Medical Cannabis Certification in a Large Pediatric Oncology Center

Abstract

In Minnesota, medical cannabis was approved for use in 2014. From July 2015 to February 2019, our center certified 103 pediatric and young adult patients for the use of medical cannabis under the qualifying conditions of cancer and treatment-related symptoms. Here, we provide a review of the literature on medical cannabis use in pediatric and young adult cancer patients. We also provide demographic data on our patients certified for medical cannabis. The most common diagnoses were leukemia/lymphoma (36%), brain tumors (37%), and malignant solid tumors (26%). The most common indications were chemotherapy-related nausea, pain, and cancer cachexia. The age range at certification was 1.4-28.7 years (median 15.3 years). The time from cancer diagnosis to certification ranged from 0.5-197 months (median 8.9 months). The majority (94%) were certified during their first line of treatment. In the 32 patients who died from recurrent or progressive cancer, the time from certification to death was 1.3-30.3 months (median 4.4 years). Despite requesting certification, a subset (24%) never had medical cannabis dispensed. In our experience, pediatric and young adult oncology patients are interested in medical cannabis to help manage treatment-related symptoms. Ongoing analysis of this data will identify the therapeutic efficacy of medical cannabis.

Keywords: cancer pain; chemotherapy-induced nausea; end-of-life care; medical cannabis; medical marijuana; pediatric oncology.

Figure 1

Age at medical cannabis certification.

Figure 2

Time from cancer diagnosis to medical cannabis certification.

Figure 3

Medical cannabis dispensed by diagnostic group.

Figure 4

Age at medical cannabis certification by diagnostic group. Figure 4 caption: Box plot of age in years at the time of medical cannabis certification by diagnostic group. Outliers are denoted by a circle with unique patient number (UPN). Brain LG = Brain Tumor low-grade. Brain HG = Brain Tumor high-grade. MCAS = Mast Cell Activation Syndrome.