Patients Should ‘Have the Conversation’ About Cannabis With Care Teams

If patients are using or have questions about cannabis during cancer care, it is important that they talk to their oncology team, an expert said.

As patients with cancer incorporate cannabis into their experience — one study found that 82.23% of cancer survivors who used cannabis did so for medical purposes, and 7.57% of cancer survivors reported cannabis use — one expert urged patients to discuss the issue of cannabis use with their care team.

Dr. Brooke Worster, professor of medicine at Thomas Jefferson University and enterprise director of supportive oncology at Jefferson Health in Philadelphia, and colleagues recently reported in Cancer that “for non-inhaled cannabis versus placebo, moderate certainty evidence supports a small benefit for pain relief and high certainty evidence shows a very small benefit on physical functioning and sleep quality.”

Learn More: Patients Using Cannabis Experienced Worse Symptoms, Perceive Less Harm

Worster provided some suggestions for patients’ cannabis-related discussions with their care teams.

Have the Conversation

“So many times, [people say] 'This is something my neighbor told me, or my friend told me, or I read on the internet,' and they're not even having the conversations [with doctors]. So, first step is please just have the conversation,” Worster advised. “Either ask, 'Is this something that might help me?' or, it's OK, and I hope patients feel empowered, to say, 'This is something I have tried, and it felt helpful.' So, start there.

“The biggest thing that I hate to see happen is that those conversations don't even happen. Because there are already gaps in terms of specific guidance that any one clinician can give a patient about exactly what product to use, or exactly what dose to use, but we can give guidance that can help people avoid risks or bad side effects or understand if there are complications that are concerning.”

For example, Worster noted for patients who are being treated with immunotherapy, there is some indication that regular use of high-CBD cannabis may be associated with an alteration in immune response.

“That has a direct connection to your immune system, the targets of the endocannabinoid system interact with your immune system,” she said. “And so, it also matters [for providers] to say 'Listen, we don't know, but we are seeing a signal here, and so I would caution you from using this every day.' And there aren't many instances where I think that's a concern, but it goes both directions. So just have the conversation.

Seek Guidance — and Be Honest

“I [would] think [about] asking either 'Can this be helpful to me?' [or] 'Is there anything I should

worry about?' or saying, 'I've been using this, and it's been helpful, can you help me make sure that I can either safely get access to it regularly or give me guidance on forms I should use or shouldn't use or things I should avoid or shouldn't avoid?'" Worster said.

Learn More: Cannabis Helped a Survivor Maintain Weight, Be Pain Free During Chemo

Don’t Mistake Cannabis for a Cure

“Don't kind of go down the internet rabbit hole of the false belief that is propagated on the internet that we have any actual data that cannabis treats cancer,” Worster said. “And I've heard a lot of [patients with cancer] sort of asking or thinking about that. And I would never want someone to forego treatments that we know are effective for something like this, where we just don't have the evidence to support that.”

Explore Clinical Trial Enrollment

In the research published in Cancer, Worster and her colleagues reported following analysis of prior studies, that “a majority of trials do not report on race and do not recruit diverse samples,” but also that “one observational study showed that cannabis use closed the disparity in pain relief reported between Black and White patients with cancer.”

“Any patient or caregiver who's reading this, please, I would encourage you [to] participate [in clinical trials],” Worster said. “If you get asked, if there is something and you see a flyer or something put up in your in the oncologist's office, inquire about it. I know that it is some additional steps for you to jump through to participate in research. But it is so important to help all of these communities be equally represented.”

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