Table Info

Table 1.

Baseline characteristics of participants (n = 25)

Characteristic		n	%	Mean	SD
Demographics	Age (year)	-	-	54.3	15.6
	Sex (female)	13	52.0	-	-
	Height (cm)	-	-	167.7	10.9
	Weight (kg)	-	-	72.2	17.3
	Body mass index (BMI, kg/m²)	-	-	25.8	6.1
	Education (Bachelor’s degree or higher)	16	64.0	-	-
	Race (white)	20	80.0	-	-
	Ethnicity (Hispanic or Latino)	2	8.0	-	-
Substance use history (last 30 days)	Days of cannabis use	-	-	12.5	11.7
	Days of alcohol use	-	-	4.4	5.9
	Days of tobacco use	-	-	2.2	7.8

SD: standard deviation; -: not applicable

Supplementary materials

The supplementary material for this article is available at: https://www.explorationpub.com/uploads/Article/file/1001138_sup_1.pdf.

Declarations

Author contributions

ADB: Conceptualization, Funding acquisition, Methodology, Project administration, Supervision, Writing—original draft, Writing—review & editing. DRC, DWB, and KEH: Conceptualization, Funding acquisition, Methodology, Writing—review & editing. GG: Investigation, Data curation, Formal analysis, Visualization, Writing—original draft, Writing—review & editing. LPG: Data curation, Formal analysis, Visualization, Writing—original draft, Writing—review & editing. RMW: Conceptualization, Funding acquisition, Methodology, Writing—original draft, Writing—review & editing.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The study was approved by the Colorado Multiple Institutional Review Board (COMIRB Panel D IRB number: IRB00002760). Initial approval was obtained in August 2018.

Consent to participate

Informed consent to participate in the study was obtained from all participants.

Consent to publication

Not applicable.

Availability of data and materials

The deidentified raw data supporting the conclusions of this manuscript will be made available by the authors, without undue reservation, to any qualified researcher.

Funding

Funding for this study was provided by the University of Colorado Cancer Center. LPG is supported by a National Science Foundation Graduate Research Fellowship [DGE 1650115]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Copyright

References

Latest global cancer data: cancer burden rises to 19.3 million new cases and 10.0 million cancer deaths in 2020 [Internet]. Lyon: International Agency for Research; c2023 [cited 2022 Sep 2]. Available from: https://www.iarc.who.int/news-events/latest-global-cancer-data-cancer-burden-rises-to-19-3-million-new-cases-and-10-0-million-cancer-deaths-in-2020/

Cancer treatment & survivorship: facts & figures 2019–2021 [Internet]. Atlanta: American Cancer Society; [cited 2022 Sep 2]. Available from: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-treatment-and-survivorship-facts-and-figures/cancer-treatment-and-survivorship-facts-and-figures-2019-2021.pdf

Palliative care in cancer [Internet]. Bethesda: National Cancer Institute; [cited 2022 Sep 2]. Available from: https://www.cancer.gov/about-cancer/advanced-cancer/care-choices/palliative-care-fact-sheet

Bar-Lev Schleider L, Abuhasira R, Novack V. Medical cannabis: aligning use to evidence-based medicine approach. Br J Clin Pharmacol. 2018;84:2458–62. [DOI] [PubMed] [PMC]

Fehniger J, Brodsky AL, Kim A, Pothuri B. Medical marijuana utilization in gynecologic cancer patients. Gynecol Oncol Rep. 2021;37:100820. [DOI] [PubMed] [PMC]

Do EK, Ksinan AJ, Kim SJ, Del Fabbro EG, Fuemmeler BF. Cannabis use among cancer survivors in the United States: analysis of a nationally representative sample. Cancer. 2021;127:4040–9. [DOI] [PubMed] [PMC]

Pergam SA, Woodfield MC, Lee CM, Cheng GS, Baker KK, Marquis SR, et al. Cannabis use among patients at a comprehensive cancer center in a state with legalized medicinal and recreational use. Cancer. 2017;123:4488–97. [DOI] [PubMed] [PMC]

Braun IM, Wright A, Peteet J, Meyer FL, Yuppa DP, Bolcic-Jankovic D, et al. Medical oncologists’ beliefs, practices, and knowledge regarding marijuana used therapeutically: a nationally representative survey study. J Clin Oncol. 2018;36:1957–62. [DOI] [PubMed] [PMC]

Cooke AC, Knight KR, Miaskowski C. Patients’ and clinicians’ perspectives of co-use of cannabis and opioids for chronic non-cancer pain management in primary care. Int J Drug Policy. 2019;63:23–8. [DOI] [PubMed] [PMC]

10.

Hutchison KE, Bidwell LC, Ellingson JM, Bryan AD. Cannabis and health research: rapid progress requires innovative research designs. Value Health. 2019;22:1289–94. [DOI] [PubMed]

11.

Bowles DW, O’Bryant CL, Camidge DR, Jimeno A. The intersection between cannabis and cancer in the United States. Crit Rev Oncol Hematol. 2012;83:1–10. [DOI] [PubMed]

12.

Martell K, Fairchild A, LeGerrier B, Sinha R, Baker S, Liu H, et al. Rates of cannabis use in patients with cancer. Curr Oncol. 2018;25:219–25. [DOI] [PubMed] [PMC]

13.

Stark DPH, House A. Anxiety in cancer patients. Br J Cancer. 2000;83:1261–7. [DOI] [PubMed] [PMC]

14.

Brintzenhofe-Szoc KM, Levin TT, Li Y, Kissane DW, Zabora JR. Mixed anxiety/depression symptoms in a large cancer cohort: prevalence by cancer type. Psychosomatics. 2009;50:383–91. [DOI] [PubMed]

15.

Curran L, Sharpe L, Butow P. Anxiety in the context of cancer: a systematic review and development of an integrated model. Clin Psychol Rev. 2017;56:40–54. [DOI] [PubMed]

16.

Rodriguez C, Ji M, Wang HL, Padhya T, McMillan SC. Cancer pain and quality of life. J Hosp Palliat Nurs. 2019;21:116–23. [DOI] [PubMed]

17.

Beck SL, Towsley GL, Berry PH, Lindau K, Field RB, Jensen S. Core aspects of satisfaction with pain management: cancer patients’ perspectives. J Pain Symptom Manage. 2010;39:100–15. [DOI] [PubMed]

18.

McNeill JA, Sherwood GD, Starck PL, Thompson CJ. Assessing clinical outcomes: patient satisfaction with pain management. J Pain Symptom Manage. 1998;16:29–40. [DOI] [PubMed]

19.

van den Beuken-van Everdingen MH, de Rijke JM, Kessels AG, Schouten HC, van Kleef M, Patijn J. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol. 2007;18:1437–49. [DOI] [PubMed]

20.

Palesh O, Peppone L, Innominato PF, Janelsins M, Jeong M, Sprod L, et al. Prevalence, putative mechanisms, and current management of sleep problems during chemotherapy for cancer. Nat Sci Sleep. 2012;4:151–2. [DOI] [PubMed] [PMC]

21.

Scarborough BM, Smith CB. Optimal pain management for patients with cancer in the modern era. CA Cancer J Clin. 2018;68:182–96. [DOI] [PubMed] [PMC]

22.

Makhlouf SM, Pini S, Ahmed S, Bennett MI. Managing pain in people with cancer—a systematic review of the attitudes and knowledge of professionals, patients, caregivers and public. J Cancer Educ. 2020;35:214–40. [DOI] [PubMed] [PMC]

23.

Graczyk M, Borkowska A, Krajnik M. Why patients are afraid of opioid analgesics: a study on opioid perception in patients with chronic pain. Pol Arch Intern Med. 2018;128:89–97. [DOI] [PubMed]

24.

Xu X, Luckett T, Wang AY, Lovell M, Phillips JL. Cancer pain management needs and perspectives of patients from Chinese backgrounds: a systematic review of the Chinese and English literature. Palliat Support Care. 2018;16:785–99. [DOI] [PubMed]

25.

Blake A, Wan BA, Malek L, DeAngelis C, Diaz P, Lao N, et al. A selective review of medical cannabis in cancer pain management. Ann Palliat Med. 2017;6:S215–22. [DOI] [PubMed]

26.

Zaki P, Blake A, Wolt A, Zhang Li, Wan A, Deangelis C, et al. The use of medical cannabis in cancer patients. J Pain Manag. 2017;10:363–74.

27.

Ostadhadi S, Rahmatollahi M, Dehpour AR, Rahimian R. Therapeutic potential of cannabinoids in counteracting chemotherapy-induced adverse effects: an exploratory review. Phytother Res. 2015;29:332–8. [DOI] [PubMed]

28.

Abrams D, Guzman M. Cannabis in cancer care. Clin Pharmacol Ther. 2015;97:575–86. [DOI] [PubMed]

29.

Bar-Lev Schleider L, Mechoulam R, Lederman V, Hilou M, Lencovsky O, Betzalel O, et al. Prospective analysis of safety and efficacy of medical cannabis in large unselected population of patients with cancer. Eur J Intern Med. 2018;49:37–43. [DOI] [PubMed]

30.

Bar-Sela G, Vorobeichik M, Drawsheh S, Omer A, Goldberg V, Muller E. The medical necessity for medicinal cannabis: prospective, observational study evaluating the treatment in cancer patients on supportive or palliative care. Evid Based Complement Alternat Med. 2013;2013:510392. [DOI] [PubMed] [PMC]

31.

Cuttler C, Lafrance EM, Craft RM. A large-scale naturalistic examination of the acute effects of cannabis on pain. Cannabis Cannabinoid Res. 2022;7:93–9. [DOI] [PubMed] [PMC]

32.

Campbell G, Hall WD, Peacock A, Lintzeris N, Bruno R, Larance B, et al. Effect of cannabis use in people with chronic non-cancer pain prescribed opioids: findings from a 4-year prospective cohort study. Lancet Public Health. 2018;3:e341–50. [DOI] [PubMed]

33.

Martin-Willett R, Master A, Bidwell LC, Sznitman SR. Cannabis use and sleep. In: Patel VB, Preedy VR, editors. Handbook of substance misuse and addictions. Springer International Publishing; 2022. pp. 1–30. [DOI]

34.

Ramaekers JG, Kauert G, van Ruitenbeek P, Theunissen EL, Schneider E, Moeller MR. High-potency marijuana impairs executive function and inhibitory motor control. Neuropsychopharmacology. 2006;31:2296–303. [DOI] [PubMed]

35.

Jager G, Kahn RS, Van Den Brink W, Van Ree JM, Ramsey NF. Long-term effects of frequent cannabis use on working memory and attention: an fMRI study. Psychopharmacology (Berl). 2006;185:358–68. [DOI] [PubMed]

36.

Crean R, Crane N, Mason B. An evidence-based review of acute and long-term effects of cannabis use on executive cognitive functions. J Addict Med. 2011;5:1–8. [DOI] [PubMed] [PMC]

37.

Broyd SJ, van Hell HH, Beale C, Yücel M, Solowij N. Acute and chronic effects of cannabinoids on human cognition—a systematic review. Biol Psychiatry. 2016;79:557–67. [DOI] [PubMed]

38.

Ranganathan M, D’Souza DC. The acute effects of cannabinoids on memory in humans: a review. Psychopharmacology (Berl). 2006;188:425–44. [DOI] [PubMed]

39.

Bhattacharyya S, Atakan Z, Martin-Santos R, Crippa JA, McGuire PK. Neural mechanisms for the cannabinoid modulation of cognition and affect in man: a critical review of neuroimaging studies. Curr Pharm Des. 2012;18:5045–54. [DOI] [PubMed]

40.

Englund A, Morrison PD, Nottage J, Hague D, Kane F, Bonaccorso S, et al. Cannabidiol inhibits THC-elicited paranoid symptoms and hippocampal-dependent memory impairment. J Psychopharmacol. 2013;27:19–27. [DOI] [PubMed]

41.

Arndt J, Das E, Schagen SB, Reid-Arndt SA, Cameron LD, Ahles TA. Broadening the cancer and cognition landscape: the role of self-regulatory challenges. Psychooncology. 2014;23:1–8. [DOI] [PubMed] [PMC]

42.

Ahles TA, Saykin AJ, Furstenberg CT, Cole B, Mott LA, Skalla K, et al. Neuropsychologic impact of standard-dose systemic chemotherapy in long-term survivors of breast cancer and lymphoma. J Clin Oncol. 2002;20:485–93. [DOI] [PubMed]

43.

Jim HS, Phillips KM, Chait S, Faul LA, Popa MA, Lee YH, et al. Meta-analysis of cognitive functioning in breast cancer survivors previously treated with standard-dose chemotherapy. J Clin Oncol. 2012;30:3578–87. [DOI] [PubMed] [PMC]

44.

Janelsins MC, Kohli S, Mohile SG, Usuki K, Ahles TA, Morrow GR. An update on cancer- and chemotherapy-related cognitive dysfunction: current status. Semin Oncol. 2011;38:431–8. [DOI] [PubMed] [PMC]

45.

Boykoff N, Moieni M, Subramanian SK. Confronting chemobrain: an in-depth look at survivors’ reports of impact on work, social networks, and health care response. J Cancer Surviv. 2009;3:223–32. [DOI] [PubMed] [PMC]

46.

How cancer has affected post-treatment survivors: a livestrong report [Internet]. Austin: Livestrong Foundation; [cited 2022 Sep 2]. Available from: https://www.livestrong.org/content/how-cancer-has-affected-post-treatment-survivors-livestrong-report

47.

Vardy J, Rourke S, Tannock IF. Evaluation of cognitive function associated with chemotherapy: a review of published studies and recommendations for future research. J Clin Oncol. 2007;25:2455–63. [DOI] [PubMed]

48.

Lange M, Joly F, Vardy J, Ahles T, Dubois M, Tron L, et al. Cancer-related cognitive impairment: an update on state of the art, detection, and management strategies in cancer survivors. Ann Oncol. 2019;30:1925–40. [DOI] [PubMed] [PMC]

49.

Ganz PA, Kwan L, Castellon SA, Oppenheim A, Bower JE, Silverman DH, et al. Cognitive complaints after breast cancer treatments: examining the relationship with neuropsychological test performance. J Natl Cancer Inst. 2013;105:791–801. [DOI] [PubMed] [PMC]

50.

Brandt J, Spencer M, Folstein M. The Telephone Interview for Cognitive Status. Neuropsychiatry Neuropsychol Behav Neurol. 1988;1:111–7. [DOI]

51.

Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–81. [DOI] [PubMed] [PMC]

52.

Newmeyer MN, Swortwood MJ, Barnes AJ, Abulseoud OA, Scheidweiler KB, Huestis MA. Free and glucuronide whole blood cannabinoids’ pharmacokinetics after controlled smoked, vaporized, and oral cannabis administration in frequent and occasional cannabis users: identification of recent cannabis intake. Clin Chem. 2016;62:1579–92. [DOI] [PubMed]

53.

Schwilke EW, Schwope DM, Karschner EL, Lowe RH, Darwin WD, Kelly DL, et al. Δ⁹-Tetrahydrocannabinol (THC), 11-hydroxy-THC, and 11-nor-9-carboxy-THC plasma pharmacokinetics during and after continuous high-dose oral THC. Clin Chem. 2009;55:2180–9. [DOI] [PubMed] [PMC]

54.

Lunn S, Diaz P, O’Hearn S, Cahill SP, Blake A, Narine K, et al. Human pharmacokinetic parameters of orally administered Δ⁹-tetrahydrocannabinol capsules are altered by fed versus fasted conditions and sex differences. Cannabis Cannabinoid Res. 2019;4:255–64. [DOI] [PubMed] [PMC]

55.

Bidwell LC, Ellingson JM, Karoly HC, YorkWilliams SL, Hitchcock LN, Tracy BL, et al. Association of naturalistic administration of cannabis flower and concentrates with intoxication and impairment. JAMA Psychiatry. 2020;77:787–96. [DOI] [PubMed] [PMC]

56.

Sobell LC, Sobell MB. Timeline follow-back. In: Litten RZ, Allen JP, editors. Measuring alcohol consumption. Totowa: Humana Press; 1992. pp. 41–72. [DOI]

57.

Martin-Willett R, Helmuth T, Abraha M, Bryan AD, Hitchcock L, Lee K, et al. Validation of a multisubstance online Timeline Followback assessment. Brain Behav. 2020;10:e01486. [DOI] [PubMed] [PMC]

58.

Beck AT, Steer RA, Brown GK. Beck Depression Inventory^®-II. San Antonio: Pearson (Psychological Corporation); 1996. [DOI]

59.

Beck AT. Beck Anxiety Inventory^®. 2nd ed. San Antonio: Pearson (Psychological Corporation); 1993.

60.

Spielberger CD, Gorsuch RL, Lushene RE. Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press; 1970.

61.

Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193–213. [DOI] [PubMed]

62.

Amtmann D, Cook KF, Jensen MP, Chen WH, Choi S, Revicki D, et al. Development of a PROMIS item bank to measure pain interference. Pain. 2010;150:173–82. [DOI] [PubMed] [PMC]

63.

Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, et al. The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol. 1993;11:570–9. [DOI] [PubMed]

64.

Wagner LI, Sweet J, Butt Z, Lai JS, Cella D. Measuring patient self-reported cognitive function: development of the Functional Assessment of Cancer Therapy–Cognitive Function instrument. J Support Oncol. 2009;7:W32–9.

65.

Stroop JR. Studies of interference in serial verbal reactions. J Exp Psychol. 1935;18:643–62. [DOI]

66.

von Bastian CC, Locher A, Ruflin M. Tatool: a Java-based open-source programming framework for psychological studies. Behav Res Methods. 2013;45:108–15. [DOI] [PubMed]

67.

Martin-Willett R, Morris BA, Wilcox R, Giordano G, Andrews-Hanna J, Banich M, et al. The influence of a 16-week exercise program, APOE status, and age on executive function task performance: a randomized trial. Exp Gerontol. 2021;152:111431. [DOI] [PubMed] [PMC]

68.

Kaiser RH, Andrews-Hanna JR, Metcalf CA, Dimidjian S. Dwell or decenter? Rumination and decentering predict working memory updating after interpersonal criticism. Cognit Ther Res. 2015;39:744–53. [DOI]

69.

Bates D, Sarkar D, Bates MD, Matrix L. The lme4 package. R Package Version. 2007;2:74.

70.

Berryman C, Stanton TR, Bowering KJ, Tabor A, McFarlane A, Moseley GL. Do people with chronic pain have impaired executive function? A meta-analytical review. Clin Psychol Rev. 2014;34:563–79. [DOI] [PubMed]

71.

Leas EC, Nobles AL, Caputi TL, Dredze M, Smith DM, Ayers JW. Trends in internet searches for cannabidiol (CBD) in the United States. JAMA Netw Open. 2019;2:e1913853. [DOI] [PubMed] [PMC]

72.

Noyes R Jr, Brunk SF, Baram DA, Canter A. Analgesic effect of delta-9-tetrahydrocannabinol. J Clin Pharmacol. 1975;15:139–43. [DOI] [PubMed]

73.

Noyes R Jr, Brunk SF, Avery DA, Canter AC. The analgesic properties of delta-9-tetrahydrocannabinol and codeine. Clin Pharmacol Ther. 1975;18:84–9. [DOI] [PubMed] [PMC]

74.

Johnson JR, Burnell-Nugent M, Lossignol D, Ganae-Motan ED, Potts R, Fallon MT. Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain. J Pain Symptom Manage. 2010;39:167–79. [DOI] [PubMed]

75.

Portenoy RK, Ganae-Motan ED, Allende S, Yanagihara R, Shaiova L, Weinstein S, et al. Nabiximols for opioid-treated cancer patients with poorly-controlled chronic pain: a randomized, placebo-controlled, graded-dose trial. J Pain. 2012;13:438–49. [DOI] [PubMed]

76.

Lynch ME, Cesar-Rittenberg P, Hohmann AG. A double-blind, placebo-controlled, crossover pilot trial with extension using an oral mucosal cannabinoid extract for treatment of chemotherapy-induced neuropathic pain. J Pain Symptom Manage. 2014;47:166–73. [DOI] [PubMed]

77.

Aminilari M, Wang L, Neumark S, Adli T, Couban RJ, Giangregorio A, et al. Medical cannabis and cannabinoids for impaired sleep: a systematic review and meta-analysis of randomized clinical trials. Sleep. 2022;45:zsab234. [DOI] [PubMed]

78.

Waissengrin B, Urban D, Leshem Y, Garty M, Wolf I. Patterns of use of medical cannabis among Israeli cancer patients: a single institution experience. J Pain Symptom Manage. 2015;49:223–30. [DOI] [PubMed]