Study: Use of cannabis for cancer symptom management
Summary
Among people with cancer, interest in the use of cannabis to manage cancer symptoms and treatment side effects is high. The world's leading professional organization of oncologists has published strategies to help adults with cancer and their healthcare providers have open, nonjudgmental discussions about the use of cannabis to manage cancer symptoms. (Posted 9/27/24)
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Most relevant for: People with cancer interested in using cannabis to help manage symptoms..
It may also be relevant for:
- people newly diagnosed with cancer
- people with metastatic or advanced cancer
- Long-term survivors
- people in treatment for cancer
Relevance: Medium-High
Strength of Science: Medium-High
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.
- Where WOULD you most likely go if you wanted to learn more about cannabis use for cancer?
- 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.
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posted9/27/24
- What treatment options are available to help manage my cancer-related symptoms and treatment side effects?
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Many cancer centers offer survivorship expertise and services, including fatigue clinics, sleep centers, experts, and pain management experts. Ask your doctor to refer you to experts who can address your symptoms and concerns. The following resources can help you find experts:
- The American Academy of Sleep Medicine's website SleepEducation.org includes a section on finding a sleep center by location.
- The American Physical Therapy Association's ChoosePT.com website allows you to search for a physical therapist in your area.
- Eatright.org, the website for the Academy of Nutrition and Dietetics, has an online tool to find a nutritionist in your area. You can search for nutritionists by specialty, including "cancer," "weight management" and "heart health."
- The National Certification Commission for Acupuncture and Oriental Medicine has a searchable directory of licensed acupuncturists.
- The Lymphatic Education & Resource Network has tips and tools for finding experts.
- The Menopause Society is an organization for menopause experts. Their website has a tool to help you find a qualified menopause expert in your area.
Updated: 08/06/2022
The following studies look at management of side effects:
Multiple cancers
- NCT02296450: Quality of Life (QoL) Assessment in Cancer Patients and Survivors With Dermatologic Conditions Using Dermatologic QoL Instruments. This large study examines how skin conditions that are related to different kinds of cancer or cancer treatments affect a patient's overall well-being.
- NCT05056077: Tools to be Fit. This quality-of-life study examines fwhat tools work best for helping cancer survivors improve their diet and exercise for people with bladder, breast, colon, endometrial, kidney (renal cell carcinoma), ovarian, or rectal cancer.
- NCT03996265: Bupropion in Reducing Cancer Related Fatigue in Cancer Survivors. This study tests how well the drug bupropion (welbutrin) reduces cancer-related fatigue for cancer survivors.
Breast cancer
- NCT04586530: Telehealth and Memory Study (TAMS). This trial seeks to confirm the effectiveness of a cognitive-behavioral therapy, the Memory and Attention Adaptation Training (TAMS), as a treatment for chemotherapy-related dysfunction among breast cancer survivors.
- NCT02290834: Chemotherapy-induced and brain changes in older adults with breast cancer. The study investigates abilities and brain images before and after chemotherapy to identify people at risk for side effects and to better understand the effects of treatment on brain structure and function.
- NCT04906200: Web-Based Symptom Monitoring and Self-Management Portal for Adolescent and Young Adult Breast Cancer Survivors. This compares a web-based patient-reported symptom-monitoring and self-management portal to standard therapy in young breast cancer survivors.
- NCT04837820: The Effect of Acupuncture on Cancer-Related Difficulties. This study tests whether acupuncture improves thinking and insomnia for breast cancer survivors. This study also looks at insomnia's link to difficulties.
- NCT03879629: TrAstuzumab Cardiomyopathy Therapeutic Intervention With Carvedilol (TACTIC). Breast cancer patients receiving Herceptin or other HER2-directed therapy are at risk of heart damage. This study looks at whether beta-blocker drugs could help prevent this from happening.
Colorectal cancer
- NCT05239338: Preserving Fertility After Colorectal Cancer Study (PREFACE). This study investigates the reproductive health and clinical outcomes among individuals diagnosed with colorectal cancer ages 18 to 49.
- NCT06420726: Resistance Exercise and Creatine in Colorectal Cancer. This study assesses the feasibilty of combining creatine supplementation with resistance training versus resistance training alone in colorectal cancer survivors.
Ovarian cancer
- NCT04533763: Living WELL: A Web-Based Program for Ovarian Cancer Survivors. This project studies whether a group-based and web-delivered tool increases quality of life and decreases stress, depressive mood, anxiety and fatigue across a 12-month period for ovarian cancer survivors.
- NCT05047926: Prehabilitation for Advanced Ovarian Cancer Patients. This study tests whether structured activity for women undergoing chemotherapy improves their physical state prior to surgery and thus improve outcomes.
cancer
- NCT03971591: Men Moving Forward: A Lifestyle Program for African-American Cancer Survivors (MMF). This study looks at Men Moving Forward (MMF), a community-based lifestyle intervention that supports adherence to nutrition and physical activity guidelines to promote improved body composition and lessen the side effects of treatment.
- NCT05155501: Pelvic Fascia spARing Radical Prostatectomy TrIAL (PARTIAL). This clinical trial studies whether pelvic fascia-sparing radical prostatectomy has similar cancer control and sexual function outcomes; and significantly better urinary function, less penile deformity and inguinal hernia risks as compared to radical prostatectomy.
Updated: 11/15/2024