Survey Says Oncologists Often Recommend Medical Marijuana, But Know Little About It

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While a majority of doctors (80 percent) discussed marijuana with their patients, nearly half of them (46 percent) recommended it for cancer-related problems.

Dr. Andrew Epstein, an oncologist with Memorial Sloan Kettering Cancer Center in New York City, said doctors may not have a full grasp of the issue, but that should not necessarily cause great concern. Regardless of this lack of understanding, around 80% of the doctors reported that they discussed cannabis treatments with their patients, and 46% still recommended these treatments. "Whatever they want to do to make themselves comfortable", said Pergam, who wasn't involved in the new research.

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. 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.

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The authors reported that there is a discrepancy between the doctors' knowledge of medical marijuana and their practices. Research on the plant's medicinal properties has increased dramatically in recent years, and there is now a substantial body of evidence supporting marijuana's effectiveness as a treatment for epilepsy and as an alternative to opioid use.

The study also reported that most of the oncologists' discussions about medical marijuana were initiated by the patients themselves. Dr. The items might be "smoked, vaporized, consumed, taken sublingually, or used topically".

No randomized trials have evaluated medical marijuana for oncology indications. However, cannabis has hundreds of active ingredients that have both synergistic and inhibitory "entourage effects", the authors noted, making comparisons between whole-plant medical marijuana and pharmaceutical cannabinoids that contain one or two ingredients. While considerable research has gone into the development of cannabinoid pharmaceuticals, much less has been completed on medical marijuana's utility in cancer and other diseases.

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According to the European study, after 6 months of medical marijuana usage, over 93% of the subjects reported that their pain had decreased.

The study was conducted in 2016 where the researchers randomly sampled 400 medical oncologists from across the country. 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.

Subsequently, 237 oncologists responded to the survey, forming the basis for data analysis.

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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). 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. 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%). 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.

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