The Minnesota Office of Cannabis Management has published a report on cancer patients in the state’s medical cannabis program, built on the patients’ own symptom ratings collected before every purchase over a period of more than eight years.
Over 6,600 patients rated eight symptoms before each purchase
The report covers patients enrolled with a cancer-related qualifying condition between 1 July 2015 and 31 December 2023. A total of 7,762 patients enrolled, and 85 percent of them — 6,621 people — made at least one purchase and are included in the analysis.
Before each purchase, patients completed a self-evaluation covering eight symptoms over the previous 24 hours: anxiety, lack of appetite, depression, disturbed sleep, fatigue, nausea, pain and vomiting. Symptoms were scored from 0 to 10, and a reduction of at least 30 percent counts as a clinically relevant improvement in the report. Men and women were represented in equal numbers, and the average age at enrollment was 58, ranging from 1 to 100 years.
Minnesota was the 22nd US state to establish a medical cannabis program, and it has an unusual feature: the agency is required by law to study the experiences of participants. The program now has more than 90,000 registered patients, and enrollment has doubled since patient fees were abolished in 2023 and more qualifying conditions were added in 2024.
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Vomiting and nausea improved in nearly half of patients
Among the 1,790 patients who reported moderate to severe vomiting at enrollment, 47.2 percent recorded a reduction of at least 30 percent within four months of their first purchase. Of those who stayed in the program, 74.4 percent maintained that improvement for a further four months.
The group with moderate to severe nausea was larger, 3,743 patients. Of those, 39.9 percent improved within four months, and 65 percent of those who continued maintained the effect. Lack of appetite improved in 38.2 percent of the 1,791 patients who reported symptoms at the start, with 62.8 percent maintaining the improvement.
Pain, anxiety and depression improved in some patients
Pain was the most common complaint: 82 percent of patients scored moderate to severe pain at enrollment. Among them, 29.9 percent — 1,631 people — reported a reduction of at least 30 percent within four months, and 53 percent of those who continued maintained that level for another four months.
Among patients with moderate to severe anxiety at enrollment, 40 percent reported improvement within four months, with the corresponding figure for depression at 44 percent. The report also notes improved sleep scores, one of the eight symptoms.
Inhalation and high THC levels dominated purchases
The purchasing data covers 35,859 transactions and 121,865 products during patients’ first year in the program. Inhalation products such as cannabis flower and vapes accounted for 48 percent of products, and among those 58.9 percent had a high or very high THC to CBD ratio.
Enteral products — those that are swallowed — such as gummies and capsules accounted for 42.5 percent. High THC levels were even more dominant there: 82.4 percent.
Few serious side effects — but major gaps in the evidence
Around 15 percent of patients reported a side effect in connection with their purchases. Most were mild (60 percent), 34 percent moderate and 6.2 percent severe. Dry mouth was the most commonly reported side effect, and fatigue the most common severe one.
The report is a registry study without a control group, and both symptoms and side effects rest on patients’ own ratings. Another caveat is loss to follow-up: patients may take part in the program only while undergoing chemotherapy, or may already be in hospice care at enrollment, which makes the share who maintained an effect a conservative estimate. The program also does not collect data on what other treatments patients receive.
“Cannabis treatment appears to be relatively safe, and we now have strong observational evidence that many patients report better control of several cancer-related symptoms,” said Dr Dylan Zylla, oncologist and medical director of the HealthPartners Cancer Research Center, who recommends starting with a low dose of THC and adjusting upwards gradually every few days.
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