Published: Sat, May 12, 2018
Medicine | By Douglas Stevenson

Cancer docs feel unprepared, but recommend marijuana anyway

Cancer docs feel unprepared, but recommend marijuana anyway

Cancer professionals often discussed medical cannabis with clients and nearly half suggested marijuana for treatment, even though less than a third of the clinicians felt sufficiently informed, a national survey revealed.

Ilana Braun, chief of Dana-Farber Cancer Institute's Division of Adult Psychosocial Oncology in MA and lead author of the study, told Wired that despite this uncertainty, there at least "seemed to be clear consensus that medical marijuana is a good adjunct to standard pain treatment, so a good add-on medication".

Dr. Andrew Epstein, an oncologist with Memorial Sloan Kettering Cancer Center in New York City, said doctors may not have a full grasp of the issue, but that should not necessarily cause great concern.

Tennessee has become the second state to pass a law allowing pharmaceutical companies to market their products for off-label uses; a House panel advanced legislation that would expand access to private sector care outside of the Veterans Affairs (VA) health system; and almost half of oncologists recommend medical marijuana to their patients.

The findings of the new survey highlighted a problem faced by many cancer patients who are recommended medical marijuana but not provided expert guidance. Dr. Non-pharmaceutical medical marijuana, however, is often whole plant, containing hundreds of active ingredients, and thus can not easily be compared to pharmaceutical cannabinoids.

" A state may have made it legal for medical cannabis to be given, but an individual might not have the process in place to give it". Oncologists in states that have not legalized medical marijuana need education about the therapeutic alternatives that might be available, he added.

But no rigorous studies in cancer patients exist. The products might be "smoked, vaporized, ingested, taken sublingually, or applied topically".

No randomized trials have actually assessed medical cannabis for oncology indications.

Oral synthetic tetrahydrocannabinol received FDA approval for dealing with chemotherapy-induced queasiness and vomiting.

According to the European study, after 6 months of medical marijuana usage, over 93% of the subjects reported that their pain had decreased.

Recent clinical practice guidelines from the American Society of Clinical Oncology (ASCO) recognize knowledge gaps about medical marijuana use in oncology. A better understanding of the logistics surrounding medical marijuana also is needed.

Researchers mailed a survey to 400 practicing oncologists in the US, randomly selected from a national database of board-certified medical oncologists.

The investigators mailed surveys to 400 randomly selected medical oncologists.

Majority of oncologists in the United States feel they are less knowledgeable about the benefits of medical marijuana. Oncologists who had a high practice volume ( 0.001). More than 70% of the patients also presented an overall improvement in their condition, after medical cannabis therapy.

Yet two-thirds of oncologists surveyed believe that medical cannabis is an effective complement to standard pain management. Two thirds of the respondents said medical cannabis is equivalent to or better than basic medications for cachexia. When evaluating its effectiveness for other conditions, however, many oncologists responded, "I do not know", from 29 percent for nausea and vomiting to 45 percent for poor sleep.

As a result, oncologists are inclined to recommend cannabis based on anecdotal evidence.

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