In Part 1 of our medical cannabis in cancer series, guest Marie Parish discussed the rising interest of patients with cancer to explore and use cannabinoids medicinally, shedding light on emerging dosage forms and providing practical education points for patients. Oncology pharmacists are positioned optimally to help patients with cancer navigate medical cannabis or find reliable information about it. In this Part 2 episode, Carlo De Angelis will take you inside Sunnybrook’s pharmacist-led Cannabis Consultation Service, which has been in existence since 2019. Join us for an insightful episode where Carlo’s expertise shines! He delves into the motivations driving patients' interest in medical cannabis, highlights key safety considerations, and shares practical strategies to support responsible cannabis use. Discover the intricacies of implementing a pharmacist-led, patient-centred cannabis consultation service, as Carlo discusses both its challenges and triumphs. If you’re in oncology pharmacy and looking to deepen your understanding of this evolving area in cancer care, this episode is a must-listen!

Learning Objectives:

• Explore why cancer patients may be increasingly curious about plant-based cannabinoids and explore the specific symptoms or side effects they hope to manage
• Describe the structure of the Cannabis Consultation Service, including referral pathways, standardized assessment tools, team roles, typical titration, andfollow up practices
• Examine the processes of implementing a pharmacist-led cannabis consultation service in an institution, from selecting suitable products to addressing clinicianhesitancy, evidence gaps, and patient safety concerns.
• Consider how cannabis evidence generation and broader collaboration may evolve cancer care symptom management over the next decade
• Establish the role of the oncology pharmacist for patients using medical cannabis, and justify why a pharmacist-led service addresses many gaps in care

Publication: Marchese M, Zhu C, Charbonneau LF, et al: Description and disposition of patients with cancer accessing a novel, pharmacist-led cannabis consultation service. JCO Oncol Pract 18:e1777-e1786, 2022

Cannabis use among cancer patients is rapidly expanding in both popularity and complexity, creating exciting challenges and opportunities for oncology pharmacists. From understanding a growing variety of product types to interpreting evolving clinical evidence on symptom relief, drug interactions, and treatment outcomes, pharmacists are essential in ensuring safe, personalized patient care. In this episode, we reveal practical insights to empower oncology pharmacists in assessing, counseling, and monitoring patients using cannabis. Discover how this emerging therapy is reshaping oncology practice and could become a game changer!

By the end of the podcast, listeners will be able to:

• Explain the rising use of recreational and medicinal cannabis among cancer patients.
• Recognize the diverse variety of cannabis product types and their relevance to oncology symptom management.
• Assess the potential impacts of cannabis on cancer treatments, including drug-drug and drug-disease interactions, safety, and therapeutic outcomes.
• Summarize current available evidence and data for cannabis use in managing oncology-related symptoms such as nausea, vomiting and pain.
• Explore practical approaches for oncology pharmacists to evaluate, counsel, and monitor patients using or inquiring.

Resource list:

1. Bar-Sela G et al. Cannabis Consumption Used by Cancer Patients During Immunotherapy Correlates with Poor Clinical Outcome. Cancers 12:2447, 2020.

2. Grimison P, et al. Oral THC:CBD Cannabis Extract for Refractory Chemotherapy-Induced Nausea and Vomiting: A Randomized, Placebo-Controlled, Phase IICrossover Trial. Ann Oncol. 2020 Nov;31(11):1553-1560.  Bar-Lev Schleider L, et al. Prospective Analysis of Safety and Efficacy of Medical Cannabis in Large Unselected Population of Patients with Cancer. Euro J of Int Med. 2018 Mar;49:37-43.

3. Khoj L, et al. Effects of Cannabis Smoking on the Respiratory System: A State-of-the-Art Review. Respir Med. 2024 Jan;221:107494.

4. Lopera V, Rodríguez A, Amariles P. Clinical Relevance of Drug Interactions with Cannabis: A Systematic Review. J Clin Med. 2022 Feb 22;11(5):1154

5. Sauer MA et al. Marijuana: Interaction with the Estrogen Receptor. J Pharmacol Exp Ther 224:404-407, 1983.

6. Taha T et al. Cannabis Impacts Tumor Response Rate to Nivolumab in Patients with Advanced Malignancies. Oncologist 24:549, 2019.

7. Worster B, Hajjar ER, Handley N. Cannabis Use in Patients With Cancer: A Clinical Review. JCO Oncol Pract. 2022 Nov;18(11):743-749. 

What skills and attitudes qualify me to be an oncology pharmacist? Join 2 authors of CAPhO’s new Competencies for Oncology Pharmacists in Canada to explore the 5 pillars of oncology pharmacist competencies. Listeners can reflect on their oncology knowledge and skillset and use the Competencies to advance pharmacy practice.

By the end of the podcast, listeners will be able to:

• Highlight why CAPhO created a collection of the knowledge, skills, and attitudes required to be an oncology pharmacist in Canada.
• List 4 competencies expected of an oncology pharmacist in Canada.
• Describe 3 practical ways in which an oncology pharmacist can use the Competencies document intheir practice.

The ISOPP CAPhO 2025 Symposium took place from April 3-7th in beautiful Victoria, British Columbia, Canada. Delegates from all over the world travelled to participate, learn, and network, including Lindon Lin, from Australia. In this episode, Lindon will share their experience from an international lens, including differences in practices and what they took away from the symposium that could be shared locally.

Learning Objectives:

• Explain why CAPhO ISOPP was chosen to attend

• Reflect on the overall experience at CAPhO ISOPP in Victoria BC earlier this month

• Highlight symposium takeaways from an International delegate

• Discuss global oncology pharmacy practice from an Australian perspective

The ISOPP CAPhO 2025 Symposium will take place from April 3-7th in beautiful Victoria, British Columbia, Canada. With participants coming from over 25 countries, you can expect Victoria to have a different feel than our annual CAPhO Conferences.

The international ISOPP template will gather pharmacists and pharmacy technicians from around the world to showcase their practices. We are seeing interesting innovations coming forward that could benefit others in their local communities. It will be an exciting event!

About the Author: Tina Crosbie

Tina Crosbie has been a clinical hematology pharmacist at the Ottawa Hospital for over 25 years and at Extend Pharmacy for the past 6 years.

Her research aims to optimize drug administration and enhance patient education.

Tina evaluates pharmacy education programs for CCCEP and actively volunteers for CAPhO.

She is the chair of the upcoming ISOPP CAPhO 2025 Symposium in Victoria, BC.

When it comes to vaccine-preventable illnesses in patients with cancer, an ounce of prevention is worth a pound of cure! Listen to our podcast to learn how pharmacy professionals can help promote this public health measure in our highly vulnerable population.

Learning Objectives:

• Describe current recommendations for specific immunizations in patients receiving treatment for cancer
• Discuss considerations for immunizations in patients with cancer with respect to timing around treatment
• Understand the role of the pharmacist in ensuring patients are up to date on vaccines

About the Author: Irina Rajakumar

“In learning you will teach, and in teaching you will learn” – Phil Collins.  This simple song lyric couldn’t be more representative of oncology pharmacy.  The pace of advancement in this field requires the need for constant learning. We will explore how we can harness our expertise and ability to learn to become the teachers needed for others to excel in this area.

Learning Objectives:

• Explore the relationship between teaching and learning
• Appreciate why teaching is a necessary role for oncology pharmacy professionals
• Stimulate reflection on one’s own personal learning and teaching philosophy

About the Author: Melanie Danilak

AML treatment options have exploded in the past 10+ years including the approval of different regimens in the non-intensive management of the disease. This podcast will review current practices and considerations for infection prevention for patients treated with myelosuppressive AML regimens.

Learning Objectives:

• Describe the epidemiology, pathophysiology, and prognostic factors in the non-intensive management of AML
• Review the Canadian Landscape with a focus on current and emerging treatment options for the non-intensive management of AML
• Discuss current antimicrobial prophylaxis practices at different North American Oncology Centres
• Review current evidence for infection prophylaxis and drug interaction management in this population
• Review monitoring, following up and supportive care considerations for the Canadian Pharmacist

About the Author: Jonathan Stevens