Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline

Journal of Clinical Oncology, Год журнала: 2024, Номер 42(13), С. 1575 - 1593

Опубликована: Март 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.

Язык: Английский

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Cannabis use among cancer patients and survivors in the United States: a systematic review

JNCI Cancer Spectrum, Год журнала: 2024, Номер 8(1)

Опубликована: Янв. 4, 2024

Abstract Background How cannabis products are being used by cancer patients and survivors in the United States is poorly understood. This study reviewed observational data to understand modes, patterns, reasons, discontinuation, adverse experiences of use. Methods PubMed PsycINFO database searches were conducted between May 2022 November 2022. Of 1162 studies identified, 27 met inclusion criteria. The intercoder agreement was strong (0.81). Results majority (74%) cross-sectional design. Study samples approximately equal proportions men women White participants. prevalence use based on national ranged 4.8% 22%. most common modes intake topical application (80%), smoking (73%), vaping (12%), ingestion edible (10%). Younger age, male gender, a current or former smoker, higher socioeconomic status associated with greater likelihood main motive for management symptoms due treatment such as pain, nausea, lack sleep, anxiety. A participants across reported that helped reduce these symptoms. Lack symptom improvement, side effects fatigue paranoia, cost, social stigma identified some reasons discontinuing Conclusions It appears may help manage However, more longitudinal needed determine whether positive outweigh over time this vulnerable population.

Язык: Английский

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Characterizing Cannabidiol Use in a Breast Cancer Population

Clinical Breast Cancer, Год журнала: 2025, Номер unknown

Опубликована: Фев. 1, 2025

Язык: Английский

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

JNCI Monographs, Год журнала: 2024, Номер 2024(66), С. 202 - 217

Опубликована: Авг. 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.

Язык: Английский

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Current cannabis use and pain management among US cancer patients

Supportive Care in Cancer, Год журнала: 2024, Номер 32(2)

Опубликована: Янв. 18, 2024

Abstract Background National studies reporting the prevalence of cannabis use have focused on individuals with a history cancer without distinction by their treatment status, which can impact symptom burden. While pain is primary motivation to in cancer, magnitude its association remains understudied. Methods We examined and management among 5523 respondents Behavioral Risk Factor Surveillance System history. Survey-weighted proportions respondents’ are reported, stratified status. Regression models estimated odds ratios (ORs) 95% confidence intervals (CIs) cancer-related use. Results Cannabis was slightly more prevalent those undergoing active relative who were not (9.3% vs. 6.2%; P =0.05). Those under likely medicinally (71.6% 50.0%; =0.03). Relative pain, persons medical control (OR 2.1, CI, 1.4–3.2) or uncontrolled twice as 2.0, 1.1–3.5). Conclusions Use patients may be related positively associated pain. Future research should investigate associations use, burden, regimens across spectrum facilitate interventions.

Язык: Английский

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Cardiovascular and Respiratory Effects of Cannabis Use by Route of Administration: A Systematic Review

Substance Use & Misuse, Год журнала: 2024, Номер 59(9), С. 1331 - 1351

Опубликована: Апрель 21, 2024

Aim: Knowledge of the cardiovascular and respiratory effects cannabis use by route administration is unclear. This evidence necessary to increase clinical public health awareness given recent trend in legalization, normalization, surge availability usage various forms products. Methods: Search was conducted Web Science, ProQuest, Psych INFO, Scopus, Embase, Medline databases, subsequently references retrieved articles. Peer-reviewed articles published between 2009 2023, that reported on were included. Studies with no report combined other illicit substances excluded. The review guided Preferred Reporting Items for Systematic Reviews Meta-analyses (PRISMA) guidelines. Results: Of 1873 retrieved, 42 met inclusion criteria encompassing six case reports, 21 reviews, 15 empirical studies. Four routes identified: smoking, vaping, oral ingestion, dabbing. Smoking most common associated both effects, such as bronchitis, dyspnea, chronic obstructive lung disease, including tachycardia, ventricular arrhythmias, myocardial infarction. Cannabis edibles minimal effects. Tachycardia effect all administration. Conclusion: does cause but conclusion remains tentative due methodological limitations

Язык: Английский

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Study of the relationship between psychoactive substance use and pain in cancer patients and cancer survivors: A French nationwide cross‐sectional study

International Journal of Cancer, Год журнала: 2024, Номер 155(6), С. 1078 - 1090

Опубликована: Май 15, 2024

Pain is a prevalent symptom among cancer patients and survivors. Psychoactive substance use (PSU) associated with both the presence severity of pain. However, little known about this association in context cancer. The primary objective was to compare prevalence PSU its relationship pain during after defined as nonmedication substances (alcohol, tobacco, e-cigarettes, cannabidiol, cannabis), frequency categorized at least yearly, monthly, weekly, or daily. Secondary objectives aimed explore relationships between characteristics, health-related quality life, anxiety, depression, deprivation, individual characteristics. Among 1041 individuals included, 44.7% (95% confidence interval [CI] 41.6%-47.8%). overall monthly 67.0% CI 64.0%-69.8%). proportions chronic neuropathic pains were higher for cannabidiol compared nonuse (70.0% vs. 39.3% 55.7% 28.1%, p < .001). In multivariate analysis, uses tobacco painful than nonpainful ones (odds ratio: 2.85 [95% 1.22-6.64] 3.76 1.13-12.44], .05). From point view patient care, study underscores need physicians prioritize smoking cessation pay attention

Язык: Английский

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Tobacco–cannabis co-use among cancer patients and survivors: findings from 2 US cancer centers

JNCI Monographs, Год журнала: 2024, Номер 2024(66), С. 234 - 243

Опубликована: Авг. 1, 2024

Cannabis use is prevalent among cancer patients and survivors may provide some therapeutic benefits for this population. However, be attenuated when cannabis co-used with tobacco, which associated more severe tobacco adverse outcomes in noncancer populations. We compared use, primary mode of and/or nontherapeutic 3 groups based on cigarette smoking status.

Язык: Английский

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Evaluating racial disparities in cancer patient-provider communication about cannabis in a state without a legal cannabis marketplace

Supportive Care in Cancer, Год журнала: 2025, Номер 33(2)

Опубликована: Янв. 8, 2025

Abstract Purpose Cancer survivors in a state with no legal access to cannabis may be hesitant discuss their use providers, particularly light of consequences which disproportionately affect certain racial groups. This study examined potential disparities the relationship status patient-provider discussions and attitudes toward where there is marketplace. Methods Survivors cancer ( N = 1003, M age 62.36; 13% Black/African-American; 41% male) completed cross-sectional survey. Weight-adjusted regressions differences between (a) comfort discussion (b) beliefs about impact legalization on patients’ providers’ discussing cannabis. Results No were observed rates or discussion, patients who used more comfortable Black had reported greatest but also perceived improvement event legalization. Conclusions highlight willingness care among already cannabis, was not hypothesized direction findings. Further work needed inform recommendations for provider-led communication

Язык: Английский

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

Internal Medicine Journal, Год журнала: 2025, Номер unknown

Опубликована: Фев. 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.

Язык: Английский

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