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12 May 2018, 06:59 | Melissa Porter
Doctors Are Recommending Cancer Patients Marijuana Despite Not Knowing Enough: Study
But eight out of 10 cancer doctors said they've discussed medical marijuana with patients in the past year, and 46 percent have gone so far as to recommend its use in cancer treatment.
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. Nearly 80% of the conversations were initiated by patients, as reported online in the Journal of Clinical Oncology (JCO).
The study raises questions about the present evidence base for medical marijuana and mentions a need for more research to examine the benefit-burden ratio for medical marijuana as compared to other treatments for cancer and cancer-related adverse effects, included Epstein, who is a clinical expert for the American Society of Medical Oncology. "While this topic is common, however, data on medical marijuana use is less so".
Braun plans to conduct clinical trials to study the effects of medical marijuana for symptoms related to cancer.
The term "medical cannabis" refers to nonpharmaceutical marijuana items that healthcare providers may suggest for restorative functions that adhere to state law. A significant proportion of medical marijuana products are whole-plant marijuana, which contains hundreds of active ingredients with complicated synergistic and inhibitory interactions.
After analyzing responses from the nationally representative sample of oncologists, there was "a concerning discrepancy" between their knowledge and practices. The guidelines note insufficient evidence to recommend medical marijuana for initial management of chronic pain in cancer survivors, although evidence suggests it is worthy of consideration as an adjuvant analgesic and for managing pain conditions that are hard to treat. Evidence also remains insufficient to recommend medical marijuana for the prevention of nausea and vomiting in patients with cancer who receive chemotherapy or radiation therapy. Of the 237 participants who responded, more than half (55 percent) practice in states where medical marijuana is legal.
There is now a lack of high-quality evidence that supports the use of medical cannabis for cancer-related illnesses which could be why so many oncologists feel ill-equipped to discuss or recommend products to their patients. A third of the doctors surveyed were convinced that cannabis was more effective than traditional pain medication, another third felt that it was less effective, with the remaining third saying they simply didn't know.
All 29 states with medical marijuana programs allow doctors to recommend it to cancer patients.
Cancer doctors appropriately consider medical marijuana as an adjunct therapy to be used alongside other established treatments, Epstein said. Of those who made recommendations, however, 56 percent reported they did not feel sufficiently informed about its medicinal use. Almost two-thirds (65 percent) also viewed it as equally or more effective than standard treatments for poor appetite and extreme weight loss.
Type of practice: Respondents practicing outside a hospital setting were more likely to recommend medical marijuana than hospital-based oncologists (54 percent vs. 35 percent). Braun and colleagues sought to obtain contemporary information about oncologists' views and knowledge about clinical use of medical marijuana.