Abstract

Simple SummaryDuring the COVID-19 pandemic, cancer survivors have been identified as a population with an increased risk for adverse outcomes. This represents an additional burden on cancer patients, who already need to cope with a variety of symptoms associated with their cancer diagnosis. In this study, we analyzed results from a COVID-19 cannabis health study and found that individuals with a history of cancer are more likely to report cannabis use to manage mental health and pain symptoms, and are more likely to report fear of a COVID-19 diagnosis, compared to adults without a history of cancer. These results support the importance and need for conversations between clinicians and their patients, particularly cancer survivors, about the use of cannabis.Clinical indications for medicinal cannabis use include those with cancer, a subgroup advised to avoid exposure to COVID-19. This study aims to identify changes to cannabis use, methods of cannabis delivery, and coping strategies among cancer survivors since the pandemic by cancer status. Chi-squared tests were used for univariate comparisons of demographic characteristics, cannabis use patterns, COVID-19 symptoms, and coping behaviors by cancer survivor status. Data included 158 responses between 21 March 2020 and 23 March 2021, from medicinal cannabis users, categorized as cancer survivors (n = 79) along with age-matched medicinal cannabis users without a history of cancer (n = 79). Compared to adults without a history of cancer, cancer survivors were more likely to report use of cannabis as a way of managing nausea/vomiting (40.5% versus 20.3%, p = 0.006), headaches or migraines (35.4% versus 19.0%, p = 0.020), seizures (8.9% versus 1.3%, p = 0.029), and sleep problems (70.9% versus 54.4%, p = 0.033), or as an appetite stimulant (39.2% versus 17.7%, p = 0.003). Nearly 23% of cancer survivors reported an advanced cannabis supply of more than 3 months compared to 14.3% of adults without a history of cancer (p = 0.002); though the majority of cancer survivors reported less than a one-month supply. No statistically significant differences were observed by cancer survivor status by cannabis dose, delivery, or sharing of electronic vaping devices, joints, or blunts. Cancer survivors were more likely to report a fear of being diagnosed with COVID-19 compared to adults without a history of cancer (58.2% versus 40.5%, p = 0.026). Given the frequency of mental and physical health symptoms reported among cancer survivors, clinicians should consider conversations about cannabis use with their patients, in particular among cancer survivors.

Highlights

  • Since the declaration of COVID-19 as a global pandemic by the World Health Organization on 11 March 2020, disparities in COVID-19-associated morbidity and mortality have emerged among older adults and individuals living with chronic health conditions [1,2].Within the United States, medicinal cannabis use is legal in certain states for individuals with certain health conditions, such as cancer [3]

  • Given the frequency of mental and physical health symptoms reported among cancer survivors, clinicians should consider conversations about cannabis use with their patients, in particular among cancer survivors

  • Ninety-six percent of cancer patients identified as medical cannabis users (Table 1)

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Summary

Introduction

Since the declaration of COVID-19 as a global pandemic by the World Health Organization on 11 March 2020, disparities in COVID-19-associated morbidity and mortality have emerged among older adults and individuals living with chronic health conditions [1,2].Within the United States, medicinal cannabis use is legal in certain states for individuals with certain health conditions, such as cancer [3]. Beyond the physical risks of COVID-19, individuals with chronic health conditions are reporting increased anxiety and depressive symptoms, as well as adverse economic outcomes including loss of employment and health insurance [8,9,10]. Prior studies, including those conducted by the study team, have documented increased reports of physical and mental health symptoms during the pandemic period among cancer survivors compared to adults without a history of cancer [4,11].

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