Cancer Survivors Less Aware of Cannabis Risks Than Doctors

Cancer survivors and the clinicians who treat them hold broadly similar views on medical cannabis, but a new study finds they part ways on two points that matter in the exam room: how aware they are of its risks, and how willing they are to bring it up. The open-access study, published in the Journal of Cancer Education, compared what 395 cancer survivors and 62 cancer care providers think about using cannabis to manage cancer-related symptoms.

The widest gap was in risk awareness. About 25% of providers said they were aware of potential health risks tied to cannabis use in cancer care, against 8.4% of survivors, a statistically significant difference. The more striking number sits underneath that gap: most people in both groups reported not knowing of any risks at all, roughly 92% of survivors and 75% of providers. On the benefit side, there was no meaningful split. Both groups attributed similar therapeutic value to cannabis for problems such as pain, nausea, and appetite loss.

Survivors were also readier to talk about it. About 69% said they felt comfortable discussing cannabis with their cancer doctor, while only 47% of providers said they felt comfortable raising it with patients. Providers held more negative views of recreational cannabis than survivors did, even though attitudes toward medical use tracked closely between the two groups.

What the survey measured

The researchers, based at VCU Massey Comprehensive Cancer Center, ran two parallel online surveys: one for adults with any history of cancer, including people in active treatment, and one for the physicians, nurses, and other clinicians who care for them. Running the same questions against both groups is the design’s main strength. Its main limit is that it is cross-sectional, capturing a single point in time, so it cannot establish cause and effect. The authors are explicit about that.

That caution matters most for the study’s subgroup findings. Among survivors, the team compared those who had ever used cannabis, about 61% of the sample, with those who never had. Cannabis users reported higher social well-being but lower physical and emotional well-being, greater mistrust of the healthcare system, and a greater tendency to delay or skip medical care. They also reported higher rates of cigarette smoking, vaping, anxiety, and depression. The groups did not differ on chronic pain, alcohol use, or sleep quality.

Those associations need to be read carefully. Because everything was measured at once, the data cannot say whether cannabis worsened anxiety and depression or whether survivors already coping with those symptoms were more likely to reach for it. The direction is unknown. The pattern lines up with a 2024 systematic review the authors cite, which concluded that medicinal cannabis, particularly high-dose synthetic THC, is generally ineffective for anxiety and depression in cancer patients.

Why the communication gap matters

With the number of US cancer survivors projected to reach roughly 26 million by 2040, even modest gaps in how patients and clinicians discuss cannabis scale into a real clinical problem. The evidence base for cannabis in cancer care remains thin and mixed, and providers often lack training to fill it, a knowledge gap other surveys of clinicians have documented. Survivors, for their part, may turn to cannabis as an alternative to opioids without a clear read on the tradeoffs.

Lead author Sunny Jung Kim, whose work focuses on survivorship and pain management, said the study grew out of a broader search for alternatives to opioid-based care. Kim singled out one pattern as clinically important: of the survivors who reported when they started, about 58% had begun using cannabis before their cancer diagnosis. Drawing a parallel to opioids, she suggested that people who used cannabis recreationally before diagnosis may be more prone to dependency and warrant closer attention.

Her prescription for the field is more rigorous evidence. “There should be stronger clinical evidence that clearly shows the benefits outweigh the potential risks,” Kim said in a statement from VCU Massey, adding that standardized clinical guidelines and more provider training would help. Much of the promising work on cannabis and cancer still sits in the laboratory, far from bedside proof.

The authors flag several constraints on their own results. The provider sample was small, at 62, which limits precision; online-panel recruitment can introduce selection bias; and the survivor group spanned many cancer types, leaving subgroup comparisons underpowered. State legalization did not significantly predict whether survivors used cannabis, though that analysis may have been too small to detect an effect. Kim’s fix is longitudinal research that tracks outcomes over time using biomarkers and other objective measures, rather than the one-time self-reports this survey and most of its predecessors rely on.

References

^{1. Kim, Sunny Jung; Motto, Farnese M.; Ming, Hannah; Clark, Viktor; Hong, Susan; Lichtman, Aron H.; and Sheppard, Vanessa B., “Perspectives on Cannabis Use among Cancer Survivors and Cancer Care Providers: Parallel Surveys” (2026). Journal of Cancer Education. https://doi.org/10.1007/s13187-026-02934-w}