The impact of cannabis for patients with cancer
Medical cannabis has been shown to reduce pain, nausea and anxiety for patients with cancer. We’ve been leading large-scale efforts to address how cannabis impacts the lives of patients with cancer since 2015. Our workgroup helped create research opportunities for patients, publish results in peer-reviewed journals, and obtain grant funding. Key external collaborators include Minnesota Department of Health (MDH) Office of Medical Cannabis, University of Minnesota, Mayo Clinic, and Memorial Sloan Kettering.
Cannabis clinical trial experience. Dylan Zylla, MD, served as site principal investigator for the nabiximols phase III randomized control trial and gained valuable experience in conducting interventional pain trials using cannabis. We completed the first observational randomized clinical trial in cancer patients using cannabis from a state medical program. We enrolled 30 of 86 eligible patients identified on screening, which demonstrated that patients express a strong desire to participate in cannabis research trials. Building on this model, we created a clinical trial using topical cannabis creams to study aromatase-inhibitor musculoskeletal symptoms in women with breast cancer at both HealthPartners and University of Minnesota.
Cannabis survey research experience. We completed two large surveys as part of a National Cancer Institute supplement award to better understand cannabis use in cancer patients. A strength of this survey was inclusion of a large percentage of patients in M Health Fairview’s rural cancer clinic sites. We also conducted a statewide survey of oncology clinicians’ perspectives with cannabis and launched an online survey assessing cannabis consumer views of cannabis as an anti-cancer agent.
Cannabis databases and systematic review experience. With colleagues from MDH, we analyzed a cohort of 1,120 cannabis consumers in the Minnesota Office of Medical Cannabis to describe self-reported symptom change, cannabis use patterns and adverse events. We have begun analysis on a clinical health care claims database that includes data on over 201,000 cannabis consumers with dispensary purchase records and 67 million cannabis non-consumers. Preliminary results in patients with any stage IV cancer who initiate immune checkpoint inhibitors show no difference in real-world time to treatment discontinuation between cannabis consumers and a matched group of cannabis non-consumers. We also published a comprehensive review article on cannabis use in cancer patients as well as a review focused on cannabis as a cancer-directed treatment.
Cannabis in Cancer Research and Education (CanCaRE) clinic and prospective cohort data collected in REDCap registry. To gauge initial interest in this clinic, we administered an anonymous survey at our HealthPartners cancer clinics. Twelve percent of the patients who responded reported current use of cannabis. Forty-three percent expressed interest in receiving more information about cannabis. Among the patients with stage IV cancer who completed the survey, 15% reported current use and 48% were cannabis naïve and “cannabis curious,” leaving their name and contact information requesting more information.
As a result, in January 2021 we launched the CanCaRE clinic at HealthPartners to educate patients interested in cannabis. We use one-on-one video consultation with an oncology advanced practice clinician to 1) provide education for patients with cancer interested in using cannabis in a safe and effective manner, and 2) to create a registry of patients with cancer who are actively using cannabis. We use this real-world data to inform oncology clinicians and patients. All patients in the clinic enter an electronic registry that collects an intake survey and tracks outcomes longitudinally over a 12-week period. We provide consultations to about 10 new patients every month.
Learn more:
HealthPartners Cannabis in Cancer Research and Education (CanCaRE) Clinic
