Study: Use of cannabis for cancer symptom management

Relevance: Medium-High

Strength of Science: Medium-High

Relevance Rating Details

What is cannabis?

Cannabis (marijuana) is found in the dried leaves, flowers, stems and seeds of Cannabis sativa or Cannabis indica hemp plants. Two main active chemicals are found in cannabis: THC (tetrahydrocannabinol) and CBD (cannabidiol). While they share a very similar chemical structure, THC is an intoxicating chemical, while CBD is not.

In the United States, cannabis is currently legalized for medical purposes in 38 states and the District of Columbia. Examples of cannabis products include CBD oil, pills, tinctures, concentrates, dry leaves, creams, gels and edible products like baked goods, candy and drinks.

What is this study about?

Researchers wanted to understand the awareness of and interest in cannabis use among people with cancer.

Why is this study important?

In 2022, there were over 18 million cancer survivors in the United States. People with cancer often have symptoms related to their cancer or treatment, such as pain, nerve problems (neuropathy), nausea, vomiting, anorexia, anxiety, depression and sleep issues. Cancer and its treatments can also have long-term impacts on quality of life.

Current treatments for cancer and treatment-related side effects do not always work. Some treatments can cause additional side effects, such as addiction. For example, opioids may be prescribed to treat moderate to severe cancer-related pain. Better approaches are needed to manage cancer-related symptoms and improve quality of life.

Using cannabis for managing cancer-related symptoms is gaining in popularity among people with cancer. While an ongoing area of research, evidence supports the use of cannabis as a way to alleviate some cancer-related symptoms.

This study highlights the need for doctors to regularly talk with patients about their awareness and interest in the use of cannabis products for managing cancer symptoms and treatment side effects. Importantly, this study found that people may be looking for information on cannabis use from sources that may be unreliable.

Study findings

This study was done at a large cancer center from November 2021 to October 2022. Participants were adults with cancer undergoing treatment and cancer survivors who had finished treatment in the last five years.

Participants completed a survey designed to better understand their cannabis use, their beliefs about the possible benefits, their knowledge of cannabis health risks and their sources for information on cannabis. A total of 1,886 people completed the survey.

• Awareness that cannabis can be used for cancer management was high.
  • 88% (1,660) were aware of using cannabis for managing symptoms and side effects.
  • 60% (1,131) were interested in learning about using cannabis for managing symptoms and side effects.

Researchers asked two questions about sources of information about cannabis. Participants were allowed to select more than one source from a list.

1. Where WOULD you most likely go if you wanted to learn more about cannabis use for cancer?
2. Which sources are you most likely to TRUST?

Most participants (1,547 or 82 percent) would most likely go to care providers to find more information about cannabis use for cancer. Other top sources patients would like to use include:

• other people with cancer
• websites or blogs
• medical marijuana stores
• pamphlets or handouts
• family and friends

Most participants (1,414 or 75 percent) would trust a doctor or nurse for information. In contrast to where people would like to find more information, very few trusted other sources, such as people with cancer, websites or blogs, medical marijuana stores, etc. 

• Cannabis use was low among people with cancer and survivors.
  • Just over 17% (320) said that they were current cannabis users. (Other studies have estimated 20-40% of cancer patients use cannabis).

• Cannabis users reported using cannabis for relieving cancer symptoms, such as sleep issues, pain, stress, nausea, vomiting and depression.        
  • Over 50% (160) believed that cannabis reduced their symptoms.
  • Almost 70% (112) reported being unaware of the potential risks associated with cannabis use.

This study suggests that most people with cancer and cancer survivors would be willing to speak to and trust their healthcare providers when seeking information on the use of cannabis. However, patients may choose not to share their personal cannabis use and healthcare providers may not feel comfortable discussing it.

Cannabis effects
This study did not look at the effects of cannabis.  However, several small studies have. Cannabis can help treat nausea and vomiting from cancer chemotherapy. Treatment with either the cannabis drug Marinol (dronabinol) or Sativex (nabiximols) has been shown to possibly be better than other drugs currently used to treat nausea and vomiting.

A few studies have found that cannabis can help reduce pain in people with cancer. Cannabis drugs have also been shown to reduce pain associated with advanced cancer. These studies have shown that people who used cannabis tended to need less pain medicine.

ASCO guidelines
To help people with cancer and their healthcare providers begin to talk about using cannabis, the American Society of Clinical Oncology (ASCO) recently published guidelines on cannabis use in adults with cancer.

The ASCO guidelines are summarized below:

• Healthcare providers should be nonjudgmental when they ask about cannabis use.
• Healthcare providers should share unbiased, evidence-based educational resources with patients interested in using cannabis.
• Healthcare providers should recommend against the following:
  • Using cannabis to improve treatment unless in the setting of a research study.
  • Using cannabis in place of treatment.
• People with cancer who are being treated for nausea and vomiting may supplement their treatment with a synthetic (made in a lab) form of THC (nabilone or dronabinol) or a quality-controlled oral 1:1 THC:CBD extract.
• People with cancer should not use more than 300mg/day of CBD due to the risk of liver disease.

What does this mean for me?

Findings from this and other studies suggest that regardless of state cannabis laws, people with cancer are interested in learning about how they can use cannabis to manage cancer symptoms.

If you are considering using cannabis to manage cancer-related symptoms, it is important to seek credible, evidence-based information about the medications you are taking, including cannabis. Talk to your healthcare providers about your options. You can also view this presentation by Greg Garber, MSW, from The Sidney Kimmel Comprehensive Cancer Center at Jefferson, who presented on this topic at our 2024 conference.

If you or your healthcare provider feel uncomfortable talking about cannabis, seek out other healthcare professionals. If you live in a state with legalized medical cannabis, these may include a doctor or nurse outside your cancer care team or a dispensary pharmacist (a licensed professional who works in medical marijuana dispensaries to provide education, advice and assistance regarding medical marijuana)

Cannabis use in cancer management remains an area of ongoing research, with known benefits and risks. You may also be interested in enrolling in a clinical trial studying the benefits and risks of cannabis to manage cancer symptoms.

Reference

Osaghae I, Talluri R, Chido-Amajuoyi OG, et al., Awareness and interest in cannabis use for cancer management among cancer survivors. 2024. Cancer Medicine 13(1):e6902.

Ilana M. Braun et al., Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline. 2024. Journal of Clincial Oncology 42 , 1575-1593.

ASCO podcast. Cannabis and Cannabinoids in Adults with Cancer Guideline

Disclosure: FORCE receives funding from industry sponsors, including companies that manufacture cancer drugs, tests and devices. All XRAYS articles are written independently of any sponsor and are reviewed by members of our Scientific Advisory Board prior to publication to assure scientific integrity.

Share your thoughts on this XRAY review by taking our brief survey.  

posted9/27/24