtained a medical cannabis authorization from a provider who was unfamiliar with their medical history. They also did not rely on their oncology team for advice about whether or how to use cannabis. Instead, they used a system of trial and error supplemented by advice available online. Although patients reported sharing their cannabis use with their oncology team, they did not report receiving much advice about its use, effectiveness, or dosing. Together, these results indicate that cannabis use is very much separate from regular medical care, at least with respect to cancer therapy. Although most patients appear to be using it responsibly to specifically target certain ailments, this disconnect between regular medical care and the physician prescribing cannabis is a problem because having 2 prescribing/medication patterns occurring simultaneously without crosstalk creates the possibility of errors and unnecessary duplication. This might occur, for instance, if an oncologist prescribes a regimen for chemotherapy-associated nausea without knowing that the patient is using cannabis for that purpose. Many consultations with medical cannabis prescribers appear to be brief and superficial, and this suggests that these secondary physicians may not have the chance to fully assess how appropriate a cannabis treatment may be for each patient or how it might fit into the established cancer treatment. Even though patients say that they disclose their cannabis use to their primary medical providers, this does little to prevent the potential for overlapping or counterproductive prescriptions because the onus is then on the patient (likely with a nonmedical background) to recognize what information may be important to pass back and forth between the 2 different providers. Communication about cannabis use is esse...

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Cancer patients' experiences with medicinal cannabis–related care

Cited by 40 publications

References 18 publications

Cannabis Use among Cancer Survivors amid the COVID-19 Pandemic: Results from the COVID-19 Cannabis Health Study

Cannabis Use among Cancer Survivors amid the COVID-19 Pandemic: Results from the COVID-19 Cannabis Health Study

Differences between cancer patients and others who use medicinal Cannabis

Education and communication are critical to effectively incorporating cannabis into cancer treatment

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