Cannabis Assessment in Oncology Patients – Evaluation Survey: Understanding Usage Patterns in a Rural Radiation Cohort in Kentucky
Evans Amoah, Waleed F Mourad, Marcus E Randall, Eddy S Yang, Brent J Shelton, Aradhana KaushalAbstract
Background
Research on self-administration of unprescribed cannabis remains limited because of its evolving legal status in the United States. We conducted, to our knowledge, the first fully independent tablet application–executed oncology survey without research staff oversight in urban and rural radiation oncology practices. Objectives were to: (1) characterize symptoms motivating cannabis use, (2) compare urban and rural patterns of use, (3) assess concomitant use with opioids and gabapentin in an opioid-endemic region, and (4) evaluate associations with patient-reported quality of life.
Materials/Methods
An IRB-approved, de-identified survey was administered to 237 adults receiving radiation therapy between July 2023 and February 2024, from an urban practice and a rural satellite of an NCI/NCCN-designated cancer center. The survey assessed demographics, symptoms, quality of life, financial toxicity, and cannabis procurement. McNemar's test compared cannabis use before versus after cancer diagnosis; Fisher's exact and Cochran-Mantel-Haenszel tests evaluated associations.
Results
Of 237 participants, 121 (51%) reported lifetime unprescribed medicinal cannabis use. Recent use after cancer diagnosis was reported by 35 patients (14.7%) versus 30 (12.7%) before diagnosis (p = 0.0625). Users most commonly reported cannabis for pain, nausea, anxiety, depression, poor appetite, and sleep disturbance; at least 80% reported symptom and quality-of-life improvement. Recent users were more likely to reside in urban than rural areas.
Conclusion
Self-administration of unprescribed medicinal cannabis use was common across demographic groups and was primarily directed toward symptom management. This study demonstrates the feasibility of fully tablet-based research in rural oncology populations and provides novel data from an opioid-endemic region.