Cancer Survivors and Providers Disagree on Medical Cannabis, Study Reveals

Cannabis is increasingly used by cancer survivors to manage pain, nausea, and anxiety, even as evidence on outcomes remains incomplete. Medical cannabis is legal in 47 U.S. states, Washington, D.C., and three territories, and its presence in survivorship care is growing. Yet the field still lacks a clear picture of how patients and clinicians perceive risks and whether they feel able to discuss use.

A new parallel-survey study from VCU Massey Comprehensive Cancer Center examined perspectives from 395 cancer survivors and 62 cancer care providers. Published in the Journal of Cancer Education, the work compares attitudes, risk awareness, and communication comfort between the groups. The goal is not to determine efficacy, but to map the information gaps that can shape real-world decision-making.

According to the study, providers were more likely than survivors to report awareness of potential cannabis risks (25% vs. 8.4%). At the same time, survivors reported greater comfort discussing cannabis with their care team than providers reported feeling comfortable raising it with patients (68.5% vs. 46.7%). The mismatch suggests that knowledge and communication barriers may be misaligned across roles.

The research also found that providers held more negative attitudes toward recreational cannabis use than survivors did. This contrast matters because provider framing can influence patient willingness to disclose symptom management strategies, including non-prescribed products.

Among survivors, those who had used cannabis reported higher social well-being but lower physical and emotional well-being. Cannabis use was also associated with greater mistrust in the healthcare system and lower overall healthcare utilization. These findings point to complex behavioral and psychosocial correlates, not merely symptom control.

Cannabis-using survivors showed higher rates of smoking and vaping and elevated levels of anxiety and depression compared with non-users. By contrast, chronic pain, alcohol use, and sleep quality did not differ between groups, highlighting that cannabis may not map neatly onto a single symptom domain.

State legality did not appear to influence whether participants used cannabis, implying that cultural, clinical, or personal factors may be more predictive than regulatory status. Notably, 57.9% of cannabis users began before their cancer diagnosis, while the remainder initiated use in response to diagnosis-related needs. The authors suggest this timing could be clinically important.

The study’s corresponding author, Sunny Jung Kim, Ph.D., links the pattern to what is seen with opioids: pre-existing use may carry a greater risk of dependency or chronic problems after diagnosis. She argues that cannabis may require similar caution for individuals entering survivorship already using it recreationally.

Looking forward, Kim calls for stronger clinical evidence, standardized guidelines, and provider education to support informed conversations. She also emphasizes the need for longitudinal research using biomarkers and objective measures to test causality rather than relying solely on self-reported outcomes.