A growing number of people undergoing cancer treatment are turning to cannabis to manage symptoms like pain, nausea, anxiety, and insomnia, with estimates suggesting that between 20% to 40% of cancer patients use cannabis or cannabinoids for relief. This trend has been propelled by the legalization of medical marijuana in many states, but the research has not kept pace with its use. This disparity has left oncologists and healthcare providers struggling to offer informed guidance on its potential benefits and risks.
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The American Society of Clinical Oncology (ASCO) published its first clinical guidelines on cannabis use for cancer patients in March 2024, emphasizing that the use of cannabis in cancer care has outstripped the scientific evidence supporting its effectiveness. Despite this, many cancer patients continue to experiment with cannabis products, often without discussing it with their healthcare providers. In one study, only about 20% of patients using cannabis had informed their oncologist.
The lack of robust clinical research presents a number of challenges. Healthcare providers, including oncologists and nurses, often feel unprepared to discuss cannabis with their patients. According to a recent survey, 40% of oncologists felt comfortable advising patients on cannabis use, but only 13% felt knowledgeable enough to do so. The National Cancer Institute (NCI) funded several studies published in JNCI Monographs to address this knowledge gap and explore the safety and efficacy of cannabis for cancer-related symptoms.
One of the major concerns is how cannabis may interact with cancer treatments, particularly immunotherapy, which could potentially be rendered less effective by cannabis use. Long-term use of cannabis may also suppress the immune system, posing additional risks. Cannabis' sedative properties, when combined with other medications, can exacerbate drowsiness, increasing the risk of accidents.
Despite these risks, some cancer patients view cannabis as a safer or more "natural" alternative to prescription medications. In some cases, patients even believe that cannabis helps treat their cancer, a misconception that highlights the need for more comprehensive education and research.
Several recent studies have examined cannabis for treating chemotherapy-induced nausea, one of the primary reasons cancer patients turn to cannabis. A Canadian clinical trial showed that THC
capsules were more effective than a placebo at reducing nausea and vomiting, though side effects like dizziness and sedation were common.
As cannabis legalization expands, access to cannabis products has become easier, with an estimated 15,000 dispensaries now operating across the U.S. However, the safety of cannabis for cancer patients remains unclear, and more research is urgently needed. The NCI has funded several studies that focus on different groups of cancer patients, including those receiving immunotherapy and those with specific cancers like multiple myeloma. Additionally, synthetic cannabis-based drugs such as dronabinol and nabilone have been FDA-approved for treating cancer-related pain.
In the meantime, oncologists are encouraged to have open discussions with their patients about cannabis use, treating it like any other medication and explaining both its potential benefits and harms. Dr. Richard T. Lee from City of Hope stresses that even in the absence of definitive research, it’s essential for providers to understand their patients’ use of cannabis and consider how it might affect their treatment plans.
Ultimately, while cannabis holds promise for alleviating some cancer-related symptoms, there remains a significant gap in evidence, and more clinical trials are needed to better understand its safety and efficacy in oncology.
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