An international survey on the knowledge, attitudes and clinical patterns of use of medical cannabis for cancer care: The TASMAN study

Background: Medical cannabis (MC) has gained traction in oncology for managing cancer-related symptoms, but its integration faces challenges due to limited evidence, inconsistent guidelines, and varied legal frameworks. Methods: The TASMAN study aimed to assess the knowledge, attitudes, and practices of oncologists and palliative care providers globally regarding MC use in cancer care. A survey of healthcare providers from diverse regions and income levels was conducted. Results: we study included 179 participants (response rate: 51.1 %), with an equal gender distribution (49.4 % female) and a median age of 37 years. Participants were primarily oncologists (71.5 %), practicing in university hospitals (40.2 %) or cancer centres (32.4 %), with over half from low- and middle-income countries. Most respondents (92.7 %) were unaware of clinical guidelines for MC. A proportion of 44.1 % were familiar with MC use, 78.8 % recognized its role in cancer pain, and 34 % identified its role in managing cachexia. Awareness of specific products was low, with only 10 % familiar with specific cannabis products. Three-quarters of respondents (84.4 %) did not prescribe MC routinely. Legal status and regulations were unclear for most participants; 40 % noted cannabis as illegal. MC use and patient requests were more common in high-income countries and the EURO region, with palliative care providers demonstrating the highest awareness and prescription rates. Conclusion: Clearer regulations, standardized guidelines, and targeted education are essential to support the safe integration of MC into oncology and palliative care, ultimately improving the quality of life for cancer patients.