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Sex differences exist in the perceived relief of cancer symptoms with medical cannabis: results from the Quebec Cannabis Registry

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Abstract

Purpose

This study explored whether symptom relief differs by sex in patients with cancer receiving medical cannabis (MC) therapy.

Methods

This is an analysis of data collected from patients with cancer enrolled in the Quebec Cannabis Registry. MC was initiated for the therapeutic management of cancer symptoms. Patients completed the revised Edmonton Symptom Assessment System (ESAS-r) questionnaire at baseline and 3-month follow-up. We examined the interaction between sex and time on each ESAS-r symptom and the interaction between time and tetrahydrocannabinol:cannabidiol (THC:CBD) ratios for each sex on total symptom burden.

Results

The analysis included 358 patients (M: 171). There were no sex differences in baseline ESAS-r scores. Three months of MC therapy led to significant improvements in pain (M: − 1.4 ± 0.3, p < 0.001; F: − 1.1 ± 0.3, p < 0.01), tiredness (M: − 1.7 ± 0.4, p < 0.001; F: − 1.2 ± 0.4, p < 0.05), anxiety (M: − 1.1 ± 0.4, p < 0.05; F: − 1.2 ± 0.4, p < 0.001), and well-being (M: − 1.2 ± 0.4, p < 0.05; F: − 1.4 ± 0.4, p < 0.01) in both sexes. Only F perceived improved drowsiness (− 1.1 ± 0.4, p < 0.05), nausea (− 0.9 ± 0.3, p < 0.05), lack of appetite (− 1.7 ± 0.4, p < 0.001), and shortness of breath (− 0.9 ± 0.3, p < 0.05). From baseline to 3-month follow-up, THC-dominant MC significantly reduced pain (− 1.52 ± 0.52, p < 0.05) in M, whereas in F it diminished nausea (− 2.52 ± 0.70, p < 0.01) and improved well-being (− 2.41 ± 0.79, p < 0.05). THC:CBD-balanced products significantly reduced pain (− 1.48 ± 0.49, p < 0.05), tiredness (− 1.82 ± 0.62, p < 0.05), anxiety (− 1.83 ± 0.54, p < 0.05), and improved well-being (− 2.01 ± 0.56, p < 0.01) in M. CBD-dominant products did not offer significant symptom relief in either sex.

Conclusion

The perceived relief of cancer symptoms from MC differs between sexes. More randomized controlled trials are needed to confirm our findings.

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Data availability

Data may be made available from the corresponding author upon request.

Code availability

N/A.

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Acknowledgements

The authors would like to acknowledge Dr. Robert Kilgour for his contribution to the final review of this manuscript. We would also like the acknowledge the support of the Quebec Cannabis Registry scientific committee members (Yola Moride, Marc O. Martel, Jordi Perez, Andrée Néron, Pierre Beaulieu, and Julie Desroches) and thank Dr. Mark Ware, who initiated the QCR in 2015 and was the Principal Investigator until July 1, 2018. Finally, we would like to thank the Cedars Cancer Foundation and Rossy Cancer Network for supporting the Medical Cannabis Program in Oncology of the McGill University Health Center, which provided most data on oncology patients to the QCR.

Funding

The QCR was supported by grants from the Canadian Consortium for the Investigation of Cannabinoids (CCIC), the Collège des Médecins du Québec (CMQ), and unrestricted grants from several licensed cannabis producers (Bedrocan, Mettrum, and Tweed; these three companies merged during the study conduct into one company called Canopy Growth Corporation). Cedars Cancer Foundation and Rossy Cancer Network supported the Medical Cannabis Program in Oncology of the McGill University Health Center, which provided most data on oncology patients to the QCR. No funding agency had input into the design and conduct of the QCR, although the CMQ was present at development meetings.

Author information

Authors and Affiliations

  1. McGill Nutrition and Performance Laboratory, 5252 de Maisonneuve Blvd West, Suite 105-B, Montreal, QC, H4A 3S5, Canada

    Popi Kasvis & Antonio Vigano

  2. Supportive and Palliative Care Division, McGill University Health Centre, 1001 Decarie Boulevard, Montreal, QC, H4A 3J1, Canada

    Popi Kasvis & Antonio Vigano

  3. Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada

    Popi Kasvis

  4. Research Institute of the McGill University Health Centre, 1001 Decarie Boulevard, Montreal, QC, H4A 3J1, Canada

    Michelle Canac-Marquis

  5. School of Medicine, Royal College of Surgeons in Ireland, 123 St. Stephen’s Green Dublin 2, Dublin, Ireland

    Saro Aprikian

  6. Department of Science, McGill University, 845 Sherbrooke St W, Montreal, QC, H3A 0G4, Canada

    MariaLuisa Vigano

Authors
  1. Popi Kasvis
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  2. Michelle Canac-Marquis
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  3. Saro Aprikian
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  4. MariaLuisa Vigano
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  5. Antonio Vigano
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Contributions

P. K.: conceptualization, formal analysis, writing-original draft, review, and editing. M. C. M.: project manager of the Quebec Cannabis Registry, data management, manuscript review, and editing. S. A. and M. L. V.: data management, manuscript review and editing. A. V.: conceptualization, manuscript review and editing, responsible for the final version of the manuscript.

Corresponding author

Correspondence to Antonio Vigano.

Ethics declarations

Ethics approval

Ethical approval for the QCR was granted by the McGill University Health Center Research Ethics Board.

Consent to participate

All patients provided informed consent prior to participating in the QCR.

Consent for publication

All patients provided informed consent to the eventual publication of results from the data collected, prior to participating in the QCR.

Competing interests

S. A. holds stock options in a licensed medical cannabis producer (Tilray); A. V. sat on the medical advisory boards of licensed producers of medical cannabis in Canada (Spectrum Therapeutics, Tilray, Syqe, and EmpowerPharm) and is the former research director for Santé Cannabis, Montreal, Canada. All other authors declare no competing interests.

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Kasvis, P., Canac-Marquis, M., Aprikian, S. et al. Sex differences exist in the perceived relief of cancer symptoms with medical cannabis: results from the Quebec Cannabis Registry. Support Care Cancer 30, 7863–7871 (2022). https://doi.org/10.1007/s00520-022-07193-1

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  • DOI: https://doi.org/10.1007/s00520-022-07193-1

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