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Differences in Medical Cannabis Use in Patients With and Without Cancer

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Key Points

  • Patients with cancer were more likely to favor forms of medical marijuana with higher amounts of THC.
  • Marijuana formulations higher in CBD, which has been shown to reduce seizures and inflammation in other studies, were more popular among people without cancer.
  • People with cancer were also more likely to prefer taking oil droplets containing medical marijuana under the tongue than using a vaporized form of medical marijuana.

People with and without cancer are more likely, over time, to use a more potent form of medical marijuana with increasingly higher amounts of tetrahydrocannabinol (THC), a new study published by Kim et al in the Journal of Palliative Medicine has shown.

“Although there is growing patient interest in medical cannabis, there is a scarcity of solid evidence about the benefits, risks, and patterns of use of marijuana products in various disease settings,” said study lead investigator Arum Kim, MD, Assistant Professor of Medicine and Rehabilitation Medicine at New York University (NYU) School of Medicine and Director of the Supportive Oncology Program at NYU’s Perlmutter Cancer Center. “Such information is important for delivering the best care.”

Since 1996, 31 states have legalized medical marijuana. Researchers analyzed data from 11,590 men and women in New York who purchased and used cannabis products from a licensed dispensary between January 2016 and December 2017. Nearly 2,000 of the patients (17.2% of the total patient cohort) had cancer.

Research Findings

The study found that people with cancer and people without cancer used different dosages of cannabis formulations with different ratios of THC and cannabidiol (CBD). The two most common formulations contained THC and CBD, but the former had 20 times more THC than CBD, whereas the latter had the opposite ratio.

Patients with cancer were more likely to favor forms of medical marijuana with higher amounts of THC, which may help to better relieve disease symptoms and side effects of treatment, including chronic pain, weight loss, and nausea. By contrast, marijuana formulations higher in CBD, which has been shown to reduce seizures and inflammation in other studies, were more popular among people without cancer, including those with epilepsy and multiple sclerosis.

People with cancer were also more likely to prefer taking oil droplets containing medical marijuana under the tongue than using a vaporized form of medical marijuana.

In the 2 years of the study, the research team found that all types of patients increased their THC dose by approximately 0.20 mg per week.

“Our study provides valuable new information about how people with cancer are using marijuana,” said study senior investigator Benjamin Han, MD, MPH, Assistant Professor of Medicine and Population Health at NYU School of Medicine. “In the absence of strong clinical research data for medical marijuana, identifying patterns of use offers some sense of how to guide patients who come in with questions for using medical marijuana and what may or may not help them.”

The researchers caution that their data did not include the type of cancer the purchasers had, how much of what they bought was used, or whether marijuana was used for symptoms unrelated to the cancer.

Researchers say they next plan to get more detailed information about how medical marijuana affects people’s response to therapy and functional status at different stages of their disease, as well as the risks and side effects of treatment. Furthermore, the profiles of other cannabinoids besides THC and CBD in medical marijuana products warrant further research, according to the study authors.

Disclosure: The study authors’ full disclosures can be found at liebertpub.com.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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