Breast cancer patients have become a rapidly growing segment of medical cannabis users in the country.
But while cannabis has shown promise in symptom management, it is not considered a cure for cancer for now.
The need for comprehensive research to understand the benefits and potential harm of medical cannabis and cannabinoids (MCC) in cancer patients is clear.
“Despite being considered safe and well-tolerated,” said Dr. Jennifer Hu, professor and division director in the Department of Public Health Science at the University of Miami School of Medicine, “MCC may result in potential interactions with cancer treatments, adverse reactions and tumor progression.”
A significant step toward understanding the role of medical cannabis and cannabinoids in breast cancer treatment comes in the form of a five-year, $3.2 million U01 award from the National Cancer Institute. The award was granted to a 12-member team led by Hu, in collaboration with experts from UF Health Cancer Center and the University of Miami Sylvester Comprehensive Cancer Center.
The research project aims to enroll 300 medical cannabis and cannabinoids users and 300 non-medical cannabis and cannabinoids users, collecting data on patient characteristics, treatment plans, clinician-reported outcomes, adverse reactions, and patient-reported outcomes. The $3.2 million fund will be allocated to cover personnel, consultants, supplies, travel, and other necessary expenses related to the research, all of which will be subject to audit and approval by the funding agency.
In Florida, recreational cannabis use remains illegal, but medical cannabis has been legal for approximately a decade. In 2023, more than 750,000 Florida patients possess active medical cannabis cards. Over 2,500 doctors are certified by the Florida Department of Health Office of Medical Marijuana Use (OMMU) to provide services.
Thomas George, an oncologist and deputy director of UF Health Cancer Center, highlights the challenge of determining for whom medical cannabis is most effective.
“It’s anecdotal,” he said. “We hear that some patient is helping. We can’t really quantify it. We can’t objectively measure how much is working. Part of the research is to figure out how best to use it and for whom will it help the best.”
One of the complexities faced by oncology providers in Florida is the misalignment of state and federal laws. While medical cannabis is legal in Florida, it remains illegal at the national level, making it difficult for medical professionals to prescribe or recommend its use.
According to George, oncology providers at UF Health Cancer Center don’t prescribe medical cannabis since UF and many oncologists are recipients of national and federal grants or program leaders.
Recent studies indicate that about 42% of breast cancer patients use MCC to alleviate treatment-related symptoms. Breast cancer represents approximately 30% of all new female cancer cases in the United States, making it the most common cancer among American women.
Breast cancer affects one in every eight American women, with a new diagnosis occurring every two minutes. At UF Health Cancer Center, the focus extends beyond treatment to encompass patient-centered care, disease biology, and patient interests, all aimed at reducing mortality rates.
Lisa Spiguel, section chief of breast surgery at UF Health, emphasizes the need to strike a balance between the risks and benefits of treatment. Surgeries and operations come with their own set of risks and benefits, while treatments such as radiation therapy and chemotherapy can yield substantial benefits but also come with potential side effects.
“There’s a risk-benefit balance that we need to think about when we embark on a treatment journey,” she said. “The hardest thing sometimes for women is not necessarily surgeries and operations, but getting through the medicine or taking the medicine that block the estrogen for five years because it affects quality of life.”
Lavinia Lampkin, 63, a health services medical tech at Alachua County Public Schools, said she was diagnosed with breast cancer in a routine visit and it felt like “a death sentence” when she was called back by the doctor who carried her mammogram.
She survived with an optimistic mindset of living “a step up” and now she is a 13-year breast cancer survivor.
What defeated her, she said, was knowing the racial, ethnic disparity in cancer trials.
Lampkin attended the “Power Over Breast Cancer Gathering” on Oct. 21 at Springhill Baptist Church hosted by the UF Health Cancer Center’s Community-Partnered Cancer Disparities Research Collaborative (CDRC). She shared her concern about the underrepresentation of minorities and marginalized groups in medical research, particularly in the context of cancer studies with George.
George told attendees that there is far less representation of underrepresented minorities and groups in medical research, particularly cancer research, which has implications for how the therapy works.
Carolyn M. Tucker, director of UF Health Cancer Center’s CDRC and Florida Blue Endowed Chair in Health Disparities Research at the University of Florida, said people of color and people with low income are underrepresented in cancer research. Black males are the least represented.
The new research project, assessing the benefits and harms of medical cannabis and cannabinoids in breast cancer patients during and after treatment, seeks to address these disparities. Half of the participants will be underserved minorities.
“Our results will be of great value to physicians and cancer patients,” Hu said, “as they will inform decision-making regarding MCC to enhance therapies, improve quality of life and minimize adverse effects.”