Cannabis and Cancer: Developing a Patient Clinic — [PODCAST] Ep 86

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The demand for medical cannabis education from both providers and patients is increasing dramatically as stigma on its use decreases. The Cannabis and Cancer Research and Education Clinic (CanCaRE) was developed to meet this growing need--providing education on safe and effective cannabis use, dosing recommendations, and symptom management strategies. Hear how using novel agents like medical cannabis to improve their patients' quality of life is part of their overall mission to provide comprehensive cancer care services.

Sarah Jax, APRN, CNP
Oncology/Hematology Advanced Practitioner
HealthPartners Cancer Research Center at HealthPartners Frauenshuh Cancer Center
Membership Liaison for the Minnesota Society of Clinical Oncology
St. Louis Park, Minnesota

“85% of oncology providers wanted more education about medical cannabis, so developing the CanCaRE clinic was an opportunity to educate both patients and providers.”

Related Content:

• Holy Smokes: Developing a cannabis clinic for patients with cancer
• HealthPartners Frauenshuh Cancer Center
• Minnesota Medical Cannabis Program
• Medical Marijuana (Cannabinoid-Derived Products) for Cancer Patients
• Cannabis and Cancer Research and Education Clinic Intake Questionnaire
• Virtual Integrative Services — [MINI PODCAST] Ep 77
• Development of a Virtual Integrative Oncology Center

This podcast is part of a special series with ACCC's Oncology Issues journal. For a deeper dive into this content, please read, “Holy Smokes,” from V37 N4.

Transcript

CANCER BUZZ: Welcome back to CANCER BUZZ. I'm your host Summer Johnson. Today, a special cannabis clinic for patients with cancer. The legalization of cannabis continues to spread across the U.S. making patients more interested in its use to alleviate side effects during cancer treatment. HealthPartners Frauenshuh Cancer Center in St. Louis Park, Minnesota developed a clinic to help educate patients and their caregivers on safe and effective cannabis use, and then track their data in a registry of participants and their outcomes.

Sarah Jax is an Advanced Practice Provider who helped create The Cannabis and Cancer Research and Education Clinic (CanCaRE).

Sarah Jax, APRN, CNP: Patients want information from their cancer care providers. But we learned that a lot of oncologists do not feel well-informed to make clinical recommendations to their patients. 85% of oncology providers wanted more education about medical cannabis. So, we felt that developing the CanCaRE clinic was an opportunity to not only provide patient education but come back to oncologists to provide them with information about medical cannabis, trends on symptoms, and better dosing regimens.

CANCER BUZZ: I would imagine that the demand for education from the providers and from patients is increasing.

Sarah Jax, APRN, CNP: Correct. Minnesota has a Minnesota Medical Cannabis Registry. That is a newer program that is only available to patients with qualifying conditions. This program is growing dramatically and we found that patients wanted more information from their cancer providers. And as a result, we felt that developing a clinic was going to be the best opportunity to provide patients with not only cancer and cannabis education, but dosing strategies and different symptom management recommendations.

CANCER BUZZ: Walk us through that referral process.

Sarah Jax, APRN, CNP: So, it is a self-referral process. So, patients are provided information in clinic. On our medical cannabis program. Physicians are also able to refer patients to the program. If they see a patient in clinic who expresses interest in learning more about medical cannabis after the referral happens, they meet one-on-one in a virtual consult with an Advanced Practice Provider, such as myself or my colleague. These visits are typically 45-to-60-minute virtual visits to provide this patient education.

CANCER BUZZ: What does the staffing model look like for the clinic? I understand that you provide a certain amount of one-on-one consultation time.

Sarah Jax, APRN, CNP: So, our clinic has been running for approximately 18 months. Initially the clinic was run just by myself with approximately four hours a week, providing medical cannabis education. Starting in 2022, we had another advanced practice provider, a physician assistant join our group to provide additional consult one-on-one with the patients.

CANCER BUZZ: Sarah, what are some of the benefits of cannabis use during cancer treatment?

Sarah Jax, APRN, CNP: I think cannabis is a newer agent to provide symptom relief. We have found that patients experiencing pain, nausea, insomnia, sometimes anxiety or depression benefit from cannabis because of different dosages and ratios of THC and CBD working together.

CANCER BUZZ: Are there any patients that cannabis doesn't make sense for?

Sarah Jax, APRN, CNP: Actually, that's a really great question. We do a medical history review during the initial consult with our cannabis patients. And we found that patients with schizophrenia or acute angina or heart problems may not be the best candidates to use medical cannabis.

CANCER BUZZ: What about patients on immunotherapy?

Sarah Jax, APRN, CNP: When we do our initial consults, we review the patient's treatment plan that they're currently receiving. There is some data showing that some immunotherapy drugs, if used with cannabis may not be as effective for the patient who is receiving immunotherapy.

CANCER BUZZ: How is your clinic working to create cost-effective programs for patients?

Sarah Jax, APRN, CNP: Yeah. So, one of the highest barriers to patient and use of cannabis is the perception of how expensive the product is. In Minnesota, medical cannabis is not covered by insurance as a result. It is a cash-based program that also requires an initial $200 registration fee. This registration fee is a once a year and can be cost prohibitive to the patients. So, with CanCaRE we strive to create cost-effective plans through individual dosing regimens for our patients.

We walk them through the different dispensary product lists, specifically how expensive each product is. We learn the budget of the patient prior to making product recommendations. We then work with them to provide dosing recommendations with different products.

CANCER BUZZ: How has your clinic added to your overall services in your cancer center and the patients’ quality of life?

Sarah Jax, APRN, CNP: So at Park Nicollet Frauenshuh Cancer Center, we have a very robust amount of services provided for the patients specific to education, quality of life and other services such as social work, music therapy, nutrition services. We felt that symptom management was such an important part of the patient's quality of life. We find that symptom management is so important to patients and that using some novel agents like medical cannabis can be so helpful to improve their quality of life

CANCER BUZZ: For more on the Cannabis and Cancer Research and Education Clinic, you can check out the latest issue of Oncology Issues in your mailbox and online. Or you can read the show notes. Next week on CANCER BUZZ, digital literacy for older adults in cancer treatment until then this is Summer Johnson.

CANCER BUZZ: CANCER BUZZ is a resource of the Association of Community Cancer Centers.