Researchers Call for Education About Cannabis Use for Cancer Survivors

As cancer survivors turn to cannabis for medicinal purposes, the authors of a new study are urgently calling for ongoing research as well as the development of standardized educational materials and clinical practice guidelines.

The study — from a team in the department of biostatistics and epidemiology at the University of Oklahoma Health Sciences Center’s Hudson College of Public Health and published in the journal, Cancer – found that 82.23% of cancer survivors who use cannabis reported doing so for medical purposes, compared to 62.58% of cannabis users with no history of cancer. Overall, 10.83% of individuals with no history of cancer and 7.57% of cancer survivors reported cannabis use.

The study analyzed 2020 data from the Behavioral Risk Factor Surveillance System (BRFSS), an annual, national, telephone-based survey designed by the Centers for Disease Control and Prevention. Researchers looked at responses from the 22 states which used the BRFSS’ optional cannabis use module (covering approximately 25.17% of the American adult population) to inquire about respondents’ utilization and administration methods of and reasons for using cannabis.

READ MORE: Patient Experiences With Medical Marijuana for Cancer Symptoms

Once researchers adjusted for factors including state-level policy, biological sex, age, education, self-reported race and ethnicity, home ownership and status of mental and physical health, both current smoking and binge-drinking were associated with cannabis use for respondents with and without a history of cancer. Daily use was associated with cannabis use for medical purposes for both groups.

The study cites a “lack of strong clinical evidence” for the effectiveness of medical cannabis and calls for more research and education on the issue.

“Clinicians are becoming increasingly more acceptingof patients using cannabis for medical purposes; however, most report not feeling equipped to make clinical recommendations,” the authors wrote.

These new findings are consistent with those from a study published in May 2018 in the Journal of Clinical Oncology that, according to a news release from the Dana-Farber Cancer Institute, found that 80% of surveyed oncologists discussed medical marijuana with patients and nearly half recommended its clinical use.

However, less than 30% of doctors “actually considered themselves knowledgeable enough to make such recommendations,” Dr. Ilana Braun, chief of the Dana-Farber Cancer Institute’s division of adult psychological oncology, said in the release.

“We can think of few other instances in which physicians would offer clinical advice about a topic on which they do not feel knowledgeable,” Braun, one of the 2018 study’s co-authors, said at the time. “We suspect that this is at least partly due to the uncomfortable spot in which oncologists find themselves. Medical marijuana is legal in over half the states, with cancer as a qualifying condition in the vast majority of laws, yet the scientific evidence base supporting use of medical marijuana in oncology remains thin.”

Use With Minimal Medical Oversight

According to the study published this month in Cancer, evidence has shown patients “using medical cannabis with minimal medical oversight,” obtaining authorization from providers unfamiliar with their medical history and relying on unregulated sources of information such as cannabis dispensary personnel.

Those findings are reinforced by an anonymous survey of patients with cancer and survivors conducted by a team from the Roswell Park Comprehensive Cancer Center’s Center for Transitional Research on Cannabis and Cancer (CTRCC) in Buffalo, New York and presented this week at the American Association for Cancer Research 2023 annual meeting in Orlando, Florida.

Less than a third (27.2%) of the patients polled in the Roswell Park survey reported having knowledge of the potency of the cannabis products they consumed, according to a news release from Roswell Park.

“Cannabis use is becoming more common among cancer patients and survivors, who often consume products to alleviate cancer symptoms and treatment side effects,” the study’s senior author, Dr. Danielle Smith, assistant professor of oncology at Roswell Park and director of population and behavioral studies for the CTRCC, said in the news release. “At Roswell Park, we recommend that patients have open and honest conversations about cannabis with their medical providers, so that the benefits and risks of cannabis use can be monitored and managed to optimize cancer treatment and overall patient well-being.”

“There are several key findings that call for additional investigation to ensure that patients and providers are able to make informed evidence-based decisions regarding the use of cannabis,” the authors of the Cancer study wrote.

These factors, according to the authors, include the lack of reported use for medical purposes “despite the lack of strong scientific literature compared with other pharmacotherapies,” the high prevalence of cigarette smoking among cannabis users and inhalation methods as the preferred means of consumption, “resulting in potential exposure to combustion‐related toxins and irritants. However, individuals reporting cannabis use for medical purposes were more likely to use oral consumption methods.”

Overall, the authors believe these findings “underscore the need for continued surveillance as well as the development of high‐quality standardized education materials.”

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