Cancer patients taking medical cannabis say they are concealing the fact from treating teams and even secretly bringing it into hospital, to avoid negative feedback on their use of the substance.
The issue has come up in qualitative research on Australian cancer patients regularly taking medical cannabis, which also highlighted a persistent belief in its benefits as a “natural” medicine versus pharmaceuticals.
Conducted under the auspices of Cancer Council SA, the study included 10 adult patients with various cancers using cannabis to treat disease-related symptoms such as pain, poor sleep, and low mood.
Interviews revealed a widespread caution among participants about disclosing their cannabis use to preserve privacy or avoid judgement, with two participants admitting to not sharing the information with their treating doctors.
In the case of one interviewee, use was disclosed with their GP, whom they reported feeling supported by, but not their oncologists as they “didn’t want the negative from him”, in their words.
“This participant then brought medicinal cannabis to hospital but did not disclose this to medical staff,” the researchers said.
Another participant commented they withheld the information based on their health care professional’s reactions to other matters, believing they would be unsupportive of medical cannabis.
However, disclosure varied by situation, the researchers noted.
“I wouldn’t discuss it with my GP but when somebody is going to operate on my heart, they need to know,” the participant, a woman in her 60s with melanoma, was quoted as saying.
While this reticence was not shared by the other interview participants, disclosure frequently occurred in an atmosphere of stigma, the researchers said.
“While some felt they were met with support, other described reactions of indiference or even dismissal,” they wrote.
Writing in Supportive Care in Cancer (link here), they said the interviews highlighted the “considerable risk” associated with medicinal cannabis due to ongoing stigma and access barriers.
“Participants were exposed to safety risks by navigating medicinal cannabis independently, as HCP were uninformed, offered little guidance, or not consulted,” they wrote.
“Accounts of HCP indifference and even dismissal in this study raise concerns about patient safety, as does participants’ navigating use through trial and error.”
“As in other research the lack of guidance from HCP likely reinforced the importance of informal support networks, and the need to undertake independent research.”
Another key issue was the cost of prescription cannabis, which had driven most of the study participants to source cannabis through illicit channels. All up, two grew cannabis themselves, which they consumed via edibles, tea, vaping or smoking. The remain eight primarily used CBD oil which they had purchased either under prescription or through friends.
Legal access was also impeded by “red tape” and medicinal cannabis was accessed in ways that maximised cost and ease, the researchers said.
Most participants knew of others who accessed legal medicinal cannabis but felt “the fiery hoops you’ve got to go through is ridiculous,” particularly while navigating cancer.