Qiu WS, Chen HD, Yang WJ, Chen MM. Paradox of protection: Re-examining cannabis use disorder in sepsis outcomes among cancer patients. World J Crit Care Med 2025; 14(4): 106085 [DOI: 10.5492/wjccm.v14.i4.106085]
Corresponding Author of This Article
Wu-Si Qiu, PhD, MD, Associate Chief Physician, Associate Professor, Department of Neurosurgery, The Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Gongshu District, Hangzhou 310012, Zhejiang Province, China. shihai954@163.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Letter to the Editor
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 9, 2025 (publication date) through Dec 6, 2025
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Publication Name
World Journal of Critical Care Medicine
ISSN
2220-3141
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Qiu WS, Chen HD, Yang WJ, Chen MM. Paradox of protection: Re-examining cannabis use disorder in sepsis outcomes among cancer patients. World J Crit Care Med 2025; 14(4): 106085 [DOI: 10.5492/wjccm.v14.i4.106085]
Wu-Si Qiu, Hao-Dong Chen, Wen-Jie Yang, Department of Neurosurgery, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, Zhejiang Province, China
Ming-Min Chen, Department of General Practice, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Co-corresponding authors: Wu-Si Qiu and Ming-Min Chen.
Author contributions: Qiu WS and Chen MM designed the study; Qiu WS, Chen HD, Chen MM, and Yang WJ performed references acquisition and interpretation; Qiu WS, Chen HD, and Chen MM wrote the manuscript; Qiu WS, Chen HD, and Yang WJ critically revised it for important intellectual content. Qiu WS and Chen MM made equal contribution to the study; All authors have read and approved the final manuscript.
Supported by the Scientific Research Fund of Hangzhou Health Department, China, No. A20251639.
Conflict-of-interest statement: All authors declare no conflicts of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wu-Si Qiu, PhD, MD, Associate Chief Physician, Associate Professor, Department of Neurosurgery, The Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Gongshu District, Hangzhou 310012, Zhejiang Province, China. shihai954@163.com
Received: February 17, 2025 Revised: April 16, 2025 Accepted: June 20, 2025 Published online: December 9, 2025 Processing time: 286 Days and 8.9 Hours
Abstract
The intersection of cannabis use disorder (CUD) and critical illness outcomes in cancer patients represents a burgeoning area of research, particularly as cannabis legalization and therapeutic applications expand globally. Adjusted analyses of a retrospective cohort study by Sager et al revealed significantly lower odds of all-cause mortality (adjusted odds ratio (aOR) = 0.83) and respiratory failure (aOR = 0.8) in CUD-positive patients, alongside elevated hospitalization costs. These findings suggest the potential immunomodulatory and organ-protective effects of cannabinoids on sepsis. Future research must prioritize mechanistic studies, prospective clinical trials, and socioeconomic interventions to translate these findings into actionable clinical strategies, to align policy recommendations with guidelines, including those presented by the National Comprehensive Cancer Network.
Core Tip: This letter critiques a recent study revealing reduced sepsis mortality in cancer patients with cannabis use disorder. We highlight methodological limitations (e.g., coding bias and lack of dosage data) and propose future directions, including mechanistic studies on cannabinoid immunomodulation and policy reforms to address socioeconomic disparities. Key innovations include reconciling paradoxical findings through updated preclinical evidence, equitable policy frameworks to translate findings into clinical practice, and aligning policy recommendations with consensus and guidelines (e.g., National Comprehensive Cancer Network).
