Many pediatric oncology patients report medical marijuana (MMJ) and hemp-based CBD use. Over 4,000 children are registered users of marijuana in Colorado, the first state to legalize recreational marijuana. Eleven states and Washington, DC have legalized marijuana for recreational use for adults older than 21.
Medical marijuana is legalized in 33 states. Additionally, due to the bipartisan Farm Bill passed in December of 2018, hemp is federally legal. Clinical trials in adults have examined MMJ for cancer-related symptoms. New research is emerging on MMJ in anticancer therapy, MMJ receptors on tumor cells, and the potential role for MMJ as an immunomodulator. Few pediatric oncology studies have evaluated MMJ. We describe the initial findings of a prospective observational study of MMJ on quality of life (QOL) in pediatric brain tumor patients. Specific aims included (1) MMJ’s association with symptoms (nausea, anxiety, pain, fatigue, cognitive problems, and movement difficulties) and (2) MMJ’s impact on family dynamics, including financial strain. Laboratory assessments of white blood cell function were measured to determine the impact of MMJ on immune function and infection risk. The legality of hemp plus the increasing use of MMJ raises significant concerns about pharmacological interactions with CBD and the medications routinely administered to children with cancer (including chemotherapy). Nurses are on the front line for discussions with patients about MMJ and must be aware of the emerging field of MMJ in pediatric cancer. Additionally, nurses can influence patient care protocols and processes for alternative therapy administration, enabling an open dialogue between providers, parents, and patients regarding treatments, symptoms, adverse effects, and drug interactions.
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- Molly Hemenway, DNP MS AC/PC-CPNP
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