Barriers and Benefits of Subsidized Medical Cannabis in Oncologic Outpatient Palliative Care
Ivan Gonzalez Corral BS , Kathryn McGrath MD , Pallavi Kumar MD MPH , Nicholas Bishop BA , Craig Kwiatkowski BA , Nirali Patel BS BA , Gary Weissman MD MSHP , Elizabeth Cooney-Zingman MPH , Andrea Segal MS MPH , Scott Halpern MD PhD MBE
The Palliative and Advanced Illness Research Center, Perelman School of Medicine at the University of Pennsylvania
Affiliationer
Outcomes
1. Participants will be able to analyze the role of subsidized medical marijuana in enhancing symptom control and quality of life for advanced cancer patients and its potential to reduce opioid use within outpatient palliative care settings.
2. Participants will be able to recognize and understand barriers such as financial access, patient knowledge, and dispensary challenges that hinder the effective use of medical marijuana in palliative care settings.
Key Message
This study examines the impact of subsidized medical marijuana on pain, symptom management, and quality of life in advanced cancer patients receiving outpatient palliative care. Findings suggest that while medical marijuana has potential benefits, barriers such as limited understanding, dispensary challenges, and financial accessibility limit its integration. Addressing these barriers is crucial to improving patient outcomes.
Abstract
Patients with cancer often experience a variety of symptoms and a reduced quality of life, exacerbated by treatment side effects. While medical marijuana (MM) shows promise in alleviating adverse side effects of chemotherapy-related symptoms like nausea, vomiting, and anorexia, its role in managing cancer-related pain and anxiety remains inconclusive. Moreover, the integration of medical marijuana into palliative care and its impact on overall quality of life is underexplored, with limited research providing conclusive results.
Objectives
To assess the impact of recommending subsidized medical marijuana in palliative care on symptom management, pain, and quality of life in patients with advanced cancer at an urban academic outpatient palliative care clinic.
Methods
In this randomized controlled trial, newly referred advanced cancer patients were surveyed on their quality of life before their first palliative care appointment. Participants (N = 148) were randomized and blinded to either the Intervention (MM) or usual care arms. They completed the McGill Quality-Of-Life Questionnaire, symptom assessments, and recorded adverse events and medication use at baseline, then every two weeks for 16 weeks.
Results
Of the 148 participants, 114 were assigned to the intervention arm, and 34 were assigned to receive standard palliative care offered for symptomatic cancer patients. Interim qualitative analysis identified key themes: (1) limited understanding of medical cannabis risks and benefits; (2) synergistic effects reducing opioid use; (3) concerns about efficacy and dosing; (4) challenges with dispensaries and staff expertise; (5) Increased financial accessibility of symptom management.
Conclusion
Medical marijuana (MM) holds promise for improving the quality of life in patients with cancer receiving palliative care. However, financial barriers and legal restrictions limit its widespread adoption. As dispensary regulations remain state-dependent and medical marijuana gains wider acceptance as a treatment option, further investigation is necessary to optimize dosing, minimize adverse effects, and enhance therapeutic outcomes.
