A review of lung biopsies from 17 patients aged 19 to 67 years old revealed bilateral pulmonary opacities, fibrinous pneumonitis, diffuse alveolar damage and bronchiolocentric pneumonia accompanied by bronchiolitis, Mayo Clinic researchers reported in the New England Journal of Medicine.4 Despite widespread news reports of possible exogenous lipoid pneumonia (presumably associated with fatty-oil “cutting” or diluting agents in e-cigarette fluid mixtures) among patients, none of these 17 patients’ biopsies revealed such cases, the authors noted.4 

The CDC did not respond to requests for information about how many e-cigarette-associated hospitalizations or deaths involved patients with cancer. Nor is it clear how many patients with cancer use marijuana or e-cigarette devices.

Thirty-three states and Washington, D.C., have medical marijuana programs, but eligibility criteria vary. A review of state laws by Cancer Therapy Advisor found that many states broadly allow cancer patients to use medical marijuana while others (like Georgia, Iowa, Maryland, and Minnesota) limit enrollment to patients with specific conditions, such as severe pain, muscle wasting, or otherwise-unmanageable nausea or vomiting. Kentucky only allowed patients with cancer to use medical marijuana in the context of a clinical trial. 

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States with medical marijuana programs for patients with cancer did not respond to requests for enrollment figures, but annual reports from state programs suggest that perhaps up to a quarter of medical marijuana program enrollees are patients with cancer.5-7 (In New Mexico, only 5.3% of 77,168 registered medical cannabis program participants listed cancer as their primary medical condition.8 Most users in this state, or 51%, cited post-traumatic stress disorder as a qualifying condition for use, followed closely by chronic pain, which was the main reason cited by 34% of users.) Exact numbers and proportions are difficult to calculate, however, because of overlapping criteria such as terminal disease, cancer diagnosis, nausea and vomiting, and chronic pain. 

In addition, not everyone with cancer who uses medical marijuana formally registers for such programs — some individuals with cancer may access marijuana through dispensaries in states where recreational use is allowed.

While it may be unclear how many cancer patients who use medical marijuana are formally enrolled in such programs, recent survey-based studies — including 1 conducted by the American Society of Clinical Oncology (ASCO) featuring members of the general population — suggest that the number of patients with cancer who use cannabis is higher than some may think. 

In the ASCO survey, medical marijuana use for symptom management was reported by 10% of individuals with cancer or who have had cancer in the past; 18% of those who were described as having active cancer reported the use of marijuana. At the time the poll was conducted, 56% reported they had difficulty accessing medical marijuana to manage cancer-related symptoms.9