Emerging evidence suggests that cannabis may exert immunosuppressive effects, particularly through the modulation of T-cell function, which plays a crucial role in cancer immunosurveillance [3]. The endocannabinoid system may also promote tumor progression, especially in gastrointestinal malignancies [4]. While cannabinoids have demonstrated some anti-neoplastic properties in preclinical studies, their effects in human cancer populations remain complex and poorly understood [5]. Behaviorally, CUD is associated with increased psychiatric burden, including depression and anxiety, which can negatively influence cancer treatment adherence and prognosis [6]. Patients with substance use disorders, including CUD, are at higher risk for delayed diagnoses, suboptimal medical engagement, and lower adherence to recommended oncologic treatments [7].