Cannabis use patterns and patient reported outcomes in oncology and hematology patients: An anonymous survey.

Abstract

e24143 Background: In a contemporary era of rapidly evolving social and regulatory changes, it is important to understand and characterize patient (pt) cannabis usage and response. Methods: In order to avoid responding bias, we performed the first ever anonymous survey in consecutive patients (pts) cared for in a City of Hope practice site in California. We analyzed demographic information, qualifying conditions, symptoms, and the cannabis product used. Pt reported outcomes of response to cannabis were collected. Improvement in control of symptoms was defined as pts choosing “total” or “a lot”. Results were tabulated and analyzed by the Chi-squared and Fisher’s Exact statistics. Results: 154 of 176 consecutive patients agreed to participate (87.5%). 72.7% had a malignancy (CA), 18.1% non-malignant hematologic disease (HEME), and 10.3% had other illnesses (OTHER). Age was < 45 in 10.3%, 45-64 in 37.0%, and > 64 in 52.6%. Older pts more frequently had CA (32.5% < 45, 70.2% 45-64, vs 81.5% > 64p = .0012). 41.8% were male. Cannabis use was reported in 24.7%. Surprisingly, this did not vary significantly by age (37.5% age < 45, 28.0% age 45-64, and 19.8% age > 64 p = .24), by disease (CA 22.9%, HEME 34.6%, OTHER 28.6% p = .41), nor by gender (male 21.9%, female 25.8% p = .57). Pts used cannabis to control their disease in 42.1%, GI symptoms (nausea, vomiting) in 28.9%, weight loss in 10.5%, fatigue in 42.1%, pain in 73.6%, and other symptoms in 36.8%. Cannabis product was marijuana (MJ) in 32%, CBD in 58% and THC in 8% and varied by age (p = .0006) but not by illness or gender. Improvement in disease was reported in 62.5%, GI symptoms in 63.6%, weight loss in 50%, fatigue in 50%, and pain in 60.7%. Symptom improvement trend was numerically higher with MJ or THC (71%) vs CBD (47%, p = .27). 73% of pts reported they would participate in a cannabis clinical trial. Conclusions: There is a high usage of cannabis. While cannabis use does not vary by age, preference for cannabis product however does vary by age. Pts reported high response rates for various symptoms, which can confound the effectiveness of anticancer or supportive medications. Clinical trials of anticancer agents should stratify by use of cannabis products to avoid misattribution of antitumor effects or side effects. Since cannabis access is expanding across the country, it provides an opportunity to perform randomized trials looking into benefits and risks of cannabis use, and dose and administration methods. Clinicians should screen for cannabis use and document it in social histories separate from the category of illegal drug use.