Cannabis Use, Pain, and Outcomes in Patients with Head and Neck Cancer Treated with Radiotherapy
Williams A, Gilbert M, and Siddiqui F. Cannabis Use, Pain, and Outcomes in Patients with Head and Neck Cancer Treated with Radiotherapy. Psychooncology 2022; 31:71-72.
Background/Purpose: Marijuana use in the population is increasing as states continue to allow for both medicinal and recreational use. As such, the prevalence of marijuana uses among patients presenting for treatment of head and neck cancer (HNC) is likely to increase as well. Anecdotally, patients are asking about marijuana use during cancer treatment and, to date, oncology professionals are lacking sufficient data to advise their patients on use during cancer care. Further, the impact of marijuana use on pain management, local disease control, and survival in HNC is not well understood. The current study examines the associations between marijuana use, pain management, and cancer outcomes in patients with HNC squamous cell carcinoma.
Methods: Patients with psychosocial and substance abuse history who were treated with either definitive or adjuvant radiotherapy between August 2018 and March 2020 were included. Overall survival (OS) and disease-free survival (DFS) were compared between current marijuana users and non-users using Kaplan-Meier curves and log-rank tests.
Results: 148 patients with HNC were included (mean age = 62.1 years, SD = 9.1), 78% were male, 73% were white. 15% of patients reported marijuana use at time of initial diagnosis and 34% reported a history of marijuana use. Older patients and males were more likely to be currently using marijuana (p = 0.005 and p = 0.04, respectively). There were no differences between current and historical/never users on self-reported worst pain or objective measures of treatment toxicity, current marijuana users were more likely to require narcotic pain medications and require a greater number of types of pain medications during treatment (p = 0.002 and p = 0.007, respectively). No other differences were found between current or historical/never users.
Conclusions and Implications: Marijuana use in HNC may result in more difficulty managing pain during treatment. Further research is needed to better understand marijuana use during cancer treatment, particularly frequency and method of use, outcomes, and quality of life.