Health Care

US cancer docs feel unprepared, but recommend marijuana anyway

US cancer docs feel unprepared, but recommend marijuana anyway

A new study published in the Journal of Clinical Oncology reports that while many oncologists are willing to discuss and even recommend medical cannabis to patients, the majority of them feel that they don't have enough knowledge about the plant medicine to make solid clinical recommendations.

"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.

The authors concluded that these findings "highlight a crucial need for expedited clinical trials exploring marijuana's potential medicinal effects in oncology (eg, as an adjunctive pain management strategy or as a treatment of anorexia /cachexia) and the need for educational programs about medical marijuana, to inform oncologists who frequently confront questions regarding medical marijuana in daily practice".

Having knowledge in medicine suggests "knowing what you understand, along with exactly what you have no idea", stated Andrew Epstein, MD, of Memorial Sloan Kettering Cancer Center in New York City City, who was not included with the research study.

A new survey indicates that oncologists often recommend or prescribe medical marijuana to their patients, although most know little about it, STAT reported. A better understanding of the logistics surrounding medical marijuana likewise is required.

The use of medical cannabis is legal in 30 states including the District of Columbia, and cancer is a qualifying condition for its use except for one state. Oncologists in states that have actually not legislated medical cannabis need education about the healing alternatives that might be offered, he added. The authors noted that the state laws encompass a complex topic, including terminology, biology, and formulations.

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.

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Medical cannabis is available in a variety of pressures and strengths, the authors continued. The products might be "smoked, vaporized, ingested, taken sublingually, or applied topically". As a result, oncologists must extrapolate from research on pharmaceutical cannabinoids or from evidence involving patients with other diseases and conditions.

Oral synthetic tetrahydrocannabinol received FDA approval for dealing with chemotherapy-induced queasiness and vomiting. Non-pharmaceutical medical marijuana, however, is often whole plant, containing hundreds of active ingredients, and thus can not easily be compared to pharmaceutical cannabinoids.

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

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

The investigators mailed surveys to 400 randomly selected medical oncologists.

A newly published survey chose to find out by asking 237 oncologists from across the country.

To date, no randomized clinical trials have examined whole-plant medical marijuana's effects in cancer patients, so oncologists are limited to relying on lower quality evidence, research on pharmaceutical cannabinoids or research on medical marijuana's use in treating diseases other than cancer. Oncologists who had a high practice volume ( 0.001).