Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline

Journal of Clinical Oncology, Journal Year: 2024, Volume and Issue: 42(13), P. 1575 - 1593

Published: March 13, 2024

To guide clinicians, adults with cancer, caregivers, researchers, and oncology institutions on the medical use of cannabis cannabinoids, including synthetic cannabinoids herbal derivatives; single, purified cannabinoids; combinations ingredients; full-spectrum cannabis.

Language: Английский

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Characterizing Cannabidiol Use in a Breast Cancer Population

Clinical Breast Cancer, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Language: Английский

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Perceptions, prevalence, and patterns of cannabis use among cancer patients treated at 12 NCI-Designated Cancer Centers

JNCI Monographs, Journal Year: 2024, Volume and Issue: 2024(66), P. 202 - 217

Published: Aug. 1, 2024

Abstract Background The legal climate for cannabis use has dramatically changed with an increasing number of states passing legislation legalizing access medical and recreational use. Among cancer patients, is often used to ameliorate adverse effects treatment. Data are limited on the extent type among patients during treatment perceived benefits harms. This multicenter survey was conducted assess residing in varied cannabis. Methods A total 12 NCI-Designated Cancer Centers, across cannabis-access status, surveys a core questionnaire recently diagnosed patients. were collected between September 2021 August 2023 pooled centers. Frequencies 95% confidence intervals measures calculated, weighted estimates presented 10 sites that drew probability samples. Results Overall reported since diagnosis respondents 32.9% (weighted), which slightly by state legalization status. most common pain, sleep, stress anxiety, side effects. Reported risks less included inability drive, difficulty concentrating, lung damage, addiction, impact employment. majority feeling comfortable speaking health-care providers though, overall, only 21.5% having done so. those who diagnosis, modes eating food, smoking, pills or tinctures, reasons sleep disturbance, followed pain anxiety 60%-68% reporting improved symptoms Conclusion geographically diverse demonstrates regardless its Addressing knowledge gaps concerning harms critical enhance patient-provider communication.

Language: Английский

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Has medicinal cannabis found a role in oncology/palliative care?

Internal Medicine Journal, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 5, 2025

Following sustained public pressure and despite a paucity of evidence to support medical benefit, medicinal cannabis (MC) was legalised in Australia 2016 for use resistant childhood epilepsy, chemotherapy-induced nausea vomiting (CINV), spasticity associated with multiple sclerosis, chronic non-cancer pain 'palliative care'.1 Over subsequent years, there has been an exponential rise the number prescriptions approved2 'indication creep'. Most common Special Access Scheme applications Therapeutic Goods Administration are pain, anxiety, sleep disorders cancer symptoms.3 Popular brands include those tetrahydrocannabinol (THC), most psychoactive cannabinoid. This is fact that THC significant side effects, it illegal drive while taking states. Cannabis remains popular amongst patients. A recent review reports one-quarter adults receiving treatment at clinic United States had used past 30 days attempt fight or ameliorate symptoms related disease its treatment.4 The reasons given by over 1000 patients survivors South Carolina were difficulty sleeping, stress/anxiety/depression pain.5 ongoing interest not surprising when uncontrolled trials continually report benefits, supported strong media bias towards positive results.6 fake news story claiming cured received 100-fold more attention than evidence-based debunking theory.7 much research undertaken answer many unknowns around (e.g. what combination cannabinoids best, dose schedule) explore where might be effective. Uncontrolled studies case continue benefit range conditions.8 Randomised controlled (RCTs) do not.9 So, hard date oncology/palliative care? There considerable vitro work pointing potential anti-neoplastic activity cannabinoids10 but sparse clinical evidence. Schloss et al. reported on safety quality-of-life benefits RCT two different cannabidiol (CBD)/THC products.11 small phase 1b study tolerability nabiximol dose-intense temozolamide relapsed glioblastoma confirmed (1:1 THC/CBD).12 powered efficacy, survival suggests further warranted. Less well known contains major carcinogens tobacco several cancers have epidemiologically linked CBD exposure.13 American Society Clinical Oncology guidelines give recommendation against place cancer-directed any augment should done context trial.14 cytochrome P450 system, specifically subfamilies 2C, 1A, 3A 2D, plays prominent role cannabinoid metabolism. CYP3A CYP2C enzymes involved metabolism prescribed medications, creating opportunity cannabinoid/drug interactions. As potent CYP3AA inhibitor, example, increase levels ribociclib, resulting increased risk adverse effects women this drug breast cancer.15 issue whether conjunction immunotherapy controversial. Deleterious respect response, time progression overall reported, cohort only.16, 17 Pain one people who take cannabinoids. systematic reviews mixed aetiologies point questionable significance.18 It difficult demonstrate pain. Cochrane Review concludes THC-containing products 'ineffective relieving moderate severe opioid refractory pain'.9 Multinational Association Supportive Care Cancer (MASCC) guidance recommends as adjuvant analgesic harm events carefully considered all patients.19 Despite pre-clinical data supporting opioid-sparing effect, very studies.20 Synthetic (dronabinol nabilone) recognised years being effective anti-nausea medications never tested modern antiemetics. placebo-controlled from Sydney21 followed promising II cross-over study22 efficacy low-dose THC/CBD CINV expense greater toxicity (sedation, dizziness anxiety). terminated early because recruitment. Driving restrictions factor, already using aversion it. authors conclude 'drug availability, cultural attitudes, legal status preferences may affect implementation' future. MASCC quotes insufficient recommend management advanced cancer, cancer-associated anorexia-cachexia taste disturbance.23 Very few quality addressed psychological (anxiety, stress depression) primary outcome measures patients.24, 25 With current evidence, cannot recommended these likelihood anxiety higher-dose THC.26 Small demonstrated cancer.18 MC palliative care,26, 27 generally 'nothing lose' scenario rather shown benefit. Our group elected total symptom burden (a summated score) holistic approach exploring cannabis. We found both alone28 1:1 CBD/THC oil29 no better care reducing although improvement addition THC. Although tolerated, commonly gastrointestinal (nausea/vomiting, diarrhoea), somnolence.18, 26 Concern raised regarding worsening psychotic (particularly THC) deleterious effect liver function.14 how dust settled? proven antiemetic (subject patient choice caveats toxicity) help some patients' sleep. expensive see government subsidy can justified based knowledge. At stage, clinicians need feel pressured prescribe, findings specialty society available assist counselling request Patients encouraged enter if available, prescribing ensure follow-up assessment and/or harms.

Language: Английский

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Prevalence of cannabis and medication use by indices of residential urbanicity and deprivation among Ohio cancer patients

Cancer Causes & Control, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 12, 2025

Abstract Purpose There is increasing interest in the use of cannabis products to alleviate symptom burden among cancer patients. Although data remain limited, some evidence suggests that state legalization associated with reduced opioid use. Indices area-level social determinants health may provide insights into patterns symptom-managing behaviors context equity. Methods Residential ZIP codes from 854 Ohio residents diagnosed invasive at an academic center were used assign rural–urban commuting area (RUCA) and deprivation index (SDI) values. RUCA was categorized as metropolitan non-metropolitan, SDI dichotomized median. Participants completed a one-time cannabis-focused questionnaire which included items on medications symptoms. Results The prevalence self-reported (19% vs. 13%) (30% 21%) higher patients living areas disadvantage lower. No differences observed for benzodiazepines or any product by residential urbanicity. Conclusion Larger, multi-institutional studies detailed measurement increased capacity examine additional are needed confirm explain these descriptive findings.

Language: Английский

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Cannabis use disorder and severe sepsis outcomes in cancer patients: Insights from a national inpatient sample

World Journal of Critical Care Medicine, Journal Year: 2025, Volume and Issue: 14(2)

Published: Feb. 27, 2025

BACKGROUND The burden of cannabis use disorder (CUD) in the context its prevalence and subsequent cardiopulmonary outcomes among cancer patients with severe sepsis is unclear. AIM To address this knowledge gap, especially due to rising patterns emerging pharmacological role cancer. METHODS By applying relevant International Classification Diseases, Ninth Tenth Revision, Clinical Modification codes National Inpatient Sample database between 2016-2020, we identified CUD(+) CUD(-) arms adult admissions sepsis. Comparing two cohorts, examined baseline demographic characteristics, epidemiological trends, major adverse cardiac cerebrovascular events, respiratory failure, hospital cost, length stay. We used Pearson χ 2 d test for categorical variables Mann-Whitney U continuous, non-normally distributed variables. Multivariable regression analysis was control potential confounders. A P value ≤ 0.05 considered statistical significance. RESULTS a total 743520 admitted sepsis, which 4945 had CUD. Demographically, cohort more likely be younger (median age = 58 vs 69, < 0.001), male (67.9% 57.2%, black (23.7% 14.4%, Medicaid enrollees (35.2% 10.7%, whom higher rates substance depression were observed. also exhibited chronic pulmonary disease but lower cardiovascular comorbidities. There no significant difference events cohorts on multivariable analysis. However, all-cause mortality (adjusted odds ratio 0.83, 95% confidence interval: 0.7-0.97, 0.001) failure 0.8, 0.69-0.92, 0.002). Both groups similar median stay, though have cost compared 94574 dollars 86615 dollars, 0.001). CONCLUSION who tended younger, black, males paradoxically significantly in-hospital failure. Future research should aim better elucidate underlying mechanisms these observations.

Language: Английский

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Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline Q&A

JCO Oncology Practice, Journal Year: 2024, Volume and Issue: 20(6), P. 767 - 770

Published: March 13, 2024

@JCO_ASCO guideline on #cannabis in cancer with @JCOOP_ASCO companion Q&A addressing key clinical questions

Language: Английский

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Cancer stage and consideration of cannabis use among adult cancer survivors in Southern California

JNCI Monographs, Journal Year: 2024, Volume and Issue: 2024(66), P. 282 - 289

Published: Aug. 1, 2024

Abstract Background The benefits of cannabis in symptom management among cancer survivors are widely acknowledged; however, patterns use by stage at diagnosis unknown. Methods Here, we examined the association between and consideration since diagnosis. We analyzed cross-sectional survey data from 954 survivors, weighted to be representative a National Cancer Institute–Designated Comprehensive Center’s patient population. used survey-weighted multivariable logistic regression examine (advanced [III/IV] versus non-advanced [I/II]) (yes no) Results Sixty percent population was diagnosed with stages cancer, 42% had considered using odds were 63% higher (odds ratio = 1.63, 95% confidence interval 1.06 2.49) III/IV than those I/II. Conclusion may predictor after

Language: Английский

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Concurrent substance use among cancer patients with and without a history of cannabis use since cancer diagnosis at an NCI-Designated Cancer Center in Florida

JNCI Monographs, Journal Year: 2024, Volume and Issue: 2024(66), P. 224 - 233

Published: Aug. 1, 2024

Abstract Background Although substance use may have adverse impacts on cancer outcomes, little is known regarding patterns of concurrent with cannabis among patients. Our objective was to examine predictors patients since their diagnosis and explore perceptions these Methods Patients treated at a National Cancer Institute–designated comprehensive center were invited participate in an electronic survey medical from August November 2021. Survey data linked internal resources including health records patient intake forms obtain history (defined as within least 3 months diagnosis) cigarettes, injection drugs, high levels alcohol, or clinically unsupervised prescription drugs (total n = 1094). Concurrent users defined those any reported the time diagnosis. We used descriptive statistics (χ2 exact tests) compare groups estimated adjusted odds ratios (AORs) 95% confidence intervals (CIs) identify nonusers cannabis. Results Approximately 45% (n 489) sample Of who using cannabis, 20% self-reported polysubstance use, while 8% (P &lt; .001). Among 2 more treatment-related symptoms (eg, pain, fatigue) likely (AOR 3.15, CI 1.07 9.27) compared without symptoms. nonusers, lower educational background 3.74, 1.57 8.92). report improved sleep .04), increased appetite .03), treatment additional conditions .04) perceived benefits use. Conclusions High symptom burden be associated

Language: Английский

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Prevalence and Correlates of Post-Diagnosis Alcohol Use among Cancer Survivors

Cancer Epidemiology Biomarkers & Prevention, Journal Year: 2024, Volume and Issue: 33(4), P. 600 - 607

Published: Jan. 31, 2024

Abstract Background: Alcohol is a risk factor for cancer and may pose unique risks survivors. Population-based studies of confirmed cases are needed to estimate the extent drinking among survivors understand which most at alcohol-related health problems. Methods: Cancer who resided in Puget Sound Surveillance, Epidemiology, End Results (SEER) region, were ages 21 74 years diagnosis, 6 17 months post-diagnosis start recruitment period (April 2020–December 2020) sent survey that included demographics, substance use, mental health, cancer-related items. Data from returned surveys (n = 1,488) weighted represent characteristics SEER region. We estimated prevalence alcohol use as well demographic, behavioral, clinical correlates three levels drinking: any drinking, exceeding prevention guidelines, hazardous drinking. Results: The was 71%, 46.2%, 31.6%, respectively. Higher income cannabis associated with increased odds all levels. Lower physical quality life, having non-colorectal gastrointestinal cancer, receiving chemotherapy within last month decreased Conclusions: at-risk higher than previous differed based on sociodemographic, factors. Impact: Findings highlight importance identifying addressing risky care settings.

Language: Английский

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