Medical cannabis in cancer patients: Prevalence, efficacy, and safety.
Journal of Clinical Oncology
Background: Cancer patients are using medical cannabis (MC) to address symptoms, however, little data exists to guide clinicians when counseling patients regarding use. We seek to define the patterns of MC use among oncology patients as well as efficacy and safety of MC. Methods: Cancer patients attending oncology office visits at Beaumont Hospital, Michigan from July – Dec 2018 were anonymously surveyed. The survey included data regarding demographics, diagnosis, treatment, symptom burden, and MC use. Patients who reported MC since their cancer diagnosis completed a section on patterns of use, efficacy, and safety. Results: Response rate was 188 of 327 (57.1%). Ages ranged from 18 to > 71, 59% were 61 or older. Early stage solid malignancy was 38%, metastatic was 41%, and hematologic malignancy was 21%. Cancer treatment was active in 80%. MC use was reported in 46 of 188 (24.5%). Median composite baseline symptom score ranging from 8 (best) to 32 (worst) was higher in patients using MC vs non-users; 17.5 vs 14.4 (p < 0.001). Pain was the symptom with the highest frequency of improvement 34/42 (81%), followed by appetite 34/44 (77%), and anxiety 32/44 (73%). MC improved ability to tolerate treatment in 24/44 (54%). The most frequent adverse effects were cloudy thinking 7/42 (17%), and decreased energy 4/41 (10%) Use of cannabis prior to cancer had no impact on median composite efficacy score (p = 0.43). Age > 61 was not associated with higher toxicity (p = 0.077). Conclusions: This data confirms MC is being utilized by a significant portion of cancer patients, across age, diagnosis, stage, and treatment. Patients with a higher severity of baseline symptoms are more likely to use MC, and report a favorable efficacy profile of MC with no increased risk of adverse effects in older population and similar efficacy in novel MC users. Minimal toxicity was reported in this cohort. Prospective studies are needed to define the efficacy and safety of MC.
Impact of MC on symptoms. Numbers represent # respondents with each answer.
WorsenedNo ImpactImprovedp value Anxiety 1 11 32 0.86 Nausea 1 17 25 0.49 Insomnia 1 20 24 0.73 Pain 0 8 34 1 Appetite 0 10 34 0.34 Energy 4 20 17 0.75 IADLs 4 32 8 0.51 Cloudy Thinking 7 27 8 0.20 Tolerate Treatment 0 20 24 0.98
Macari D, Gbadamosi, MD B, Ezekwudo D, Khoury J, Jaiyesimi IA, Gaikazian SS. Medical cannabis in cancer patients: Prevalence, efficacy, and safety. J Clin Oncology 2019 May 19:37(15S); 23099.