Patients with cancer, survivors lack knowledge about potency of cannabis products
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Only a small proportion of patients with cancer and survivors who use cannabis know the concentration of THC and CBD they typically consume, according to results of a survey.
“Patients with cancer and survivors are increasingly consuming cannabis to manage symptoms from treatment and from the disease itself, and this can occur well into survivorship,” Danielle Smith, PhD, MPH, assistant professor of oncology at Roswell Park and director of population and behavioral studies for Roswell Park Comprehensive Cancer Center’s Center for Translational Research on Cannabis and Cancer, told Healio. “However, there are different compounds in cannabis that contribute to its therapeutic effects or potential harms. Therapeutic benefits and potential risks really depend on the types of products that people are consuming.”
Smith spoke with Healio about the findings and implications of her team’s anonymous survey study, presented at this year’s American Association for Cancer Research Annual Meeting.
Healio: What prompted you to conduct this study?
Smith: We have so many cannabis products on the market now — patients can get cannabis flower, but also newer products like vapes and edibles. The two main compounds in most cannabis products on the market are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC can provide pain relief, but is also responsible for the high associated with cannabis. When consumed chronically, products with very high THC levels can increase the likelihood for abuse and problematic use. High doses of THC can also make some people feel very anxious or paranoid, and can even contribute to cardiac events like rapid heart rate and heart attack. By contrast, CBD has pain-relieving and anxiety-relieving effects and does not produce a high. Different cannabis products can have very different levels of THC and CBD, and some of these products might pose potential risks to patients. It is important for doctors who provide care to patients with cancer who consume cannabis to know the THC or CBD levels in the products their patients are consuming. But it isn’t clear if patients are aware of, or pay attention to, THC or CBD levels. This was our motivation for looking at this issue.
Healio: How did you conduct this study?
Smith: We conducted an anonymous survey on cannabis use among a randomly selected sample of patients and survivors here at Roswell Park. This was done right after New York state legalized cannabis for nonmedical use in 2021. Among the patients who used cannabis, we asked questions about what types of cannabis products they usually use, and whether they could tell us the numeric levels of THC or CBD in those products. We found that although most patients could tell us very generally if they used products containing mostly THC or mostly CBD, only 27.2% of those surveyed were aware of the actual numeric concentration of THC or CBD in the products they consumed. We also found that patients who use products that are more likely to be commercially sold and labeled, like oral capsules or vaping products, were more likely to be able to provide the numeric values of these products compared with patients who used products like cannabis flower.
Additionally, we found that patients who reported getting their information about cannabis from formal sources like medical providers had better awareness of THC and CBD levels on their products, as did patients who purchased their cannabis from well-regulated sources.
Healio: What do you expect to be the implications of this study?
Smith: My takeaway is that if providers are discussing cannabis with their patients, they should be aware that asking patients about the exact levels of THC or CBD in the products they use isn’t a reliable method of obtaining this information. Providers may need to play a larger role in educating themselves about cannabis and then use that information to inform useful dialogue and educate their patients.
Healio: How can hematologists/oncologists help patients make informed decisions about cannabis?
Smith: Because patients are rarely aware of the exact levels of THC and CBD in the products they consume, providers might want to start thinking about other ways to get that information, if possible. For instance, if a patient is not able to tell you the numeric level of their product, maybe have them bring the packaging of the products they’re using to their appointments. I think providers need to start leveraging other ways to collect that information, in addition to having these dialogues and discussing cannabis in general.
For more information:
Danielle Smith, PhD, MPH, can be reached at Roswell Park Comprehensive Cancer Center, 665 Elm St., Buffalo, NY 14023; email: danielle.smith@roswellpark.org.
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Goulette ML, et al. Abstract 6472 / 26. Presented at: American Association for Cancer Research Annual Meeting; April 14-19, 2023; Orlando.
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