June 25, 2018

Doctors Are Recommending Cancer Patients Marijuana Despite Not Knowing Enough

12 May 2018, 05:20 | Silvia Roy

Doctors Are Recommending Cancer Patients Marijuana Despite Not Knowing Enough


As of the JCO article's publication date, 30 states and the District of Columbia had legalized use of marijuana for medical purposes, and all but one of the laws included cancer as a qualifying condition. The research published online today in the Journal of Clinical Oncology. A better understanding of the logistics surrounding medical marijuana likewise is required. Jerry Mitchell, a medical oncologist at the Zangmeister Cancer Center in OH, said getting asked about marijuana is not surprising given the popularity of its byproducts.

California enacted the United States' first medical marijuana law in 1996, and today its use is legal in more than 30 states, nearly all which list cancer as a qualifying condition. By contrast, cannabinoid pharmaceuticals, which are available with a prescription through a pharmacy, contain no more than a couple of active ingredients. Non-pharmaceutical medical marijuana, however, is often whole plant, containing hundreds of active ingredients, and thus can not easily be compared to pharmaceutical cannabinoids. Jerry Mitchell, a medical oncologist at the Zangmeister Cancer Center in OH, stressed on the problem of "a big knowledge gap", explaining that the scarcity of randomized controlled trials can put doctors in a tough spot.

Medical marijuana comes in a variety of strains and potencies, the authors continued.

Previous surveys of oncologist attitudes about medical marijuana addressed only use as an antiemetic and were conducted prior to passage of current laws.

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Most cancer doctors say they don't know enough about medical marijuana to provide an informed opinion to patients.

Almost half of USA cancer doctors who responded to a survey say they've recently recommended medical marijuana to patients, although most say they don't know enough about medicinal use. For them, therapeutic cannabis is just as effective as the conventional medication against the side effects of chemotherapy such as pains, nausea or lack of appetite. The survey consisted of 30 questions that attempted to shed light onto oncologists' views and practices with medical marijuana, including whether or not they discussed it's use with their patients, recommended it, and how informed they felt in making recommendations concerning medical marijuana. The survey also indicated that the majority of conversations about medical marijuana were initiated by the patient.

Among those who said they recommended marijuana, 56 percent said they did not have sufficient knowledge to do so.

Recommendations: Nearly half (46 percent) recommended medical marijuana use to patients in the past year. Majority of the respondents viewed medical marijuana as helpful in managing pain and more effective in treating anorexia and cachexia, a cancer-related adverse event characterized by muscle weakness and sudden loss of weight.

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The proportion of oncologists who responded "I don't know" regarding medical marijuana's effectiveness varied by indication, from 27.6% for poor appetite/cachexia to 45.1% for poor sleep.

Geographic location: Oncologists practicing in the Western United States were more likely to have discussed (95 percent) or recommended (84 percent) medical marijuana, and oncologists practicing in the South were least likely (69 percent and 35 percent, respectively).

After analyzing responses from the nationally representative sample of oncologists, there was "a concerning discrepancy" between their knowledge and practices.

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