Use of Medical Cannabis by Patients With Cancer: Attitudes, Knowledge, and Practice

Medical cannabis use in young adults with cancer: a self-reported survey study

OBJECTIVES

Medical cannabis is increasingly used by young patients with cancer. We aimed to describe the patterns and perceptions of medical cannabis use among young adults with cancer.

METHODS

This cross-sectional survey was conducted from March to May 2021 and included patients aged 18-45 from the Department of Oncology at Sheba Medical Center, as well as participants from the Stop-Cancer social platform. Participants completed an anonymous questionnaire assessing demographics, disease status, cannabis permit status, use patterns and perceptions.

RESULTS

Of the 605 participants who completed the survey, 250 held an active cannabis permit. Median age was 38 (IQR 33-43); 69% were female. Permit holders were less frequently employed (48% vs 76%, p<0.0001), more likely to report prior cannabis (36% vs 21%, p<0.0001) or tobacco use (39% vs 25%, p=0.0003) and define their cancer as 'active' (38% vs 12%, p<0.0001). Among the 371 cancer survivors, 118 (31%) held active permits. Nearly 60% of permit-holding survivors completed their cancer treatment ≥12 months before the survey, and 40% were at least 2 years from treatment. Of cancer survivors holding a cannabis permit, 69% reported daily cannabis use and 67% consumed cannabis through a smoking route. Cannabis was used primarily for managing sleep disturbances (69%), pain (62%) or mood disorders (42%). 21% of survivors considered reducing cannabis consumption.

CONCLUSIONS

Medical cannabis use is prevalent among young adults with cancer, with many continuing to use it during survivorship and after completing cancer treatment. Targeted education on non-smokable forms of cannabis, as well as support for reducing or ceasing cannabis use among young cancer survivors, is needed.

The association of perceived cannabis risks and benefits with cannabis use since cancer diagnosis

BACKGROUND

Many patients with cancer use cannabis to help alleviate untreated cancer symptoms and side effects.

METHODS

We examined associations of perceived benefits and risks and postdiagnosis cannabis use in a weighted sample of adult cancer survivors through a 1-time survey. Fifteen perceived cannabis use benefits and 19 perceived risks were operationalized as both summary scores and report of any benefits or risks. Survey-weighted logistic regression provided covariate-adjusted odds of postdiagnosis cannabis use for each benefit-risk measure.

RESULTS

Among the weighted population of 3785 survivors (mean [SD] age = 62.2 [13.5] years), one-third used cannabis after diagnosis. Perceiving any benefits increased the odds of postdiagnosis cannabis use more than 500%, and perceiving any risks lowered the odds by 59%. Each SD increase in endorsed benefits doubled the odds of postdiagnosis cannabis use, while each SD increase in endorsed risks reduced the odds by 36%.

CONCLUSION

An accurate understanding of benefits and risks is critical for informed decision making.

Cannabidiol oil or placebo in advanced cancer-disease progression and survival: a secondary analysis

OBJECTIVES

Medical cannabinoids have become increasingly popular over the last decade. Preclinical trials suggest cannabinoids, for example, cannabidiol (CBD), may provide an anticancer effect; however, good-quality clinical information supporting this is lacking. We assessed the effect of CBD treatment on disease progression and survival in patients enrolled in a study of CBD versus placebo for symptom management in patients with advanced cancer (MEDCAN-1).

METHODS

We reviewed the clinical records of all patients enrolled in the MEDCAN-1 Study (CBD vs placebo) at days 14, 28 and 56 of study follow-up, for evidence of disease progression. The proportion of participants with disease progression by treatment arm at each time point was compared, as was survival between both groups from study entry to the censor date (end of study period) and the effect of treatment arm and disease progression status on survival.

RESULTS

Of the 135 patient records assessed, 128 were included in the final analysis. 36% (n=46) had progressive disease documented at day 28, rising to 49.2% (n=63) by day 56. No significant difference in disease progression was noted between the two groups at days 14 (p=0.33), 28 (p=0.67) or 56 (p=0.50). There was no difference in survival between both groups from study entry to censor date (p=0.38). Disease progression at day 14 was highly predictive of mortality (p<0.001).

CONCLUSIONS

In this substudy analysis, treatment with CBD oil did not affect disease progression or survival over the course of 56 days in patients with advanced cancer.

Knowledge, attitudes, and current practices toward lung cancer palliative care management in China: a national survey

Scope

The present investigation seeks to illuminate the current state and disparities in the knowledge, attitudes, and practices (KAP) among healthcare professionals regarding the management of lung cancer palliative care (LCPC) in China, while simultaneously assessing the prevalence and context of patient-controlled analgesia (PCA) usage in the management of cancer-related pain.

Methods

A total of 2093 healthcare practitioners from 706 hospitals across China completed a structured questionnaire that probed various facets of LCPC management. The questionnaire consisted of seven thematic sections, incorporating chi-square tests and Fisher's exact probabilities to statistically assess the discrepancies in KAP among healthcare professionals across different hospital grades. Ordered data distributions among hospital grades were compared using non-parametric Kruskal-Wallis H and Mann-Whitney U tests. Multiple-choice items were subjected to multiple-response cross-tabulation analysis, while the Spearman rank-order correlation coefficient was employed to gauge potential associations among variables.

Results

Around 84.2% of the respondents perceived anti-tumor therapy to be of equal importance to palliative care. Statistically significant differences (χ² = 27.402, P = 0.002) in satisfaction levels were observed, with participants from Tertiary hospitals demonstrating higher satisfaction compared to those from Secondary and Primary hospitals. Pain emerged as the most prevalent symptom necessitating LCPC. Major impediments to LCPC adoption included patients' and families' concerns about the safety of long-term palliative care-related drug use. 31.1% of the respondents cited the most frequent rationale for PCA use as cases involving patients who required systemic administration of large opioid doses or exhibited intolerable adverse reactions to opioids. The principal deterrents against the use of PCA for cancer pain management were (1): apprehension about adverse drug reactions due to overdose (2), concern about the potential for opioid addiction, and (3) the anticipated increase in patients' economic burdens. Over the preceding 24-month period, 33.9% of the surveyed healthcare practitioners reported no engagement in either online or offline LCPC-related training initiatives.

Conclusion

This study emphasizes the pressing need for comprehensive training in LCPC among Chinese health personnels, particularly focusing on the effective management of cancer pain symptoms.