Growing Use of Medical Cannabis Among Cancer Patients
A series of recent studies highlights the rising use of cannabis among cancer patients and its implications. Research shows that 20% to 40% of individuals undergoing cancer treatment use cannabis or cannabinoids, often referred to as medical marijuana. They turn to these products to manage symptoms like nausea, pain, sleeplessness, anxiety, and stress.
This increase in cannabis use aligns with the legalization of medical cannabis in many states. However, research on the safety and effectiveness of specific cannabis products for cancer-related symptoms is still lacking. The American Society of Clinical Oncology (ASCO) published its first clinical guidelines on cannabis use in March 2024, stating that “cannabis and/or cannabinoid access and use by adults with cancer has outpaced the science supporting their clinical use.”
One major challenge is that many oncologists feel unprepared to discuss cannabis with their patients. In a recent study, nearly 40% of oncologists and nurses said they were comfortable advising patients about cannabis. Yet only about 13% felt knowledgeable about it. This research, funded by the NCI and conducted at designated cancer centers, was published in August in JNCI Monographs.
Dr. Richard T. Lee, lead investigator and head of the Cherng Family Center for Integrative Oncology at City of Hope, noted that patients are increasingly interested in using cannabis to manage their symptoms. As cannabis becomes more accessible, providers will encounter more patients using various cannabis products, including flavored gummies and tinctures.
Dr. Lee emphasized the importance of asking patients about their cannabis use and treating it like any other medication, highlighting both potential benefits and harms.
Legal Access vs. Safety Concerns
Historically, cannabis use among cancer patients was largely illegal in the U.S. Now, 14 states allow medical use, and an additional 24 states and the District of Columbia permit both medical and recreational use. A recent Pew Research Center study found that nearly three-quarters of Americans live in states where cannabis is legal in some form.
Dr. Susanna Ulahannan from the University of Oklahoma noted that younger patients are more likely to use cannabis for anxiety and sleep issues. In contrast, older patients often turn to cannabis only when traditional medications fail.
Accessing cannabis is relatively easy, with about 15,000 dispensaries across the U.S. However, questions remain about its safety for cancer patients. Dr. Gary Ellison from NCI pointed out that we lack a clear understanding of cannabis safety. There are concerns about cannabis potentially interfering with cancer treatments, particularly immunotherapy, which can be less effective when combined with cannabis.
Cannabis can also suppress the immune system, especially with long-term use, according to Dr. Mohab Ibrahim from the University of Arizona. Additionally, cannabis may interact with other medications, enhancing sedation and increasing the risk of falls or accidents.
Patients often feel that the benefits of cannabis outweigh the risks, making it challenging for providers to communicate potential downsides. Dr. Ulahannan noted that many patients believe there are more “natural” ways to manage symptoms than prescription medications. Some even mistakenly think cannabis can treat their cancer.
Importance of Open Communication
To facilitate discussions about cannabis, oncologists should familiarize themselves with state laws and their institutions’ policies. Understanding how cannabis affects the body and interacts with medications is crucial.
Dr. Lee recommended that providers review ASCO guidelines and the existing literature on cannabis and cancer. Dr. Ulahannan urged patients to inform their oncologists about any supplements, including cannabis products. A study showed that only 20% of patients using cannabis discussed it with their oncologist.
This underscores the need for open communication between clinicians and patients. Knowing what patients are taking can help providers identify possible causes for side effects and adjust treatments accordingly. Without these discussions, important insights may be overlooked.
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