Cancer Survivors and Providers Show Significant Gaps in Medical Cannabis Risk Awareness and Communication, VCU Study Finds
核心洞察
A VCU Massey Comprehensive Cancer (搜索) Center study surveyed 395 cancer survivors and 62 providers, revealing that only 8.4% of survivors recognized cannabis risks compared to 25% of providers.
While 68.5% of survivors felt comfortable discussing cannabis with their care team, only 46.7% of providers shared that comfort level, highlighting a communication gap.
More than half (57.9%) of cannabis-using survivors began use before their cancer (搜索) diagnosis, a group researchers say may need more careful attention for dependency risks.
A new study from Virginia Commonwealth University Massey Comprehensive Cancer Center (搜索) has uncovered significant gaps between cancer (搜索) survivors and their healthcare providers regarding awareness of medical cannabis risks and comfort in discussing its use. Published in the Journal of Cancer Education, the research surveyed 395 cancer survivors and 62 cancer care providers, offering one of the most detailed snapshots to date of how both groups navigate the increasingly prevalent use of cannabis in cancer symptom management.
The findings arrive at a time when medical cannabis is legal in 47 states, Washington, D.C., and three U.S. territories, with use continuing to grow among both the general population and cancer (搜索) survivors. Despite this expansion, the study reveals that critical disconnects in risk perception and communication persist.
Risk Awareness Gap Between Survivors and Providers
One of the study's most striking findings was the disparity in risk awareness. Cancer (搜索) care providers were significantly more likely than survivors to report awareness of the potential risks of cannabis use — 25% versus just 8.4%. This nearly threefold difference underscores a potential vulnerability among patients who may be using cannabis without fully understanding its possible adverse effects.
"Both cancer (搜索) survivors and healthcare providers share some similarities in their perceptions about using medical cannabis, but there are also gaps in perceived risk awareness and patient-provider communication," said Sunny Jung Kim, Ph.D., the study's corresponding author, a researcher in the Cancer Prevention and Control program at Massey and an associate professor at the VCU School of Public Health.
Communication Comfort: A Two-Way Disconnect
The study also revealed an asymmetry in communication comfort. While 68.5% of cancer (搜索) survivors reported feeling comfortable discussing cannabis with their care team, only 46.7% of providers said they felt comfortable bringing up the topic with patients. This gap suggests that even when patients are open to conversations, providers may hesitate to initiate them, potentially leaving important clinical discussions unaddressed.
Providers also held more negative attitudes toward recreational cannabis use than survivors did, adding another layer of complexity to patient-provider interactions around the topic.
Profile of Cannabis-Using Survivors
Among the survivor cohort, those who had used cannabis reported greater social well-being than those who had never used it. However, they also reported lower physical and emotional well-being, greater mistrust in the healthcare system, and lower use of healthcare services overall. Cannabis-using survivors also had higher rates of smoking, vaping, anxiety, and depression than non-users, though the two groups did not differ in chronic pain, alcohol use, or sleep quality.
Notably, whether cannabis was legal in a survivor's state did not appear to influence whether they used it, suggesting that legal status alone may not be a primary driver of use patterns in this population.
Pre-Diagnosis Use and Dependency Concerns
A particularly important clinical distinction emerged: more than half (57.9%) of the survivors who used cannabis had started before their cancer (搜索) diagnosis, while the remainder began using it specifically in response to their diagnosis. Kim drew a parallel to opioid use patterns observed in cancer populations.
"I see a similar pattern with opioids (搜索). Cancer (搜索) survivors who were already using opioids before diagnosis are more likely to develop dependency or opioid-related problems," Kim said. "I think something similar might apply to cannabis. People who were already using it recreationally before their cancer diagnosis may be more inclined to develop dependency or chronic cannabis use problems, so I think that group may need more careful attention."
The Opioid Alternative Context
Kim noted that the study grew out of a broader effort to identify alternatives to opioid-based care. "People are seeking different approaches to avoid or reduce long-term opioid use, and cannabis is one of them," she said. Patients commonly use cannabis to try to manage pain, nausea, anxiety, depression, fatigue, and loss of appetite, though the evidence base in cancer (搜索) survivors remains evolving.
Call for Stronger Evidence and Guidelines
Looking ahead, the research team emphasized the need for more rigorous clinical evidence. Kim called for longitudinal studies that move beyond self-reported survey data. "We need longitudinal studies establishing causality with biomarkers and objective measures," she said. "The data shouldn't just be self-reported outcomes. It should be based on longitudinal follow-up data incorporating biomarkers and objective measures to evaluate the actual outcomes of medical cannabis use rather than perceived outcomes."
Kim also advocated for standardized clinical guidelines regarding cannabis use for cancer (搜索) survivors, arguing that more education and training on the topic would give providers greater confidence in discussing and recommending medical cannabis when appropriate.
"Patient-provider communication is really critical," Kim concluded. "Having open discussions with providers will help reach informed decisions."