Cannabis in Oncology Nursing: Reducing Polypharmacy and Managing Symptoms

At the OneOncology APP Symposium, Morvarid Rezaie, DO, HMDC, FACOI, a palliative care physician at The Center for Cancer and Blood Disorders, addressed a key challenge for oncology nurses: managing the complex symptom burden of cancer patients while minimizing polypharmacy.

In an interview with Oncology Nursing News, Rezaie explained how medical cannabis serves as a multimodal tool that can simplify care plans and improve patient outcomes.

Combatting pill fatigue and polypharmacy

Oncology nurses are often on the front lines of monitoring medication adherence and managing the side effects of extensive drug regimens. Rezaie noted that cannabis is particularly effective because it can manage multiple symptoms simultaneously, including pain, nausea, vomiting, decreased appetite, anxiety, and sleep disturbances. For patients struggling with "pill fatigue," cannabis offers a streamlined alternative.

“You get this one little entity, like one little gummy or one tincture dropper, that can help manage so many different things as opposed to having various pills that do the job,” Rezaie said. By replacing multiple prescriptions with a single delivery method, nurses can help reduce the physical and mental burden of medication management for their patients.

The science of synergy: Cannabinoids and opioids

Understanding the biological mechanism of pain relief is crucial for nurses providing patient education. Rezaie highlighted that cannabis is not just an alternative to traditional pain management but a complementary tool that works in tandem with opioids.

She explained that the human body’s internal landscape supports this collaborative effect: “When you look inside the body, those receptors for opioids and cannabinoids sit side-by-side. So there is some synergy there that helps them work together better.” This synergy allows for more effective pain control, potentially allowing for better management of refractory symptoms that opioids alone may not fully address.

Actionable counseling for the oncology nurse

Beyond the biological benefits, Rezaie provided a practical framework that oncology nurses can use when counseling patients on breakthrough pain. Rather than immediately reaching for additional opioid doses, she suggests a "cannabis-first" strategy for certain situations.

“I always counsel patients, “Look, maybe try the cannabis first before you take your opioid if the pain is still breaking through after a couple hours,” she shared.

This approach empowers patients to utilize the synergistic properties of cannabinoids to manage fluctuations in pain levels, providing an additional layer of support in their daily care routine.

By integrating these insights into their practice, oncology nurses can better advocate for multimodal symptom management. Whether it is reducing the number of pills a patient must swallow or explaining the "side-by-side" nature of pain receptors, medical cannabis represents a significant evolution in the supportive care toolkit.