Understand why cannabis conversations matter in oncology.

Learn about a conversation framework that can help clinicians feel more confident in having nonjudgemental cannabis conversations with adult cancer patients.

• Nayak, M. M., Revette, A., Chai, P. R., Lansang, K., Sannes, T., Tung, S., & Braun, I. M. (2023). Medical cannabis-related stigma: cancer survivors’ perspectives. Journal of Cancer Survivorship, 17(4), 951-956. https://doi.org/10.1007/s11764-022-01297-7

• Nayak, M. M., Chai, P. R., Tung, S., Revette, A., & Braun, I. M. (2026). Medical Cannabis Formulations, Administration Routes, and Dosing: Perspectives of Patients With Cancer Who Consume. Clinical therapeutics, 48(1), 51–56 https://doi.org/10.1016/j.clinthera.2025.11.004

Understand cannabis’ complex legal history.

• National Conference of State Legislatures. (n.d.). State medical cannabis laws. https://www.ncsl.org/health/state-medical-cannabis-laws

Explore how the predominant cannabinoids THC and CBD interact with the endocannabinoid system and why route of administration matters.

• Ohno-Shosaku, T., & Kano, M. (2014). Endocannabinoid-mediated retrograde modulation of synaptic transmission. Current opinion in neurobiology, 29, 1–8. https://doi.org/10.1016/j.conb.2014.03.017

• Zou, S.; Kumar, U. (2018). Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System. International Journal of Molecular Sciences, 19(3), 833. https://doi.org/10.3390/ijms19030833

Understand common symptom targets in oncology as evidence-supported, evidence-refuted, or evidence-insufficient/mixed.

• Hardy, J., Greer, R., Huggett, G., Kearney, A., Gurgenci, T., & Good, P. (2023). Phase IIb Randomized, Placebo-Controlled, Dose-Escalating, Double-Blind Study of Cannabidiol Oil for the Relief of Symptoms in Advanced Cancer (MedCan1-CBD). Journal of clinical oncology: official journal of the American Society of Clinical Oncology, 41(7), 1444–1452. https://doi.org/10.1200/JCO.22.01632

• Hesketh, P. J., et al. (2020). Antiemetics: ASCO guideline update. Journal of Clinical Oncology, 38(24), 2782–2797.https://doi.org/10.1200/JCO.20.01296

• Nayak, M. M., Chai, P., Catalano, P. J., Pirl, W. F., Tulsky, J. A., Tung, S. C., Lin, N. U., Andrade, N., Johns, S., Vaz, C., Hughes, M., & Braun, I. M. (2024). Cannabidiol for Scan-Related Anxiety in Women With Advanced Breast Cancer: A Randomized Clinical Trial. JAMA network open, 7(12), e2450391.https://doi.org/10.1001/jamanetworkopen.2024.50391

• Simon, L., Baldwin, C., Kalea, A. Z., & Slee, A. (2022). Cannabinoid interventions for improving cachexia outcomes in cancer: a systematic review and meta-analysis. Journal of cachexia, sarcopenia and muscle, 13(1), 23–41.https://doi.org/10.1002/jcsm.12861

• Yeshurun, M., Shpilberg, O., Herscovici, C., Shargian, L., Dreyer, J., Peck, A., Israeli, M., Levy-Assaraf, M., Gruenewald, T., Mechoulam, R., Raanani, P., & Ram, R. (2015). Cannabidiol for the prevention of graft-versus-host disease after allogeneic hematopoietic cell transplantation: Results of a phase II study. Biology of Blood and Marrow Transplantation, 21(10), 1770–1775.https://doi.org/10.1016/j.bbmt.2015.05.018

Learn about oncology-relevant risks: medical (including cannabis use disorder), product-related, and legal and financial.

• Bahji, A., Stephenson, C., Tyo, R., Hawken, E. R., & Seitz, D. P. (2020). Prevalence of Cannabis Withdrawal Symptoms Among People With Regular or Dependent Use of Cannabinoids: A Systematic Review and Meta-analysis. JAMA network open, 3(4), e202370. https://doi.org/10.1001/jamanetworkopen.2020.2370

• Bar-Sela, G., Cohen, I., Campisi-Pinto, S., Lewitus, G. M., Oz-Ari, L., Jehassi, A., Peer, A., Turgeman, I., Vernicova, O., Berman, P., Wollner, M., Moskovitz, M., Meiri, D. (2020). Cannabis Consumption Used by Cancer Patients during Immunotherapy Correlates with Poor Clinical Outcome. Cancers, 12(9), 2447.https://doi.org/10.3390/cancers12092447

• Dawson, D., Stjepanović, D., Lorenzetti, V., Cheung, C., Hall, W., Leung, J. (2024). The prevalence of cannabis use disorders in people who use medicinal cannabis: A systematic review and meta-analysis. Drug and Alcohol Dependence, 257, 111263.https://doi.org/10.1016/j.drugalcdep.2024.111263

• Lira, M. C., Heeren, T. C., Buczek, M., Blanchette, J. G., Smart, R., Pacula, R. L., Naimi, T. S. (2021). Trends in Cannabis Involvement and Risk of Alcohol Involvement in Motor Vehicle Crash Fatalities in the United States, 2000‒2018. American journal of public health, 111(11), 1976–1985. https://doi.org/10.2105/AJPH.2021.306466

• Lo, L. A., Christiansen, A., Eadie, L., Strickland, J. C., Kim, D. D., Boivin, M., Barr, A. M., MacCallum, C. A. (2023). Cannabidiol-associated hepatotoxicity: A systematic review and meta-analysis. Journal of internal medicine, 293(6), 724–752.https://doi.org/10.1111/joim.13627

• Perisetti, A., Gajendran, M., Dasari, C. S., Bansal, P., Aziz, M., Inamdar, S., Tharian, B., Goyal, H. (2020). Cannabis hyperemesis syndrome: an update on the pathophysiology and management. Annals of gastroenterology, 33(6), 571–578.https://doi.org/10.20524/aog.2020.0528

• Taha, T., Meiri, D., Talhamy, S., Wollner, M., Peer, A., Bar-Sela, G. (2019). Cannabis Impacts Tumor Response Rate to Nivolumab in Patients with Advanced Malignancies. The oncologist, 24(4), 549–554.https://doi.org/10.1634/theoncologist.2018-0383

Observe the SHARE conversation framework applied to a situation in which the patient and the clinician differ in opinion on cannabis risks.

Observe the SHARE conversation framework applied to an older, cannabis-naïve adult with comorbidities.