Exploring cancer survivors’ attitudes, perceptions, and concerns about using medical cannabis for symptom and side effect management: A qualitative focus group study

Victorson, David; McMahon, Megan; Horowitz, Bruriah; Glickson, Sydney; Parker, Brandy; Mendoza-Temple, Leslie

doi:10.1016/j.ctim.2019.102204

Cited by 20 publications

(18 citation statements)

References 24 publications

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“…20,21 To the best of our knowledge, this is the first study that applied the TPB to understand the impact of national legalization of cannabis on cancer survivors' decision to medicate or not medicate with cannabis using qualitative methodology. While Victorson et al explored attitudes of American cancer survivors regarding medical cannabis for their symptom management using focus groups, 5 results from the United States (US) are difficult to interpret, as state-level legalization legislation remains in conflict with federal law. 22 Thus, the legal status of cannabis remains ambiguous, and patients' attitudes in the United States will be influenced by this ambiguity.…”

Section: Discussionmentioning

confidence: 99%

“…Cancer survivors––individuals diagnosed with cancer until the end of their life 1 ––have reported medicating with cannabis or drugs containing cannabinoid 2 . They report favorable outcomes for managing chemotherapy‐induced nausea and vomiting, cancer‐related pain, anorexia, insomnia, and depression, 3,4 as well as an improvement in their quality of life 5 . While there are a limited number of high‐quality clinical trials evaluating the effectiveness of cannabis in alleviating cancer symptoms, 6,7 some countries have legalized nonmedical cannabis.…”

Section: Introductionmentioning

confidence: 99%

“…2 They report favorable outcomes for managing chemotherapy-induced nausea and vomiting, cancer-related pain, anorexia, insomnia, and depression, 3,4 as well as an improvement in their quality of life. 5 While there are a limited number of high-quality clinical trials evaluating the effectiveness of cannabis in alleviating cancer symptoms, 6,7 some countries have legalized nonmedical cannabis. In Canada, the Cannabis Act 8 (effective as of 17 October 2018), which replaced the Access to Cannabis for Medical Purposes Regulations, 8 enables individuals to purchase cannabis and cannabinoid products through licensed producers for personal use without medical documentation.…”

Section: Introductionmentioning

confidence: 99%

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Understanding cancer survivors’ reasons to medicate with cannabis: A qualitative study based on the theory of planned behavior

et al. 2020

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Background Prior to nonmedical cannabis legalization in Canada, individuals were only able to access cannabis legally through licensed producers with medical authorization. Now with an additional legal access system designed for nonmedical purposes, it is unclear what factors influence cancer survivors’ decisions to medicate or not medicate cannabis as a complementary therapy to alleviate their cancer symptoms. Methods We recruited cancer survivors via social media. Interested individuals were purposively sampled to ensure maximization in terms of age, sex, and province of residence. Constructs of the Theory of Planned Behavior were explored during the telephone interviews as participants described what influenced their decisions to medicate or not medicate cannabis to manage their symptoms. Results Interviews were conducted with 33 cancer survivors. All individuals believed that cannabis would manage their cancer symptoms. Those that chose to medicate with cannabis provided a variety of reasons, including that cannabis was a more natural alternative; that it reduced their overall number of prescription drugs; and that safer products had become available with the legalization of nonmedical cannabis. Some individuals also indicated that support from physicians and validation from family and friends were important in their decision to medicate with cannabis. Individuals who opted not to medicate with cannabis raised concerns about the lack of scientific evidence and/or possible dependency issues. Some also felt their physician's disapproval was a barrier to considering cannabis use. Conclusions The findings revealed that recreational legalization made using cannabis appear safer and easier to access for some cancer survivors. However, physicians’ censure of cannabis use for symptom management was a barrier for survivors considering its use.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Understanding cancer survivors’ reasons to medicate with cannabis: A qualitative study based on the theory of planned behavior

et al. 2020

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“…Dubin et al ( 2017 ) suspect there is a mismatch between physicians’ formal curriculum, which emphasizes stigma reduction, and the hidden curriculum, which implicitly reproduces anti-cannabis attitudes. Furthermore, when patients forgo medical cannabis over concerns of stigma, they may experience unnecessary pain, suffering, and unwarranted stress (Victorson et al 2019 ; Ryan and Sharts-Hopko 2017 ). “Medicine can only be effective if it is taken, and stigma and lack of acceptability can interfere with compliance and safe access” (Rudski 2014 :318).…”

Section: Stigmamentioning

confidence: 99%

A qualitative review of cannabis stigmas at the twilight of prohibition

Reid

2020

J Cannabis Res

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Background As laws change and cannabis use increases, it is worthwhile to take a rich account of cannabis stigmas in society, and this review identifies a disjunction between quantitative investigations on cannabis users and qualitative investigations on the same population. This is also the first attempt to explicate cannabis stigmas as they manifest on multiple analytical levels. Following brief explanations of the normalization hypothesis and the concept of stigma, this review is organized between structural (macro) stigmas, social (meso) stigmas, and personal (micro) stigmas. Furthermore, since cannabis stigmas are similar to the stigmas faced by sexual minorities in that each is physically concealable, the two groups are compared here because the literature base is more extensive with the latter. Methods This qualitative review synthesizes the body of empirical studies on both medical and nonmedical cannabis use with attention to stigma, stereotypes, and other social consequences. Studies considered for the review mostly come from the social sciences, particularly sociology. The information presented here is primarily drawn from peer-reviewed articles on cannabis users in the USA, though research from similar national contexts is cited as well. Results This review suggests claims of normalization may be premature. While stigmas surrounding cannabis appear to have diminished, there is little evidence that such stigmas have entirely disappeared. It is possible that sweeping claims of cannabis normalization may be symptomatic of unchecked social privileges or social distance from cannabis users. Such claims may also be the product of valuing quantitative data over the nuanced accounts uncovered through qualitative investigations. Conclusion This substantial coverage of the literature indicates the lived experience of a post-prohibition society is not the same as a one where cannabis is normalized. Individuals working with those who use cannabis should not assume stigmas have disappeared, especially since cannabis stigmas often intersect with other sources of social inequality. While a comprehensive discussion of ways to combat lingering social stigmas is beyond the scope of this review, it concludes by highlighting some of the strategies identified through research which help users resist or mitigate these oppressive forces. Future research would be wise to prioritize the experiences of people of color, women, and adult populations if the hope is to identify ways to further normalize the plant in American society.

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“…To alleviate these symptoms, some cancer patients have looked toward alternative medicine, either in addition to conventional cancer therapies or as a substitute for adjuvant therapies 4 . Qualitative data suggest that cancer patients generally have favorable attitudes toward use of medical cannabis (or marijuana) for cancer symptom and side‐effect management 5,6 . Cannabis has been shown to demonstrate varying levels of benefit in symptom relief 7,8 among cancer patients actively undergoing treatment, including that from nausea and vomiting, 9,10 insomnia, anxiety, and depression, 6 and loss of appetite, 11 and cachexia 12 .…”

Section: Introductionmentioning

confidence: 99%

Cannabis use among cancer survivors in the United States: Analysis of a nationally representative sample

Elizabeth

Ksinan

Kim

et al. 2021

Cancer

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Background Research on cannabis use among those with a history of cancer is limited. Methods Prevalence of past‐year cannabis use among individuals with and without a cancer history and predictors of use within these 2 groups were determined using data from the Population Assessment of Tobacco and Health study, a nationally representative, longitudinal survey conducted in the United States (waves 1‐4; 2013‐2018). Discrete time survival analyses were used to estimate baseline (wave 1) predictors (physical health status, mental health status, pain, and demographic variables) on past‐year engagement with cannabis within individuals who reported a cancer diagnosis at wave 1 (n = 1022) and individuals who reported never having cancer at any wave (n = 19,702). Results At the most recent survey, 8% of cancer survivors reported past‐year cannabis use, compared with 15% of those without a cancer history. Across 4 time points, an estimated 3.8% of cancer survivors engaged with cannabis, as compared to 6.5% of those without a cancer history. Across both groups, older age and having health insurance were associated with lower likelihood of engaging in cannabis use, whereas greater levels of pain were associated with higher likelihood of engaging in cannabis use. Among those without a cancer history, being female, White, and having better mental health status were associated with lower likelihood of engaging in cannabis use. Conclusions Although cannabis use prevalence is lower among cancer survivors, the reasons for use are not markedly different from those without a cancer history. Continued monitoring of use, reasons for use, and harms or benefits is warranted. Lay Summary Results from this study, which uses data from the Population Assessment of Tobacco and Health Study, indicate that cannabis use is generally increasing across cancer survivors and those without a history of cancer. Cancer survivors are using cannabis at slightly lower rates than those without a history of cancer. Factors related to pain seem to be more prevalent in cancer populations relative to the general population, and could be contributing to cannabis use within cancer survivor populations.

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Exploring cancer survivors’ attitudes, perceptions, and concerns about using medical cannabis for symptom and side effect management: A qualitative focus group study

Cited by 20 publications

References 24 publications

Understanding cancer survivors’ reasons to medicate with cannabis: A qualitative study based on the theory of planned behavior

Understanding cancer survivors’ reasons to medicate with cannabis: A qualitative study based on the theory of planned behavior

A qualitative review of cannabis stigmas at the twilight of prohibition

Cannabis use among cancer survivors in the United States: Analysis of a nationally representative sample

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