Empowering Radiation Therapists to Support Cancer Patients on Cannabis for Therapeutic Purposes

Abstract

Introduction

Since the legalization of recreational cannabis in 2018, its use among cancer patients for symptom management has likely increased [7]. However, evidence guiding its efficacy and clinical application remains limited, raising concerns about potential misuse without appropriate healthcare guidance [2,5]. Radiation therapists (RTTs) receive minimal training on cannabis for therapeutic purposes (CTP), limiting their ability to provide informed patient care despite patients’ expressed desire to receive information from their healthcare professionals [4,5,7]. This quality improvement project aimed to increase RTTs' confidence and preparedness to engage in evidence-based discussions regarding CTP with cancer patients at our institution, supporting more informed, patient-centred care and advancing professional practice. It also sought to increase RTT awareness and facilitate appropriate patient referrals to the pharmacist-led Cannabis Consulting Service (CCS) available at our institution. The CCS provides patients with education, clinical guidance, safe access and support regarding therapeutic cannabis use [3].

Materials and Methods

This quality improvement initiative used online, anonymous surveys to assess RTTs' knowledge, confidence, and clinical practices regarding CTP, and to evaluate the impact of an educational intervention. The survey was adapted from a previously developed, institutionally approved instrument and modified for local use [6]. Participation was voluntary and conducted at a single institution.

The pre-intervention survey assessed baseline knowledge, perceived preparedness based on existing education and training, and self-reported confidence in discussing cannabis with patients. It also evaluated awareness of the pharmacist-led CCS, explored clinical practice patterns, including frequency of initiating conversations about cannabis use, and documented actions taken when patients disclosed use. Participants also identified priority topics for further education.

An evidence-based educational intervention was then delivered, incorporating guidance on low-risk use, safety considerations, communication strategies, and practical tools for initiating patient discussions [1].

A post-intervention survey, using the same survey platform, reassessed knowledge, confidence, preparedness, and anticipated changes in practice. All responses were collected anonymously. Descriptive statistics were used to summarize data and compare pre- and post-intervention results.

Results

A total of 84 of 120 RTTs completed the baseline survey (response rate: 70%), indicating strong departmental engagement with the topic of CTP. Baseline findings demonstrated that patient-initiated discussions regarding cannabis use were common in clinical practice. However, respondents reported low levels of confidence and felt inadequately prepared to provide evidence-based guidance or engage in meaningful conversations about CTP.

Following delivery of the educational intervention, RTTs reported notable improvements in confidence. Post-intervention survey results showed an increase of greater than 50% in self-reported confidence to discuss cannabis with patients (Figure 1).

Participants also demonstrated high levels of engagement with the educational sessions and provided positive feedback on their relevance to clinical practice. Staff expressed particular interest in practical components of the intervention, including tools to support patient conversations and information on the pharmacy-led CCS. Increased awareness of the referral pathway was reported, with respondents highlighting the importance of clear, actionable steps to facilitate appropriate patient referrals. In response to this initiative, a revamped patient educational resource was also developed to further support ongoing staff learning and sustain practice improvements.

Overall, the intervention was associated with improved perceived preparedness among RTTs to engage in patient-centered, evidence-based discussions regarding CTP.

Figure 1. Improved confidence among Radiation Therapists in discussing cannabis with patients after education intervention.

Conclusions

This quality improvement initiative improved RTT confidence and preparedness in discussing CTP within a single institution and supported more informed, patient-centered care. High engagement and interest in the referral pathway highlight the importance of practical guidance and accessible resources. The initiative also promoted open, nonjudgmental dialogue within clinical practice. Future efforts will focus on enhancing patient education materials, strengthening interprofessional collaboration, and supporting high-quality research to guide clinical practice.