Neuroblastoma and Medical Cannabis: What Research Shows
Neuroblastoma is a childhood cancer of young nerve cells, and medical cannabis does not treat it. Everything known about cannabinoids and neuroblastoma comes from cells in a dish and a few animal experiments, never from children in treatment. Any cannabis product, including CBD, belongs in a conversation with your child’s oncologist first, because it can interact with chemotherapy and supportive medicines.
Built on laboratory research published from 1995 to 2026: cell studies, animal work and a few studies in people.
When your child has neuroblastoma: the advice, promises and fears
A neuroblastoma diagnosis turns a family’s week upside down. Within days you are learning words like MYCN and MIBG, signing consent forms, and fielding messages from relatives who have “read something about cannabis oil.” This page sorts what is known from what is hoped, so you can bring clear questions to the people treating your child.
Searching at 2 a.m.
Many parents describe the same night: the child finally asleep, a phone in hand, and a search bar filling with “neuroblastoma survival rate,” “can neuroblastoma be cured,” “does CBD shrink tumors.” The results mix hospital pages, forum threads and product ads, often on the same screen.
Some of what you find will be accurate and frightening. Some will be hopeful and wrong. Both are hard to tell apart when you are exhausted, which is why the sections below say plainly what kind of evidence stands behind each claim.
Oils that promise a cure
Online sellers and well-meaning friends sometimes point to laboratory studies in which cannabinoids killed neuroblastoma cells. Those studies are real. What they show is narrower than the stories built on them: a cell in a dish, exposed to a measured concentration of one compound, with no immune system, liver or growing brain around it.
No cannabis oil has been shown to shrink neuroblastoma in a child. A product that promises to is making a claim nobody has tested.
A supplement the oncologist doesn’t know about
The quieter risk is the product given at home without telling the care team. Chemotherapy for neuroblastoma is dosed precisely, and several of its drugs are cleared by the same liver enzymes that process THC and CBD. Antioxidant supplements raise their own questions during treatment.
Oncologists ask about everything a child takes, including “natural” products, so they can keep doses safe. Telling them is not a confession. It is information they need.
What is neuroblastoma?
Neuroblastoma is a cancer that starts in neuroblasts, the immature nerve cells that build the sympathetic nervous system before birth. That system runs automatic body functions such as heart rate and blood pressure. Its tissue runs along both sides of the spine and inside the adrenal glands, the small glands that sit on top of the kidneys, so neuroblastoma most often begins in the belly, especially in an adrenal gland, and less often in the chest, neck or pelvis [1].
It is the most common cancer in babies under one year old. About 600 to 800 children are diagnosed in the United States each year, the average age at diagnosis is about 1 to 2 years, and most cases are found by age 5 [2]. It is rare after age 10.
Neuroblastoma
What it is: a malignant tumor made mostly of immature neuroblasts.
How it behaves: can grow and spread to bone, bone marrow, liver, lymph nodes and skin.
What it means: treatment depends on the risk group, from watchful waiting to intensive therapy.
Ganglioneuroblastoma
What it is: a mixed tumor with both immature and more mature nerve cells.
How it behaves: sits in the middle of the spectrum; some types act like neuroblastoma.
What it means: the pathology report on the tumor’s makeup guides the plan.
Ganglioneuroma
What it is: a benign tumor of fully matured nerve cells.
How it behaves: grows slowly and does not spread.
What it means: often treated with surgery alone, or simply watched.
So is neuroblastoma benign or malignant? Neuroblastoma itself is a malignant cancer, but it belongs to a family of tumors that runs from malignant to benign, and some infant tumors mature or shrink on their own.
Quick answers
Is neuroblastoma hereditary? Does it run in families?
Rarely. Most neuroblastomas are not inherited. In a small share of families, changes in the ALK or PHOX2B genes are passed from parent to child and raise the risk; children with Costello syndrome, Noonan syndrome or neurofibromatosis type 1 also have a higher risk [1].
If more than one family member has had neuroblastoma, or a child has tumors in more than one place, the care team may suggest genetic counseling.
How common is neuroblastoma, and how rare?
It is rare in absolute terms, with about 600 to 800 new cases a year in the United States, yet it is the most common cancer in infants under one year old [2].
How does neuroblastoma start? Can it begin before birth?
Neuroblasts normally mature into nerve cells or adrenal cells. Neuroblastoma starts when some of them keep dividing instead. Because neuroblasts form in the womb, the process can begin before birth, and some tumors are first seen on a prenatal ultrasound. Parents did not cause it: no habit in pregnancy has been shown to lead to neuroblastoma.
Can adults get neuroblastoma? Is it a brain cancer?
Adults can get it, but very rarely; the disease is rare after age 10 [2]. In adults it tends to grow more slowly and respond differently to treatment, so care usually involves a center that sees pediatric tumors.
Neuroblastoma is not a brain tumor. It starts in nerve tissue outside the brain, although it can occasionally spread to the bones of the skull or the area around the eyes. Searches for “neuroblastoma brain cancer in adults” usually mix it up with brain tumors that have similar-sounding names and are treated differently.
Can dogs get neuroblastoma?
Tumors of nerve and adrenal tissue are occasionally reported in dogs, but they are uncommon and handled by veterinary oncologists. Nothing on this page about children, medicines or cannabis applies to pets; cannabis products can poison dogs.
What are the symptoms of neuroblastoma?
Symptoms depend on where the tumor sits and whether it has spread. The most common are a lump in the belly, neck or chest and bone pain; less common are fever, shortness of breath, high blood pressure and severe watery diarrhea, and infants can have painless bluish lumps under the skin [1]. Many of these look like ordinary childhood illnesses, which is why the diagnosis often takes more than one visit.
Where is the tumor, or where has it spread?
Doctors’ reports name the place; pick the one you were told about, or read them all.
Belly and adrenal gland. A swollen or firm belly, a lump a parent feels during a bath, poor appetite, belly pain, or constipation when the tumor presses on the bowel or bladder. This is the most common starting place.
Chest. Cough, noisy breathing or shortness of breath, sometimes trouble swallowing. Tumors high in the chest can also cause Horner syndrome.
Neck. A lump in the neck that does not go away like a swollen gland would. A tumor here can press on nerves to the face and cause Horner syndrome: a drooping eyelid, a smaller pupil and less sweating on one side of the face.
Bones and bone marrow. Bone pain, limping, refusing to walk, irritability in a toddler who cannot say what hurts. When the marrow is involved, low blood counts can bring tiredness, pale skin, bruising and fevers.
Around the eyes. Dark circles or bruising around both eyes, sometimes called “raccoon eyes,” and eyes that bulge forward. Both come from spread to the bones around the eye sockets, not from an injury.
Hormone effects. Many neuroblastomas release catecholamines, the “fight or flight” hormones, which can raise blood pressure, speed up the heart or cause sweating. High blood pressure can also come from a tumor squeezing the artery to a kidney. A few tumors release a hormone that causes severe watery diarrhea. Rarely, the immune system’s reaction to the tumor causes fast, jerky eye movements and unsteady muscles (opsoclonus-myoclonus).
Does neuroblastoma cross the midline?
Often, yes. On scans, neuroblastoma tends to wrap around nearby blood vessels and grow across the middle of the body. That is one way doctors tell it apart from Wilms tumor, the other common belly tumor of early childhood, which starts inside the kidney.
| Feature | Neuroblastoma | Wilms tumor |
|---|---|---|
| Where it starts | Adrenal gland or nerve tissue along the spine | Inside the kidney |
| Crosses the midline | Often; wraps around blood vessels | Rarely; pushes vessels aside |
| Calcium on scans | Common (calcifications) | Uncommon |
| Usual age | Babies and toddlers | Usually a little older, in the preschool years |
How is neuroblastoma diagnosed and staged?
No single test diagnoses neuroblastoma. Doctors combine urine and blood tests, imaging and a biopsy, then test the tumor’s genes to decide the risk group [1]. Does neuroblastoma show in blood tests? Routine blood work can show low blood counts or other clues, but it cannot confirm the diagnosis on its own.
| Test | What it looks for | What it can’t tell you |
|---|---|---|
| Urine catecholamines (VMA, HVA) | Breakdown products of the hormones most neuroblastomas release | Where the tumor is or how far it has spread; some tumors release none |
| Blood tests | Blood counts, liver and kidney function, markers of tumor activity | Whether a tumor is neuroblastoma |
| Ultrasound, CT, MRI | Size and location of the tumor, calcium deposits, contact with vessels and organs | What kind of cells the tumor is made of |
| MIBG scan | Neuroblastoma cells anywhere in the body, using a tracer they absorb | Tumors that do not take up the tracer |
| Biopsy and bone marrow sample | The tumor’s cells under a microscope and its genes (MYCN, ALK) | How the child will respond to treatment |
Stages and risk groups
Most centers now stage neuroblastoma with the International Neuroblastoma Risk Group (INRG) system, which uses imaging before surgery [1]. The stage is then combined with age, the tumor’s appearance and its genes to place a child in a low, intermediate or high risk group.
| Stage | In plain words | Usual risk group |
|---|---|---|
| L1 | Tumor in one area, with no features on scans that make surgery risky | Most often low risk |
| L2 | Tumor in one area, with one or more features that make surgery risky (for example, wrapped around a vessel) | Low or intermediate, depending on genes and age |
| M | Spread to distant parts of the body, such as bone or bone marrow | Often high risk, especially after 18 months of age |
| MS | A child under 18 months with spread limited to skin, liver or bone marrow | Often low or intermediate; some of these tumors shrink on their own |
Words you may see in the pathology report
Homer Wright rosettes
A pattern the pathologist sees under the microscope: tumor cells arranged in a ring around a center of fine nerve fibers. It is a classic sign of neuroblastoma and related tumors. It helps name the tumor; it does not set the risk group.
MYCN amplification
Extra copies of a gene called MYCN in the tumor cells. Tumors with MYCN amplification tend to grow faster, and the finding usually moves a child into a higher risk group [1].
ALK
A gene that can be changed in the tumor, or rarely inherited. An ALK change matters because drugs that target ALK are being studied, and the care team may test for it [1].
Favorable and unfavorable histology
Histology is how the tumor tissue looks under the microscope. “Favorable” tumors look more mature for the child’s age and tend to behave better; “unfavorable” tumors look less mature and count toward a higher risk group.
Neuroblastoma ICD-10 code
ICD-10-CM, the U.S. diagnosis code set, has no single code for neuroblastoma: it is coded by where the tumor starts [3]. A tumor of the adrenal gland is usually coded in the C74.9 group, and a tumor of nerve tissue elsewhere in the C47 group. The exact code on insurance forms or a medical card application comes from the treating doctor’s records.
Can neuroblastoma be cured?
Yes, many children are cured, and the chance depends above all on the risk group. Low-risk and intermediate-risk neuroblastoma have a good chance of being cured [1]. High-risk neuroblastoma is harder to treat, and its outlook has improved as new treatments have been added.
Which risk group did the care team name?
It is written in the treatment plan; if you are not sure, it is a fair first question for the oncologist.
Low risk. Treatment is often surgery alone, or careful watching for some infants, with chemotherapy only if the tumor causes symptoms [1]. More than 95 out of every 100 children in this group live at least five years after diagnosis [4].
Intermediate risk. Usually several cycles of chemotherapy, with surgery when the tumor can be removed safely, and radiation for tumors that do not respond [1]. Around 95 out of every 100 children live at least five years [4].
High risk. Treatment comes in phases: intensive chemotherapy and surgery, then high-dose chemotherapy with a stem cell transplant and radiation, then maintenance with an antibody drug (dinutuximab) and isotretinoin [1]. Around 60 out of every 100 children live at least five years [4]. This is also the answer to “can a child survive stage 4 neuroblastoma”: many do, and the care team can say what the numbers mean for your child.
Relapsed or refractory. “Relapsed” means the cancer came back; “refractory” means it did not respond fully to treatment. There is no single standard plan; options include more chemotherapy, targeted radiation with MIBG, and clinical trials [1].
How long can you live with neuroblastoma?
Survival figures count children who are alive five years after diagnosis, and many live far longer: children cured of low-risk and intermediate-risk disease usually grow into adulthood. Five-year numbers also describe children treated years ago, so they trail behind today’s treatments. They cannot predict one child’s course.
Can neuroblastoma come back?
It can, and the risk is highest in high-risk disease, usually within the first few years after treatment. That is why follow-up visits, urine tests and scans continue long after treatment ends. Low-risk tumors rarely come back.
Where does your situation fit, and what should you ask next?
Twelve short questions about the patient, the diagnosis and the treatment so far. Your answers stay in this browser and shape a summary you can take to the oncologist.
12 questions · about a minute · your answers stay in this browser
Why are cannabinoids being studied in neuroblastoma?
Every person has an endocannabinoid system: a set of receptors, mainly CB1 and CB2, together with the body’s own cannabinoid-like messengers and the enzymes that make and break them down. It helps regulate pain, appetite, mood and how nerve cells grow. THC and CBD from the cannabis plant act on parts of this same system.
Neuroblastoma cells grow from developing nerve tissue, and in the lab they carry the CB1 receptor and other receptors cannabinoids can reach; researchers have also engineered them to carry extra CB1 or CB2 [5][6]. That is the whole reason researchers test cannabinoids on them: a receptor on a cancer cell is a possible handle. A handle is not a treatment, and most of the studies below were not designed to find one.
Which compound are you reading about?
Product labels and articles name them; pick one to see what lab studies did with it.
THC is the compound in cannabis that causes a high. In neuroblastoma cells it reduced cell survival, though at a higher concentration than CBN did [7]. Other cell work tracked how THC changes the cell’s proteins, or how its relative delta-8-THC switches on nerve-signaling genes, without testing it against cancer at all [8][9].
CBD does not cause a high. In two human neuroblastoma cell lines it triggered apoptosis, the cell’s built-in self-destruct program, through several receptors and small regulating molecules called microRNAs [10]. A larger protein-profiling study found CBD changed hundreds of proteins in the cells without settling whether that helps or harms [8].
CBN forms as THC ages. In one cell study it was the most potent of the plant cannabinoids tested against neuroblastoma cells [7]. It has not been studied in animals or people with neuroblastoma.
Whole-plant extracts combine many cannabinoids and plant compounds. High-CBD extracts killed neuroblastoma cells in a dish, and the effect weakened when vitamin E was added [11]. Which ingredient did the work is not known.
The body’s own cannabinoids, such as anandamide and 2-AG, slowed the growth of mouse neuroblastoma cells, more so when the enzymes that break them down were blocked [12]. Other work used them to study how the cells grow nerve-like branches [6].
Lab-made compounds are designed to hit one receptor. A compound that activates CB2 slowed tumors in mice carrying human neuroblastoma [13]. Others were research tools to map receptors and enzymes, and none of them is sold as a product [14][15][16].
What the research shows, from strongest to weakest
Medical evidence climbs a ladder. Cell studies come first, then animals, then people observed in real life, and finally clinical trials that test a treatment against a comparison. For cannabinoids and neuroblastoma, research has reached the second rung, and only once.
-
Cells in a dish
Many studies on human and mouse neuroblastoma cell lines, with THC, CBD, CBN, extracts and lab-made compounds.
Reached
-
Animals
One mouse study of a lab-made compound that targets CB2, not a cannabis product.
Reached
-
People observed
No study has followed children with neuroblastoma who used cannabinoids.
Not reached
-
Trials in children
No clinical trial has tested a cannabinoid as a neuroblastoma treatment.
Not reached
The highest rung reached: one mouse study of a lab-made compound [13].
Browse the studies yourself
Every cannabinoid study cited here. Neutral results are included.
Cannabis extracts, THC and CBN reduced neuroblastoma cell survival
Extracts and single cannabinoids lowered cell survival and switched on caspases 3 and 7, enzymes that carry out cell death. CBN worked at a lower concentration than THC [7].
Does not mean: that any of these amounts is safe or works in a child.
High-CBD cannabis extracts killed most cells in the dish
Extracts from high-CBD strains killed neuroblastoma cells and slowed their energy machinery. Adding vitamin E reduced the effect [11].
Does not mean: that an extract from a store has the same makeup or effect.
CBD and THC changed hundreds of proteins in the cells
A protein survey after a day of exposure showed shifts in energy production and in how the cell handles damaged proteins. The authors did not find an anticancer effect [8].
Does not mean: that these changes help or harm a patient.
Delta-8-THC switched on nerve-signaling genes
Cells grown to resemble nerve cells turned up genes for glutamate signaling after delta-8-THC [9]. The study used the cells as a model of neurons, not of cancer.
Does not mean: anything about treating neuroblastoma.
CBD triggered self-destruction in two cell lines
CBD set off apoptosis through serotonin and TRPV1 receptors and through microRNAs that control cell survival [10].
Does not mean: that CBD shrinks tumors in a body.
CB1 and CB2 receptors shaped how the cells grew branches
Cells with extra CB1 grew longer nerve-like branches than cells with extra CB2, and the body’s own cannabinoid 2-AG was far more plentiful than anandamide [6].
Does not mean: a treatment effect; this is basic biology.
A sugar-blocking drug moved the CB1 receptor inside the cell
Blocking how the cell attaches sugars to proteins reduced the usual form of CB1 and pushed more of it into the nucleus [5].
Does not mean: anything a patient can use.
The body’s own cannabinoids slowed cell growth
Anandamide and related messengers slowed mouse neuroblastoma cells, more when their breakdown enzymes were blocked [12].
Does not mean: that raising these messengers in a child is possible or safe.
A computer search pointed to CB2; a CB2 compound slowed tumors in mice
A data-mining tool flagged CNR2, the gene for the CB2 receptor, as a target in high-risk neuroblastoma. A lab-made CB2 activator, GW405833, slowed tumor growth in mice given 45 mg/kg a day [13].
Does not mean: that THC, CBD or any cannabis product does the same; the dose was for mice in a study, not a guide.
A drug meant to raise anandamide hit other targets
WOBE437 bound proteins its makers did not intend, and the results were inconclusive [14].
Does not mean: anything for treatment; it is a research tool.
Compounds blocking two enzymes had a neutral result
Molecules that block MAGL, an enzyme that breaks down 2-AG, and a DNA enzyme were tested on cell growth; the effect was not clear [15].
Does not mean: that this approach works.
Cannabinoid receptors switched on a signaling enzyme
Activating cannabinoid receptors moved an enzyme that makes the messenger cyclic GMP; a CB1 blocker stopped it [16].
Does not mean: a treatment effect; this maps how the receptor works.
Sandalwood oil compounds acted on the CB2 receptor
Compounds from sandalwood oil, and lab-made versions of them, bound CB2 and raised calcium inside the cells [17].
Does not mean: that sandalwood or any essential oil treats cancer.
Copaiba oil worked through CB2 with mixed results
Copaiba oil, rich in beta-caryophyllene, changed cell signaling through CB2 and lowered cell survival at higher concentrations [18].
Does not mean: that copaiba oil is a treatment.
No studies in this group.
How big is the effect?
In people, it has never been measured. No study reports how much a cannabinoid changes tumor size, survival or relapse in a child. The numbers that exist are lab concentrations.
Whole-plant extracts gave larger numbers in a dish: a high-CBD extract killed 72% of neuroblastoma cells and the synthetic cannabinoid WIN55,212-2 killed 76%, and vitamin E at 1 µM blunted the effect [11]. These are percentages of cells in one experiment, not response rates in patients.
What kinds of studies is this evidence built on?
Each row is one type of study, strongest at the top. The bar shows how many studies of that type exist; the number is printed at the end of the row. Gray bars are lab and animal work.
Show as a table
| Study design | Number of studies |
|---|---|
| Randomized trials in people | 0 |
| Case-control studies | 2 |
| Case reports | 1 |
| Animal studies | 2 |
| Cell and lab studies | 23 |
What science doesn’t know yet
The open questions are larger than the answers. The authors of these studies say so themselves, and their limitations are the reason no doctor can recommend cannabis against neuroblastoma. These are the main gaps that further research would have to close, and each of them is still unknown today.
- Whether any cannabinoid slows neuroblastoma in a living body: there is almost no animal work and none in people [13].
- How a child’s body absorbs, spreads and clears these compounds, and what amount would be safe; no pharmacokinetic or dosing data exist for this disease [11][8].
- Whether results from one or two cell lines, mostly SH-SY5Y, hold for the many genetic types of neuroblastoma [6][5].
- Which ingredient in a whole-plant extract does the work, since THC, CBD and minor cannabinoids were not separated [11].
- Why results disagree between models: one study in mouse cells contradicted earlier findings in other cells [14].
- How cannabinoids interact with the chemotherapy, antibody therapy and isotretinoin children actually receive.
Where neuroblastoma research is heading
The main lines of neuroblastoma cancer research are elsewhere. They include antibody therapy such as dinutuximab, drugs that target ALK, targeted radiation with MIBG and cell therapies being tested in trials [1]. Families can look up open studies on ClinicalTrials.gov, the U.S. registry of clinical trials [19], and the oncologist can say which ones fit.
No trial of a cannabinoid as a treatment for neuroblastoma is part of that picture today.
Can cannabinoids help with treatment side effects?
This is where cannabinoids have an established medical use, and it is separate from treating the tumor. The FDA has approved a few prescription medicines made from or modeled on cannabinoids: dronabinol (Marinol, Syndros), nabilone (Cesamet) and the CBD medicine Epidiolex [20]. Dronabinol and nabilone are used for nausea and vomiting from chemotherapy. They were studied mainly in adults, not in children with neuroblastoma, and the care team decides whether one fits.
Which side effect worries you most?
These are the side effects families most often ask about.
Nausea. Nausea from chemotherapy is the best-studied use: dronabinol and nabilone are prescribed for it when standard anti-nausea drugs are not enough. For children, oncologists usually start with standard anti-nausea medicines. Adults can read more on our nausea page.
Appetite and weight. Dronabinol is also approved for loss of appetite with weight loss in people with AIDS [20]. Children in treatment often need a dietitian and sometimes tube feeding; whether a cannabinoid adds anything for a child is for the team to judge.
Pain. Bone pain from neuroblastoma and pain after surgery are treated with standard pain medicines that are well understood in children. Research on cannabinoids for pain comes from adults with other conditions; see our chronic pain page.
Sleep. Hospital stays, steroids and worry all disturb sleep. Cannabinoids can cause drowsiness, but drowsiness is not healthy sleep, and in a child it adds to the sedation from other medicines. Adults can read our insomnia page.
Prescription cannabinoids
What it is: FDA-approved medicines such as dronabinol and nabilone, with a fixed dose in each capsule [20].
Who prescribes: the oncologist or another treating doctor, as part of the care plan.
Quality control: made and tested to federal drug standards.
Dispensary products with a card
What it is: cannabis products sold under a state medical program, in many forms and strengths.
Who prescribes: no one; a certifying physician recommends access, and the program sets the rules.
Quality control: state lab testing, which varies from state to state.
Is cannabis safe for a child in cancer treatment?
There is no safety data on cannabis for children with neuroblastoma. What is known comes from how these compounds work in general, from adult studies, and from what poison centers see. Three risks stand out for a child.
Sedation
THC and, to a lesser degree, CBD cause drowsiness. Many children in treatment already take anti-nausea drugs, opioids or sedatives that do the same, and the effects add up.
The developing brain
A young child’s brain is still wiring its endocannabinoid system. How regular THC affects that process in early childhood has not been studied, which is a reason for caution, not reassurance.
Accidental poisoning from edibles
Gummies and chocolates look like candy. A child who finds an adult’s edibles can become very drowsy or unresponsive and may need emergency care. Store any product locked and out of reach.
Drug interactions to discuss with the oncologist
Open each one. This is what is known, not a complete list.
Chemotherapy drugs cleared by liver enzymes Known from how drugs work
THC and CBD are processed by liver enzymes of the CYP450 family, which also clear several chemotherapy drugs. A cannabinoid can slow or speed that clearance, so a carefully set chemotherapy dose may end up too strong or too weak. The oncologist and pharmacist can check each drug.
Antioxidant supplements, including vitamin E Lab signal
In neuroblastoma cells, vitamin E reduced how strongly a cannabis extract killed the cells [11]. Antioxidants are also a common question during chemotherapy in general. Tell the team about every vitamin and supplement, not just cannabis.
Anti-nausea medicines and sedatives Known from how drugs work
Many anti-nausea drugs, antihistamines and sleep aids cause drowsiness. Cannabis adds to it. Combined, they can make a child hard to wake or unsteady.
Opioid pain medicines Known from how drugs work
Opioids and cannabis both slow the nervous system. Together they deepen drowsiness and can slow breathing. Any change to pain treatment goes through the care team.
No interactions in this group.
Who should not use cannabis for this
- Anyone hoping to replace or delay chemotherapy, surgery, radiation or immunotherapy.
- A child receiving any product the oncologist has not been told about.
- Children or adults taking several sedating medicines at once.
- Anyone pregnant or breastfeeding.
- People with a history of psychosis, or a strong family history of it, when THC is involved.
Next: talk to a licensed physician about whether any of these apply
Ways to use cannabis: what each form avoids
Cannabis is not only smoked. It is eaten, held under the tongue, applied to the skin and taken as prescription capsules, and each form avoids some risks and keeps others. This section describes them; choosing one is a conversation with a doctor, and for a child, with the oncologist.
How is it used, or how would it be?
Choose the closest; most people combine more than one.
Specific to smoking
Joints, blunts, pipes and bongs burn the plant, and the smoke irritates the throat and lungs. Not for a child, and not near one: secondhand smoke reaches a child with a weakened immune system.
Specific to vaping and dabbing
Dry-herb vaporizers, oil cartridges and dabbed concentrates avoid burning, but a hot aerosol still passes through the airways, and concentrates carry high THC. Not for a child.
Specific to edibles and capsules
Gummies, chocolates, drinks and capsules avoid the airways. They act later and last longer, and the compound passes through the liver before reaching the blood. A second dose taken because “nothing happened yet” is a common cause of too much, and edibles are the form children find by accident.
Specific to tinctures and sprays
Oils and tinctures held under the tongue, and mouth sprays, avoid the airways and let the dose be measured by drops. Part of the dose is still swallowed and goes through the liver.
Specific to topicals and patches
Creams and balms act mostly where they are applied. Transdermal patches are different: they deliver the compound into the blood, so interactions with medicines still apply.
Specific to prescription cannabinoids
Dronabinol, nabilone and the CBD medicine Epidiolex are FDA-approved drugs with fixed doses [20]. They come from a pharmacy on prescription, not from a dispensary with a medical card.
True of every form
THC acts the same once it is in the blood: drowsiness, dizziness, and in some people anxiety. Anything swallowed or absorbed meets the same liver enzymes that clear chemotherapy, and a product with only CBD carries different risks from one with THC. The choice of form, if any, belongs with the doctor.
Is neuroblastoma a qualifying condition for a medical card?
In many states, yes. Every state with a medical cannabis program keeps its own list of qualifying conditions, and cancer appears on most of them, sometimes with wording about its symptoms or its treatment. Neuroblastoma is a cancer, so it usually falls under that heading.
Whether a particular patient qualifies is confirmed by a physician who reviews the medical records, not by the diagnosis name alone. The rules also differ sharply depending on the patient’s age.
Who is the patient?
Programs treat patients under 18 differently in every state.
An adult patient. Adults with neuroblastoma, or adult survivors living with late effects of treatment, can usually apply in their own name. The path is an evaluation with a physician licensed in your state, a signed recommendation if you qualify, and registration with the state program. The steps are laid out below.
A child or teen. State laws handle minors separately. Where minors can be patients at all, a parent or legal guardian usually applies on the child’s behalf and registers as the child’s caregiver, the term most laws use, and many states require a second physician’s signature or a specialist’s certification. Some states limit minors to low-THC or CBD products.
The decision starts with the child’s oncologist. Read how the law treats cannabis and minors and the rules in your state’s cannabis laws.
Medical card or recreational purchase
In states that also sell cannabis to adults without a card, the two routes differ in more than paperwork.
| Aspect | With a medical card | Recreational |
|---|---|---|
| Taxes | Often exempt from some state cannabis taxes | Full cannabis taxes |
| Limits | Often higher purchase and possession limits | Lower limits |
| Products | Access to medical dispensaries and, in some states, stronger products | Retail products only |
| Age | Usually 18+; minors only through a parent or guardian where the law allows | 21+ |
| Physician involvement | A licensed physician reviews your condition and medicines | None |
| Document | A physician’s recommendation and a state card or registration | A government ID |
Will a card save you money?
Often, in states where medical patients skip some of the taxes recreational buyers pay. How much depends on the state’s tax rules and how much a patient buys; our guide to medical and recreational cannabis taxes walks through the differences.
What the program in your state involves
A medical program typically means a physician’s recommendation, registration with the state, and purchases at licensed medical dispensaries. Some states let patients or caregivers grow a small number of plants at home; others do not. A few states accept cards from other states; see which states accept out-of-state medical cards.
What a card does and does not protect
A state card protects patients under state law. It does not change federal law, and that matters in a few places:
- Firearms: federal law treats cannabis users as barred from buying or owning guns, card or not.
- Work: some states protect patients from being fired for off-duty use; jobs with federal rules or safety duties usually do not allow it.
- Privacy: state patient registries are confidential and are not shared with employers.
- School: a few states let parents or nurses give a student medical cannabis at school under strict rules; most do not.
Details for each state are in our laws and regulations guide.
More: cannabis laws by state
What this means if you are considering it
For a child with neuroblastoma, the next step is a conversation with the oncologist, not a product. For an adult patient or survivor, it may also be a medical evaluation. Either way, a short list of questions makes that conversation easier.
Questions to ask your child’s oncologist
Tap the ones you want to ask.
What to bring
An evaluation makes sense if
- The patient is an adult, or a minor in a state that allows it with a guardian.
- The oncologist knows and has no objection.
- The goal is relief of symptoms, not treatment of the tumor.
- You can share records and a full medicine list.
It is not the right step if
- The hope is to replace or delay cancer treatment.
- The oncologist has not been told.
- Symptoms are new, severe or getting worse.
- The patient is pregnant or breastfeeding.
This page is educational and does not replace your child’s oncologist. It does not diagnose or recommend treatment.
How to get a medical card online
Everything happens online; there is nowhere to drive. These steps are for an adult patient. For a patient under 18, state law sets a separate path through a parent or legal guardian.
Fill in the intake form
Your diagnosis, symptoms, medicines and state.
See a physician licensed in your state
A one-on-one appointment; you agree on the time with the physician, so keep an hour free rather than a minute.
Receive your signed recommendation
Only if the physician finds that you qualify.
Register with your state
Submit the recommendation to the state program, which issues the card.
What you end up with
Across 250 reviews from patients in the states where we are licensed. We do not sort them by score and do not hide the low ones.
- 150,000+patients evaluated – everyone who has been through an appointment with us, in every state where we are licensed
- Since 2017doing only this: online evaluations for medical cannabis programs, and nothing else on the side
A recommendation signed by a physician licensed in your state, and access to your state’s medical program once it registers you. Your recommendation and documents stay in your account. The physicians who review this page and see patients are listed on our doctors page; how the evaluation works is described on the medical card page.
Renewing your card
Medical cards expire, most often after a year, depending on the state. Renewal means a new evaluation and a new state registration before the old card runs out. Common renewal questions are answered in our medical card FAQ.
Questions people ask about neuroblastoma and cannabis
Can neuroblastoma be cured?
Yes, often. Low-risk and intermediate-risk neuroblastoma have a good chance of cure, and more than 95 out of 100 (low risk) and around 95 out of 100 (intermediate risk) of those children live at least five years [4]. High-risk disease is harder to treat, with around 60 out of 100 children living five years [4]. See outlook by risk group.
Is neuroblastoma fatal?
It can be, mostly in high-risk or relapsed disease, but many children survive and grow up. The risk group is the best guide, and your child’s oncologist can explain what it means for your child.
Does neuroblastoma come back?
It can, mainly in high-risk disease and usually in the first few years after treatment. Regular follow-up tests are designed to catch it early. Low-risk tumors rarely return.
Does neuroblastoma run in families?
Rarely. A small share of cases are linked to inherited changes in the ALK or PHOX2B genes [1]. Most children have no family history. See hereditary neuroblastoma.
Does neuroblastoma show in blood tests?
Not on its own. Blood tests can show clues such as low blood counts. Urine tests for catecholamine breakdown products, scans and a biopsy confirm it [1]. See how it is diagnosed.
Can adults get neuroblastoma?
Yes, but it is very rare after age 10 [2]. It is not a brain tumor. See neuroblastoma in adults.
Can a dog get neuroblastoma?
Similar nerve and adrenal tumors are occasionally seen in dogs, and a veterinary oncologist handles them. Cannabis products are toxic to dogs.
Can cannabis cure neuroblastoma?
No. Cannabinoids have harmed neuroblastoma cells in lab dishes and one lab-made compound slowed tumors in mice [7][13], but no study has tested cannabis as a treatment in children. See what the research shows.
Can a child get a medical marijuana card?
In some states, through a parent or legal guardian and often with a second physician’s approval; in others, not at all. Start with the oncologist and your state’s law. See qualifying with neuroblastoma.
Is CBD or delta-8 without a card the same thing?
No. Apart from one prescription CBD medicine, CBD and delta-8 products sold over the counter are not FDA-approved drugs, and the FDA has acted against companies selling them with health claims [20]. Their labels are not checked the way medicine labels are. They interact with medicines like any other cannabinoid. A medical program product is state-tested, and a prescription cannabinoid is a regulated drug.
More: medical card FAQ
More research on cannabis and neuroblastoma
This page cites a selection of studies. Our research library holds every study we track on cannabis and neuroblastoma, from laboratory work to clinical trials, and lets you filter them by cannabinoid, study type and year.
- studies
- 100+
- in people
- 30
- clinical trials
- 0
References
21 sources
- 1. National Cancer Institute. Neuroblastoma Treatment (PDQ), Patient Version. 2026.
- 2. American Cancer Society. Key Statistics for Neuroblastoma. 2026.
- 3. Centers for Disease Control and Prevention, National Center for Health Statistics. ICD-10-CM. 2026.
- 4. American Cancer Society. Survival Rates by Risk Group for Neuroblastoma. 2026.
- 5. Modulation of Endocannabinoid-Binding Receptors in Human Neuroblastoma Cells by Tunicamycin. DOI: 10.3390/molecules24071432 PMID: 30979007
- 6. Cannabinoid receptor subtype influence on neuritogenesis in human SH-SY5Y cells. DOI: 10.1016/j.mcn.2020.103566 PMID: 33049367
- 7. Effect of Cannabis sativa L. extracts, phytocannabinoids and their acetylated derivates on the SHSY-5Y neuroblastoma cells’ viability and caspases 3/7 activation. DOI: 10.1186/s40659-024-00506-0 PMID: 38802872
- 8. Proteome-Wide Profiling Using Sample Multiplexing of a Human Cell Line Treated with Cannabidiol (CBD) and Tetrahydrocannabinol (THC). DOI: 10.3390/proteomes11040036 PMID: 37987316
- 9. Δ8-THC Induces Up-Regulation of Glutamatergic Pathway Genes in Differentiated SH-SY5Y: A Transcriptomic Study. DOI: 10.3390/ijms24119486 PMID: 37298437
- 10. Role of miRNA in the regulation of cannabidiol-mediated apoptosis in neuroblastoma cells. DOI: 10.18632/oncotarget.26534 PMID: 30713602
- 11. Characterization of the Antitumor Potential of Extracts of Cannabis sativa Strains with High CBD Content in Human Neuroblastoma. DOI: 10.3390/ijms24043837 PMID: 36835247
- 12. Increasing antiproliferative properties of endocannabinoids in N1E-115 neuroblastoma cells through inhibition of their metabolism. DOI: 10.1371/journal.pone.0026823 PMID: 22046372
- 13. Integrative discovery of treatments for high-risk neuroblastoma. DOI: 10.1038/s41467-019-13817-8 PMID: 31900415
- 14. Chemical Proteomics Reveals Off-Targets of the Anandamide Reuptake Inhibitor WOBE437. DOI: 10.1021/acschembio.2c00122 PMID: 35482948
- 15. Dual inhibition of MAGL and type II topoisomerase by N-phenylmaleimides as a potential strategy to reduce neuroblastoma cell growth. DOI: 10.1016/j.ejps.2011.11.011 PMID: 22127371
- 16. Cannabinoid receptor-mediated translocation of NO-sensitive guanylyl cyclase and production of cyclic GMP in neuronal cells. DOI: 10.1016/j.neuropharm.2007.06.027 PMID: 17707868
- 17. Cannabinoid Receptor Type II Ligands from Sandalwood Oil and Synthetic α-Santalol Derivatives. DOI: 10.1021/acs.jnatprod.3c00282 PMID: 37450763
- 18. Fast-Acting and Receptor-Mediated Regulation of Neuronal Signaling Pathways by Copaiba Essential Oil. DOI: 10.3390/ijms21072259 PMID: 32218156
- 19. U.S. National Library of Medicine. ClinicalTrials.gov. 2026.
- 20. U.S. Food and Drug Administration. FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD). 2026.
- 21. Alex’s Lemonade Stand Foundation. Alex’s Lemonade Stand Foundation for Childhood Cancer. 2026.