How to Spot Safe Cannabis Products for Cancer Care

Nurses need to know where patients are getting their cannabis products and should look out for a few red flags.

Despite the fact that patients may be interested in their use, many oncology clinicians are uncomfortable — or unwilling – to discuss cannabis for cancer care. However, considering the amount of risky products available for purchase, it is crucial that nurses and doctors talk about cannabis use to keep their patients safe.

“We know that in cancer patients, cannabinoids have been used mostly as part of palliative care to alleviate pain, relieve nausea, and stimulate appetite. More recently we just had some information come out in the Journal of Clinical Oncology talking about how oncologists really aren’t comfortable or even willing to talk to their patients about the use of cannabis. Yet, around 84% of our patients are seeking some kind of advice from their clinicians,” said Eloise Theisen, MSN, RN, AGPCNP-BC.

Theisen is the president of the American Cannabis Nurses Association. She recently led a presentation on cannabis use in cancer care at the 2020 ONS Bridge virtual meeting.

She explained that the human body has something called an endocannabinoid system, made up of neurotransmitters that bind to cannabinoid receptors. The system, which exists to maintain homeostasis, helps to balance mood, appetite, sleep, and pain perception. “This really is the science behind why we see cannabis working for so many different conditions,” Theisen said.

In the oncology setting, patients have used cannabis to help with pain, sleep, nausea, anxiety, and appetite stimulation.

However, cannabis is not a perfect cure-all, and patients need to be careful of where they get their products, because the FDA does not regulate it. There are some mislabeled or deceitful products that patients can purchase online.

“There are no regulations at this point, although the FDA is working on it,” Theisen said. “So these products are not likely to best tested, and they may not be safe. There’s been reports where they contain synthetic cannabinoids or other harmful chemicals.”

Theisen said that recent research found that up to 70% of CBD products are mislabeled. “We know that many of our patients are immunocompromised, so we really want to be looking at those test results to make sure that whatever they’re putting in their body isn’t going to make them worse or potentially put them at risk,”

Patients and clinicians should look for the following when purchasing a CBD product:

  • It underwent independent, third-party testing
  • The manufacturer identifies if the product was tested for heavy metals, mold, pesticides, and other contaminants like residual solvents
  • If chemicals like acetone or isopropyl alcohol were used to extract the oils from the plant

“I want to talk about these products that are sold on the internet to give us as oncology clinicians the tools to make sure that our patients are getting high-quality, safe, and effective products,” Theisen said. “Because we know [patients are] using them.”