Medical Cannabis Use in Glioma Patients Treated at a Comprehensive Cancer Center in Florida

Abstract

Background: Glioma is a devastating primary tumor of the central nervous system with difficult-to-manage symptoms. Cannabis products have been postulated to potentially benefit glioma patients. Recent state legalization allowed investigators an opportunity to study glioma patients' adoption of medical marijuana (MM). Objective: Our goals were to: (1) determine the prevalence of marijuana use, both through physician recommendation and self-medication, and (2) evaluate its perceived risks and benefits in glioma patients. Design: Self-report data were collected and descriptive analyses were conducted. Setting/Subjects: Participants were adult, English-speaking patients undergoing treatment for primary nonrecurrent malignant glioma in neuro-oncology clinics at an NCI-designated Comprehensive Cancer Center. Measurements: The survey on MM was adapted from previous research and included questions on knowledge and attitudes toward MM; use, frequency, type, and sourcing of MM; and reasons for use of MM and perceived symptom relief among users. Results: A total of 73 patients were surveyed. The majority of participants were aware that MM was legal in the state, and most reported learning of this through the media. Over 70% of participants reported having considered using MM, and a third reported using marijuana products after their diagnosis. Most received recommendations from friends/family rather than a medical provider, and only half of the users had obtained a physician's recommendation. Users generally reported benefits. Conclusions: With the increasing national conversation that accompanies legalization, glioma patients are pursuing marijuana for the treatment for their symptoms. More research and education is needed to bring health care providers into the conversation.

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“…Regardless of the potential benefits on restricting tumor growth, a third of surveyed glioblastoma patients reported using some form of medical marijuana for relief from symptoms ranging from pain and nausea to insomnia and emotional lability, with the vast majority of those reporting symptom improvement [ 110 ]. Similarly, over 67% of patients with primary brain malignancy reported a moderate to significant improvement in their overall condition after 6 months of cannabis use [ 111 ].…”

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“…At 6 months, 36.3% of patients reported no more nausea or vomiting, 54.7% claimed symptom improvement, and 9% reported no change ( Bar-Lev Schleider et al, 2018 ). A study by Reblin and colleagues (2019) looked at medical marijuana use in patients with gliomas treated at a comprehensive cancer center in Florida. Thirteen patients used medical marijuana (smoked or ingested THC, CBD only, or THC and CBD oil) for the treatment of nausea; 12 reported symptom relief and 1 reported no effect (Reblin et al, 2019).…”

“…25.8% said the symptom disappeared at 6 months, 62.1% reported improvement, and 12.1% reported no change ( Bar-Lev Schleider et al, 2018 ). Reblin and colleagues (2017) reported on 12 patients who used medical marijuana as an appetite stimulant, and all reported symptom relief. In the Minnesota study by Anderson and colleagues (2019), 1,000 patients reported a lack of appetite, and 38.8% achieved a 30% or greater improvement in appetite within 4 months of initiating the use of medical marijuana.…”

“…In this same study, of the 1,113 patients reporting fatigue, only 27% had an improvement of 30% or more after 4 months. Reblin and colleagues (2019) had only 2 patients using cannabis as a sleep aid, but both found relief from medical marijuana.…”

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“…Several studies on the allergic and nutritional epidemiology of glioma showed an inverse association between allergy and gliomas but did not provide any causal relationship between them [ 46 ]. The nutritional epidemiology studies suggested that various food groups and nutrients were associated with glioma risk; the results were inconclusive and not replicable in subsequent research [ 24 , 47 ]. The results of epidemiological analysis also suggested the presence of an inverse association between cancer and certain neurological conditions, mainly age-related neurodegenerative diseases [ 48 ].…”