Doctors Are Recommending Cancer Patients Marijuana Despite Not Knowing Enough

Cancer Docs: We Need More Research on Medical Marijuana

This is the first USA national survey on the subject since the use of medical cannabis was authorized in the United States.

"Unfortunately, at this time, the evidence base to support medical marijuana's efficacy in oncology is young", Braun says. In the 22 intervening years, however, no randomized clinical trial has investigated the utility of whole-plant medical marijuana to alleviate symptoms such as pain, insomnia, or nausea and vomiting in patients with cancer. However, cannabis has numerous active components that have both synergistic and repressive "entourage results", the authors kept in mind, making comparisons between whole-plant medical cannabis and pharmaceutical cannabinoids that contain a couple of components.

Many studies have explored the use of pharmaceutical cannabinoids, which are highly refined, quality-controlled products consisting of one or two active ingredients and available through a pharmacy.

The private investigators sent by mail studies to 400 randomly chosen medical oncologists.

The researchers found that only 30% of oncologists felt sufficiently informed to make recommendations regarding MM. 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.

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

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Seven out of 10 oncologists surveyed in the United States said they aren't informed enough about the risks and benefits of medical marijuana to recommend its use to patients, according to findings published May 10 in the Journal of Clinical Oncology. 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. 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.

- Physician discussions: 80% reported discussing medical marijuana with patients, and 78% reported that these conversations were most frequently initiated by patients and their families. However, a latest survey revealed that nearly half of the respondents recommended cannabis for their cancer patients. Roughly two-thirds of respondents viewed MM as a helpful adjunct to standard pain management strategies; a similar proportion viewed MM as equally or more effective than standard treatments for anorexia/cachexia.

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%). More than 70% of the patients also presented an overall improvement in their condition, after medical cannabis therapy. "These findings are clinically important and suggest critical gaps in research, medical education, and policy regarding medical marijuana". More research needs to be done so that doctors can recommend products with the proper knowledge.

"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.

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