Tetrahydrocannabinol and Cannabidiol Use in an Outpatient Palliative Medicine Population.

BACKGROUND: Palliative medicine physicians are challenged by lack of guidance regarding effectiveness and dosing of cannabis products in the setting of their emerging popularity. OBJECTIVE: The aim of this study was to describe early patterns of tetrahydrocannabinol (THC) and cannabidiol (CBD) use in Florida following passage of the state's first medical marijuana law. We describe here the perceived benefits, side effects, and beliefs expressed by patients in a single outpatient academic palliative medicine practice. METHODS: A cross-sectional survey was performed of a sequential convenience sample of patients who presented to an outpatient academic palliative medicine clinic over a 3-month period. RESULTS: In all, 24% (14/58) of respondents reported THC use, with half using THC on a daily basis. Patients reported improvements in pain, appetite, and nausea. In all, 71% (10/14) began using THC after the diagnosis of their chronic illness, and the most common form of usage was vaping. In all, 24% (14/58) of patients reported CBD use. Patients reported improvements in pain, and the most common form of usage was topical application. None of the patients had used CBD prior to the onset of their chronic illness. In all, 21% (3/14) of THC users and 21% (3/14) of CBD users thought that their substance was helping to cure their illness. Individual reported side effects in both groups were minimal. CONCLUSIONS: Approximately a quarter of outpatient palliative care patients use THC or CBD, often on a daily basis. Palliative care providers should be aware of the frequency, diverse usage, and beliefs behind cannabis product use in this patient population.

Querying Patients With Cancer About Sexual Health and Sexual and Gender Minority Status: A Qualitative Study of Health-Care Providers.

BACKGROUND: Although national organizations advocate that health-care providers ask patients about sexual health and sexual and gender minority status-to learn, for example, about side effects of treatment and to understand patients' social support-these conversations often do not occur. This study explored health-care providers' reasons for having/not having these conversations. METHODS: This single-institution study recruited health-care providers from medical oncology, hematology, radiation oncology, and gynecology. Face-to-face interviews were recorded, transcribed, and analyzed qualitatively. RESULTS: Three main themes emerged: (1) patient-centric reasons for discussing/not discussing sexual health and sexual and gender minority status ("So I think just the holistic viewpoint is important"); (2) health-care provider-centric reasons for discussing/not discussing these issues ("That's going to take more time to talk about and to deal with…" or "I was raised orthodox, so this is not something we talk about…"; and (3) reasons that appeared to straddle both of the above themes (eg, acknowledgment of the sometimes taboo nature of these topics). CONCLUSION: Although many health-care providers favor talking with patients with cancer about sexual health and sexual and gender minority status, limited time, personal reluctance, and the taboo nature of these topics appear at times to hamper the initiation of these conversations.

Cancer patients and their companion animals: results from a 309-patient survey on pet-related concerns and anxieties during chemotherapy.

The purpose of this study was to explore whether cancer patients, who are actively receiving cancer therapy and who sometimes have only a few months to live, have anxieties or concerns that arise as a result of not being able to care for their pets during their illness or after their demise. A survey was developed and utilized among such patients to assess whether they had pet-related concerns and anxieties and to determine whether they desired more information on available pet-related resources. Three hundred nine patients completed the survey, and 170 (55%) had a pet(s). The majority described that their pets helped them during their cancer. Only 4% of all patients and 7% of the pet owners desired more information on community resources for pet care, and 80% of pet owners had family members who were already helping them with pet care. Cancer patients appear to benefit from their pets and report few pet-related concerns. Healthcare providers at other medical centers should consider determining whether their patients have needs and anxieties related to caring for their pets and whether educational efforts should be put forth to focus on such issues.

Evaluating the WEB training program for cancer screening in Native American women.

The Native Women Enjoying the Benefit (WEB) program trains nurses to perform breast and cervical cancer screening examinations for Native American women. Several evaluations have shown that the program improves nurses' knowledge and skills, and nurses value its positive impact on clinic, nurse, and patient behaviors. Beyond effectiveness, program longevity often rests upon equilibrium that results from alignment between a program's values and principles with those of its sponsoring organization and pertinent surrounding environments. We examined how Native WEB values align with those of its 2 most relevant environments-the medical institution (immediate environment) that sponsors it and the broader health care context (distal environment). We found that social justice views articulated in Catholic social teaching served as a convenient synthesis of the 2 environments' values and principles. We used this conception of social justice to determine whether the Native WEB program reflected the perspectives of its immediate and distal environments.