Published: Sat, May 12, 2018
Medicine | By Brett Sutton

Many Oncologists Discuss, Recommend Medical Marijuana

Many Oncologists Discuss, Recommend Medical Marijuana

The study specifically focused on medical marijuana, defined as non-pharmaceutical cannabis products that providers recommend for therapeutic use and did not include pharmaceutical grade cannabinoids. The research published online today in the Journal of Clinical Oncology. "While this topic is common, however, data on medical marijuana use is less so". "The scientific evidence base supporting use of medical marijuana in oncology remains thin", Braun said.

Cancer patients are pretty much the only people who are guaranteed access to medical marijuana in states where it's legal.

"[The findings] highlight a crucial need for expedited clinical trials exploring marijuana's potential medicinal effects in oncology. and the need for education programs about medical marijuana to inform oncologists who frequently confront questions regarding medical marijuana in practice", the authors concluded.

Recent clinical practice guidelines from the American Society of Clinical Oncology (ASCO) recognize knowledge gaps about medical marijuana use in oncology. "Our study suggests that there is clearly room for improvement when it comes to medical marijuana".

The investigators mailed surveys to 400 randomly selected medical oncologists. However, cannabis has hundreds of active ingredients that have both synergistic and inhibitory "entourage effects", the authors noted, making comparisons between whole-plant medical marijuana and pharmaceutical cannabinoids that contain one or two ingredients. The survey questioned whether they discussed medical marijuana with their patients, whether they recommended it, and how informed they felt in doing so. Respondents were also asked about their views on the effectiveness of medical marijuana for cancer-related symptoms such as pain, nausea and vomiting, depression, anxiety, poor appetite, poor sleep, and general coping, as well as its risks compared to other treatments.

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.

Veterans Affairs Reform Bill Earlier this week, a House panel advanced legislation that would expand the number of veterans who are eligible to see private health specialists and would entitle veterans enrolled in the Veterans Affairs (VA) health system to see a private doctor twice a year without a co-pay, according to The Hill. However, a latest survey revealed that nearly half of the respondents recommended cannabis for their cancer patients.

The study found that about two-thirds of oncologists in states where medical marijuana is legal believe that medical marijuana is beneficial when used in combination with standard treatments for symptoms such as pain, poor appetite and weight loss.

The proportion of oncologists who reacted "I do not know" concerning medical cannabis's effectiveness varied by indicator, from 27.6% for poor appetite/cachexia to 45.1% for bad sleep.

The U.S. National Institute on Drug Abuse has more about medical marijuana.

- Type of practice: Respondents practicing outside a hospital setting were more likely to recommend medical marijuana than hospital-based oncologists (54% vs. 35%). "These findings are clinically important and suggest critical gaps in research, medical education, and policy regarding medical marijuana". "I think marijuana has a lack of evidence behind some things for benefit and may have some downsides, but I do not think marijuana, per se, is a highly risky therapy", Epstein said. "We also need to extend our survey to other specialties, and to patients with cancer".

"In this study, we identified a concerning discrepancy: although 80% of the oncologists we surveyed discussed medical marijuana with patients and almost half recommended use of the agent clinically, less than 30% of the total sample actually consider themselves knowledgeable enough to make such recommendations", said Ilana Braun, MD, chief of Dana-Farber Cancer Institute's Division of Adult Psychosocial Oncology. More research needs to be done so that doctors can recommend products with the proper knowledge.

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