Abstract P4-10-08: Characterizing cannabidiol use in a breast cancer population

Abstract Background: Cannabidiol (CBD) is an exogenous cannabinoid found in the plant Cannabis sativa and is thought to have broad therapeutic value. It works via different receptors than Δ9-tetrahydrocannabinol (THC) and, as such, lacks the psychoactive effects associated with cannabis intoxication. While CBD is becoming more commonly used in preclinical and clinical research studies in patients with breast cancer, few studies have explored these patients’ attitudes toward CBD use outside of the research setting. This survey study aimed to characterize the rate of and benefits from CBD use in patients with breast cancer, while also identifying barriers and limitations to its use. Methods: Individuals being seen at the University of Michigan Rogel Cancer Center for a diagnosis of breast cancer were given a flyer inviting them to participate in an online survey characterizing current and former CBD use. The survey questions were adapted from a previously published questionnaire conducted in patients with chronic pain conditions. All data was collected anonymously. The survey was accessed between September 2020 and March 2021. Survey responses were excluded if a patient had no history of breast cancer diagnosis or if a majority of the survey was incomplete. Results: A total of 114 survey responses meeting criteria for inclusion were collected. Most respondents were female (n = 113), White (n = 101, 88.6%) and the average age was 55.7 years (range 30-96 years). 51 respondents (44.8%) reported an annual household income of over $100,000. 83 respondents (72.8%) were currently receiving treatment for breast cancer. 44 respondents (38.6%) had ever used CBD to manage pain or other symptoms, and 26 of the 44 (59%) reported current use of CBD. Of the 18 patients who no longer used CBD, the most common reasons reported for stopping its use were lack of efficacy (35%) and expense (25%). Negative side effects were reported by 5%. Respondents continuing to use CBD most often reported using it to manage pain (19%), anxiety (18%), insomnia (15%), and joint stiffness (15%). It was less commonly used to manage depression (8%), fatigue (7%), and memory (4%). On a continuous scale of 1 (very much worse) to 7 (very much improved), respondents reported a median change in pain with CBD use of 6 (range 4 - 7, n=17), a median change in anxiety of 5.6 (range 4.1 - 7, n=16), a median change in insomnia of 6.3 (range 4 - 7, n=13) and a median change in joint stiffness of 5.6 (range 3 - 7, n=13). 61 respondents (53.5%) reported never using CBD to manage pain or other symptoms; the most common reasons were lack of symptoms (12%) or well-controlled symptoms (13%), lack of research on CBD use (15%), lack of regulation and fear of production contamination (14%), worry about side effects associated with CBD use (14%), and interactions with other medications (12%). Few respondents were concerned about expense (2%), CBD’s legal status (4%), or family and friends’ opinions (3%). Conclusions: While less than half of patients in this survey study reported previous or current CBD use, breast cancer patients who are using CBD seem to derive symptomatic benefit from reduction in pain and improvement in insomnia. Barriers to use of CBD include expense, concern about lack of CBD research, and concern about its interaction with other medications. While negative side effects were rarely reported in former CBD users, this remained a top concern for patients who had never used CBD. As CBD becomes increasingly used in the clinical setting, it will be important for physicians to help navigate these concerns related to its use. Additional research is needed to determine which patient-reported symptoms are most likely to be impacted by CBD use, as use in this patient population could lead to improvement in quality of life. Citation Format: Nicole Grogan, Norah Lynn Henry. Characterizing cannabidiol use in a breast cancer population [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-10-08.