Adapting ANCHOR for Cancer Patients and Survivors: A Cannabis Nurse-Led Harm Reduction Intervention to Improve Cannabis Use Disclosure and Safety

Ciné Brown, BS
University of Miami

Co-authors: Ciné Brown¹, Renessa Williams¹, Bria-Necole Diggs¹, Bright Tamakloe¹, Benedictus Atsu Hlormenu¹, Denise C. Vidot^1
1University of Miami

Background: Cannabis is increasingly used by individuals with current or prior cancer to manage symptoms and treatment-related effects, yet disclosure to oncology clinicians remains limited. Nondisclosure may hinder clinicians’ ability to assess product potency, routes of administration, drug-drug interactions, and other safety concerns. Advancing Nurse-led Cannabis Harm Reduction (ANCHOR) is a nurse-led, technology-delivered brief harm-reduction intervention originally designed for young adults 18-35 who self-medicate with cannabis.

Objective: To use cancer patient and survivor data to 1) adapt ANCHOR for cancer care; and 2) define intervention components that strengthen cannabis disclosure, informed decision-making, and clinical safety.

Methods: Cross-sectional data from the ongoing cannabis and cancer study (P30CA240139) adult cancer patients and survivors (N=472) were analyzed to characterize 1) cannabis and/or psychedelic use before, during, and after cancer cancer care and 2) disclosure to healthcare professionals. Findings were mapped through the Intervention Mapping framework and cannabis nursing guidance to an adaptation matrix addressing population needs, intervention content, delivery, and implementation. Core ANCHOR components were retained when compatible with oncology care, and modifications were specified for cancer-related symptoms, treatments, medications, caregivers, and referral pathways.

Results: Of the sample, 43.8% in active chemotherapy reported the use of cannabis to mitigate side effects of chemotherapy and/or comorbidities; 37.9% reported daily cannabis use during chemotherapy; 61.8% reported cannabis use at time of survey. Only 2.6% of cannabis consumers reported they received instructions on how to use cannabis from their oncologist; yet 85.7% reported asking their oncologist about cannabis. The most prevalent reported reasons for SCCC patients to consume cannabis were pain (57.9%), difficulty sleeping (50.0%), and nausea/vomiting (28.9%). An estimated 47.4% of our sample stopped consuming cannabis after a cancer diagnosis. The most reported reasons for stopping use were high cost (33.3%), drug-drug interaction concern (33.3%), and uncertainty about safety/effectiveness (22.2%). The cancer-adapted ANCHOR model retained a synchronous, single-session telehealth encounter with a trained cannabis nurse and added nonjudgmental disclosure prompts; review of symptom goals, product composition, potency, dose, and route; medication and cancer-treatment interaction screening; high-THC harm-reduction counseling; red-flag escalation to oncology clinicians; caregiver inclusion when appropriate; and survivorship, supportive-care, and palliative-care referrals. Patient materials were reframed around informed use and shared decision-making rather than abstinence.

Conclusions: The marked gap between cannabis-related use and clinical disclosure identifies an actionable safety and communication target in cancer care. The cancer-adapted ANCHOR model preserves the accessibility and relational strengths of nurse-led telehealth while adding oncology-specific risk assessment and referral pathways.