Background: Patients with cancer are increasingly using cannabis to alleviate symptoms of pain, nausea, insomnia, and appetite loss. Despite the increased popularity of cannabis, little is known about the patterns of use in the cancer population, efficacy in treating symptoms outside of small clinical studies, and out-of-pocket expenses. We assessed self-reported efficacy and patterns of cannabis use from patients with cancer registered with the Minnesota Cannabis Program (MCP). Methods: We conducted an anonymous survey from December 2021-January 2022 of 797 individuals with cancer-associated pain, nausea/vomiting and/or anorexia currently enrolled in the MCP who had purchased a cannabis related product in the preceding three months. The mailed survey included questions about cancer history, cannabis use, and changes in symptoms. We conducted a descriptive analysis to describe patterns of use. Results: 225 individuals responded to the survey after a single mailing for a 28% response rate. 70% reported using cannabis at least once prior to cancer diagnosis. Respondents had diverse cancer diagnoses (breast (24%), lung (14%), colorectal (10%), prostate (9%)) and were more often female (52%), married, (71%), white (95%), and retired (40%) with a median age of 62.0. Most respondents (46%) had stage IV disease with the remaining 34% stage 1-3 (20% unknown). Household income varied across respondents with 10% reporting annual income <$20,000, 39% between $50-100k, and 33% with incomes ≥100k. 88% purchased at least one product with THC:CBD (tetrahydrocannabinol/cannabidiol) composition >1. Respondents reported that oral products were preferred to vaporizers (81% vs 45%) and 75% reported at least daily use. 27% reported monthly average out of pocket expenses for cannabis of $100-200; with 31% spending ≥$200/mo. The Table outlines perceived change in symptoms amongst users. Conclusions: Patients with cancer in the MCP with recent cannabis purchases predominantly use high THC:CBD products delivered via oral or vaporizer route on daily basis. While out of pocket costs for these products can be significant, many respondents report significant improvements in cancer related symptoms.