As reported in the Journal of Cancer Education by Kim et al, parallel surveys of cancer survivors and cancer care providers showed gaps in risk awareness and communication about cannabis use. underscoring the need for open, nonjudgmental dialogue and clinical guidance. Although attitudes toward medical cannabis were generally similar between groups, providers were more likely to report awareness of potential risks; survivors, meanwhile, were more likely than providers to report comfort discussing cannabis use in the cancer care setting.
Study Details
In the cross-sectional study, investigators conducted parallel online surveys of 395 cancer survivors and 62 cancer care providers in the United States. The surveys assessed attitudes toward cannabis, perceived risks and benefits, reasons for use, and patient-provider communication. Among cancer survivors, investigators also evaluated cannabis use status, health-care mistrust, health-care utilization, quality of life, mental health, and risk behaviors.
Among survivors, 51.1% were currently in treatment, and 40.8% had been diagnosed within the previous 2 years. The survivor sample included patients with breast, blood, prostate, lung, colorectal, and other cancers.
Among the 395 cancer survivors, 60.8% reported ever using cannabis; among those who reported when they started using cannabis, 57.9% initiated use before their cancer diagnosis and 42.1% after diagnosis. Among the 62 cancer care providers, most were registered nurses or physicians; 24.2% of providers reported ever prescribing medical cannabis.
Key Findings
Positive and negative attitudes toward medical cannabis did not significantly differ between cancer survivors and cancer care providers. However, providers had more negative and less positive attitudes toward recreational cannabis than survivors.
Cancer care providers were more likely than survivors to report awareness of potential risks associated with cannabis use for cancer and symptom treatment: 25% vs 8.4% (P < .01). However, most survivors and providers reported not knowing any potential risks of cannabis use: 91.6% and 75%, respectively. There were no significant differences between survivors and providers in perceived therapeutic benefits of cannabis use for cancer-related nausea, pain, lack of appetite, or poor sleep quality.
Cancer survivors were more likely to feel comfortable discussing cannabis with their cancer doctors than providers were discussing cannabis with their patients: 68.5% vs 46.7% (P < .01).
Among cancer survivors, cannabis ever-users reported higher social well-being than never-users (P = .03), but lower physical well-being (P < .001) and emotional well-being (P = .02). Cannabis ever-users also reported greater health-care system mistrust than never-users (P < .001), although health-care satisfaction scores did not significantly differ.
Cannabis ever-users were also more likely to report underutilization of health-care services in the previous 12 months, including delayed or avoided care, unfilled prescriptions, and missed follow-up appointments. They also had higher rates of cigarette smoking (P = .026), e-cigarette use (P < .001), anxiety (P < .001), and depression (P < .001). There were no significant differences in chronic pain, alcohol consumption, or sleep quality.
The investigators concluded: “Future longitudinal studies using these survey measures can clarify gaps in perceptions and patient-provider communication regarding cannabis use, thereby informing evidence-based clinical guidelines and advancing patient-centered oncology care.”
Sunny Jung Kim, PhD, of the Department of Social and Behavioral Sciences, School of Public Health, Virginia Commonwealth University, Richmond, is the corresponding author for the Journal of Cancer Education article.
DISCLOSURE: The study was supported by the American Cancer Society Institutional Research Grant. The authors reported no conflicts of interest regarding the publication of this work.
