{"id":46816,"date":"2024-10-16T12:00:00","date_gmt":"2024-10-16T12:00:00","guid":{"rendered":"https:\/\/www.cancer.gov\/news-events\/cancer-currents-blog\/2024\/medical-cannabis-oncologists-patients-communication"},"modified":"2024-11-03T15:11:46","modified_gmt":"2024-11-03T15:11:46","slug":"as-more-people-with-cancer-use-medical-cannabis-oncologists-face-questions-they-struggle-to-answer","status":"publish","type":"post","link":"https:\/\/ogkologos.com\/en\/as-more-people-with-cancer-use-medical-cannabis-oncologists-face-questions-they-struggle-to-answer\/","title":{"rendered":"As More People with Cancer Use Medical Cannabis, Oncologists Face Questions They Struggle to Answer"},"content":{"rendered":"

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More people with cancer are using cannabis products to help manage the symptoms of their disease or side effects caused by treatment.<\/p>\n

Credit: iStock\/FatCamera<\/p>\n<\/p><\/div>\n<\/figcaption><\/figure>\n<\/p><\/div>\n

A series of new studies is putting a spotlight on the growing use of cannabis among people with cancer and some of the trend\u2019s downstream effects. <\/p>\n

According to findings from several of the studies, anywhere from about 20% to 40% of people being treated for cancer use cannabis or cannabinoids\u2014often broadly referred to as medical marijuana\u2014to help manage side effects<\/a> like nausea, pain, sleeplessness, anxiety, and stress.<\/p>\n

The growing popularity of cannabis products among people with cancer has tracked with the increasing number of states that have legalized cannabis for medical use. But research has lagged on whether and which cannabis products are a safe or effective way to help with cancer-related symptoms and treatment-related side effects.<\/p>\n

The first-ever clinical guidelines on cannabis use<\/a> from the America Society of Clinical Oncology (ASCO), published in March 2024, put it bluntly: \u201cCannabis and\/or cannabinoid<\/a> access and use by adults with cancer has outpaced the science supporting their clinical use.\u201d<\/p>\n

Among the most-pressing challenges caused by this scientific evidence deficit, several of the studies found, is that oncologists and other cancer care providers feel ill-equipped to talk with their patients about medical cannabis.<\/p>\n

In one of the studies, for example, although nearly 40% of the oncologists and oncology nurses surveyed said they were comfortable offering guidance to patients on cannabis use, only about 13% said they felt that they were knowledgeable about cannabis<\/a>. The studies, all funded by NCI and conducted at NCI-Designated Cancer Centers, were collectively published in August in JNCI Monographs<\/em>.<\/p>\n

\u201cPatients are highly interested in cannabis\u201d to help them deal with cancer\u2019s physical and mental fallout, said the study\u2019s lead investigator, Richard T. Lee, M.D., who heads the Cherng Family Center for Integrative Oncology at City of Hope in California. <\/p>\n

As the legal landscape of medical cannabis continues to change, Dr. Lee continued, providers are only going to be seeing more patients who are using tropical-flavored cannabis gummies or mandarin orange\u2013flavored cannabis tinctures. <\/p>\n

So even without reliable evidence, it\u2019s important to ask patients if they are using cannabis products and for what purpose, he said. And for now, \u201ctreat it like any other medication, and explain that it has potential harms and potential benefits.\u201d<\/p>\n

With expanding legality of medical cannabis comes easier access<\/h2>\n

For years, people with cancer have used cannabis to help manage a range of effects from cancer and other diseases. But until the last decade or so, that practice was almost uniformly illegal in the United States. And because cannabis is what\u2019s known as a schedule 1 drug<\/a>, it\u2019s still essentially illegal at the federal level.<\/p>\n

At the state level, cannabis is now legal for medical use in 14 states and for recreational and medical use in an additional 24 states and the District of Columbia. According to a recent Pew Research Center study, overall, nearly three-quarters of Americans now live in a state where cannabis is legal for medical and\/or recreational use<\/a>.<\/p>\n

According to Susanna Ulahannan, M.D., an oncologist at the University of Oklahoma\u2019s Stephenson Cancer Center, her younger patients are most likely to use cannabis, often to help with issues like anxiety and trouble sleeping.<\/p>\n

Her older patients, however, are more reluctant. And when they do ask about it, Dr. Ulahannan explained, it\u2019s usually when the standard medications she prescribes for problems like pain or lack of appetite aren\u2019t cutting it.<\/p>\n

\u201cThat\u2019s usually when they bring it up to me,\u201d she said. \u201c\u2018I\u2019ve tried this and it\u2019s not working. What do you think about trying medical marijuana instead?\u2019\u201d<\/p>\n

And in states where cannabis is legal, for those who want to try it, it\u2019s easy to get. According to the Pew study, in fact, there are about 15,000 cannabis dispensaries in the United States.<\/p>\n

Is medical cannabis safe for people with cancer?<\/h2>\n

Access to cannabis is one thing. But whether it is safe to use is another question altogether.
\u201cWe absolutely \u2026 don\u2019t have a good handle on safety,\u201d said Gary Ellison, Ph.D., M.P.H, of NCI\u2019s Division of Cancer Control and Population Sciences, who led one of the JNCI Monographs studies. <\/p>\n

One of the biggest concerns is whether cannabis products might interfere with patients\u2019 cancer treatments. For example, results from some small studies have suggested that cannabis can make immunotherapy treatments less effective<\/a>. <\/p>\n

Indeed, it\u2019s known that cannabis can suppress the immune system<\/a>, particularly when used over a long period, explained Mohab Ibrahim, M.D., Ph.D., medical director of the Comprehensive Center for Pain & Addiction at the University of Arizona Health Sciences.<\/p>\n

There are other potential downsides, Dr. Ibrahim continued. <\/p>\n

For example, cannabis can be a powerful sedative<\/a> \u201cand can interact with other medications and be synergistic<\/a>,\u201d he said. In other words, if somebody is taking another medication that makes them drowsy or less alert, using cannabis at the same time may magnify that drowsiness. And that can increase the risk for things like falls and car accidents, he explained.<\/p>\n