Medicine

US cancer docs feel unprepared, but recommend marijuana anyway

US cancer docs feel unprepared, but recommend marijuana anyway

Overall, almost eight in 10 cancer doctors reported having discussed marijuana with patients or their families, with 46 percent recommending it for pain and other cancer-related problems to at least one patient in the past year.

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.

Many oncologists recommend medical marijuana (MM) clinically despite not feeling sufficiently knowledgeable about its utility, according to a study published online May 10 in the Journal of Clinical Oncology.

"A state might have made it legal for medical marijuana to be dispensed, but an individual might not have the process in place to dispense it". 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.

In the United States, cancer is one of the conditions that allows patients access to medical marijuana. 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.

But no rigorous studies in cancer patients exist.

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

But for other ailments, the medical powers of cannabis are less certain.

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Oral synthetic tetrahydrocannabinol received FDA approval for treating chemotherapy-induced nausea and vomiting. Two thirds of the respondents said medical cannabis is equivalent to or better than basic medications for cachexia.

The authors reported that there is a discrepancy between the doctors' knowledge of medical marijuana and their practices.

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

Of the 400 oncologists in the sample, 376 responded to the survey (overall response rate of 63%).

Beliefs on potential benefit: More than two-thirds (67 percent) believed medical marijuana to be a helpful treatment for alleviating pain, when used together with standard therapies, and a majority viewed it as presenting a lower risk than opioids for overdose death (75 percent) and addiction (52 percent).

Size of practice: Oncologists who saw the most patients each week were more likely to have discussed medical marijuana than those who saw the least patients (89 percent vs. 70 percent). A minority said medical cannabis was at least equivalent to basic therapy for nausea and vomiting (48.4%), stress and anxiety (45.8%), coping (40.3%), and poor sleep (34.9%).

Recent clinical practice guidelines from the American Society of Clinical Oncology (ASCO) recognize knowledge gaps about medical marijuana use in oncology. One or more co-authors disclosed relationships with UpToDate and Wolters Kluwer, and compensation for expert testimony.


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