Parent and patient perceptions of medical marijuana in the childhood cancer context

Abstract

Background Medical marijuana (MM) is legal in 34 US jurisdictions. Yet, little is known about patient and parent perceptions of MM in pediatric cancer care. We examined attitudes, beliefs, and experiences regarding MM among parents of children with cancer and adolescent and young adult (AYA) patients, to help frame future research initiatives. Procedure In this qualitative study, we conducted semi‐structured, one‐on‐one interviews with parents and AYAs at a comprehensive cancer center. Interviews were audio‐recorded, transcribed, and coded using both descriptive and inductive coding approaches. We used content and framework analysis to identify key themes. Results Fifteen parents and 15 AYAs enrolled. Participants were generally receptive to MM use, concurrently weighing benefits and risks. Participants most often endorsed MM use for relief of nausea, anorexia, and pain. Simultaneously, participants identified concerns about MM, including potential physiologic and psychological effects on children and lack of research. However, concerns were frequently minimized, relative to chemotherapy or supportive care medications with perceived greater side effect profiles. Many participants expressed uncertainty regarding legal access, citing complex processes to obtain MM. Few participants had discussed MM with their oncologist, instead seeking guidance from the internet, family, or peers. Importantly, we elicited several misconceptions regarding MM, including its utility as cancer‐directed therapy. Conclusion Patients and families are receptive to using MM, motivated by potential for symptom relief and cancer‐directed effects. Yet, lack of empiric evidence is a barrier, underscoring the need for robust clinical trial data to support MM recommendations and use.

Perspectives of pediatric oncologists and palliative care physicians on the therapeutic use of cannabis in children with cancer

“… 9 In another qualitative study, adolescents and young adults with cancer, and their parents, endorsed cannabis to manage nausea, pain, and anorexia after weighing the risk of potential physiological and psychological side effects of cannabis. 27 The majority of physicians in our study also believed that cannabis has a role in symptom control, especially among children receiving palliative care. The physicians' perspectives likely symbolize the positive benefits observed in their clinical practice or their awareness of the emerging data on the benefits of cannabis for symptom control among children with cancer, especially in a palliative care setting where the risks associated with cannabis are low.…”

“…Only a small proportion (14%) reported side effects related to cannabis use, such as throat and abdomen pain 9 . In another qualitative study, adolescents and young adults with cancer, and their parents, endorsed cannabis to manage nausea, pain, and anorexia after weighing the risk of potential physiological and psychological side effects of cannabis 27 . The majority of physicians in our study also believed that cannabis has a role in symptom control, especially among children receiving palliative care.…”

“…Despite limited evidence on the safety or efficacy of cannabis in pediatric oncology, parents or caregivers of children with cancer may use cannabis products for various indications, including nausea, vomiting, pain, lack of appetite, mood, and as an anticancer agent. 9 , 10 , 11 In a few recently published studies, children and young adults with cancer reported using cannabis products for nausea and vomiting, depressed mood, sleep disturbances, pain, poor appetite and weight loss. 9 , 10 In a study from Israel, nearly 80% of children and their parents, believed that cannabis alleviated their physical and psychological distress; however, the study used no control group, and outcomes were self‐reported.…”

“…However, limited data exist on the use of cannabis for conditions outside of epilepsy. Despite limited evidence on the safety or efficacy of cannabis in pediatric oncology, parents or caregivers of children with cancer may use cannabis products for various indications, including nausea, vomiting, pain, lack of appetite, mood, and as an anticancer agent 9–11 . In a few recently published studies, children and young adults with cancer reported using cannabis products for nausea and vomiting, depressed mood, sleep disturbances, pain, poor appetite and weight loss 9,10 .…”

Medical marijuana in pediatric oncology: What your patients are thinking

“…So how should pediatric oncology programs approach the topic of MM? In this issue of Pediatric Blood and Cancer , Ananth and colleagues used a qualitative research design to characterize patient and family perception of MM from a single institution in a state with permissive rules toward both medical and recreational marijuana 4 . The authors interviewed both parents of younger children as well as adolescent/young adult (AYA) patients.…”