# Cannabis stigma and symptom management considerations in cancer survivors: a mixed-methods exploration of patient perspectives

## TL;DR

This study explores cancer survivors' attitudes toward cannabis use and stigma, finding generally positive views but some concerns about disclosure and opioid-related stigma.

## Contribution

The novel contribution is the mixed-methods exploration of cannabis stigma and symptom management decisions among cancer survivors.

## Key findings

- Most cancer survivors had positive attitudes toward cannabis and did not report experiencing stigma.
- Some survivors intentionally avoided discussing cannabis use with providers due to perceived or internalized stigma.
- Opioid-related stigma was reported as a significant factor in symptom management decisions.

## Abstract

This study aims to assess for indications of stigma and attitudes toward cannabis among cancer survivors (CS) who use or consider the use of cannabis.

This study employed a convergent, parallel mixed methods design utilizing focus group and questionnaire data to assess the presence of stigma among a sample of CS (n = 23) who use (n = 10) and do not use (n = 13) cannabis to manage symptoms. CS were recruited from a multi-site observational study in the Northeast U.S. region that assesses cannabis use among oncology patients.

A total of 23 CS participated in this study. In general, this sample appeared to have positive attitudes towards cannabis, as indicated by quantitative results, and most CS felt accepting or neutral about other CS using cannabis, irrespective of whether they used or not. Most CS did not indicate experiences of stigma for cannabis use, did not feel judged by their medical providers, and indicated a feeling of empowerment to do whatever was needed to feel better. However, several CS reported intentional nondisclosure to their providers. Many CS discussed the presence of opioid-related stigma, both perceived from society and internalized, which appeared to play an important role in their symptom-management decision-making.

Findings from this study suggest that while cannabis stigma may not be commonplace for CS, some do experience it. Further, opioid stigma appears to be perceived and intertwined in the decision-making processes for CS in this sample.

The online version contains supplementary material available at 10.1007/s00520-026-10523-2.