Cancer Doctors Recommend Medical Marijuana Without Being Fully Informed

By Paul Gaita 05/17/18

A new study explored the discrepancy between oncologists' understanding of medical marijuana and their recommendation rate.

doctor speaking to patient

A new study has found that a vast majority of oncologists (doctors who specialize in cancer treatment) discuss the use of medical marijuana with patients, and nearly half of that group recommends it as treatment, but less than a third regard themselves as well-versed enough on the subject to make such a suggestion.

The study also suggested that the disparity between understanding and recommendation was due in part to an increase in medical marijuana's availability to patients, and in particular, to cancer patients, who qualify for its use in most states, combined with a perceived lack of evidence that supports its use for oncology treatment.

Providing more concrete evidence for medical marijuana use in the form of randomized clinical trials could be key to reversing this trend, according to the study authors.

The study, published in the May 2018 edition of the Journal of Clinical Oncology, is the first nationally representative survey of medical oncologists in regard to attitudes toward and knowledge of medical marijuana since it became legal at the state level.

To conduct their research, the study authors—from the Dana-Farber Cancer Institute, Harvard Medical School and Brigham and Women's Hospital in Boston, among other institutions—mailed a survey to a random nationwide sample of 400 medical oncologists.

Among the issues addressed in the survey were oncologists' opinions on how effective they felt medical marijuana was for a variety of conditions, including pain management, and what risks they believed were possible from its use.

Responses were collected from 63% of the oncologists who received the survey, and among the key findings was that while 80% of respondents conducted a discussion about medical marijuana with their patients, and 46% recommended its use for treatment, only 30% could state that they felt "sufficiently informed to make recommendations regarding medical marijuana."

Despite this schism, an additional 67% viewed it as a helpful element of pain management treatment, and 65% considered it equally or more effective as a treatment for anorexia and cachexia, or wasting syndrome.

Study co-author Ilana Braun, MD, chief of Dana-Farber Cancer Institute's Division of Adult Psychosocial Oncology, said that the divide between understanding and recommendation in regard to medical marijuana is a unique scenario.

"We can think of few other instances in which physicians would offer clinical advice about a topic on which they do not feel knowledgeable," she said.

According to Braun, legalization efforts may be at the heart of the discrepancy: "Medical marijuana is legal in over half the states, with cancer as a qualifying condition in the vast majority of laws, yet the scientific evidence base supporting use of medical marijuana in oncology remains thin."

According to Science Daily, no randomized clinical trials have looked at the effect of whole-plant medical marijuana in cancer patients, so doctors must rely on research into pharmaceutical cannabinoids or medical marijuana use on other diseases.

Study co-author Eric G. Campbell, a professor at the University of Colorado School of Medicine, said that improved research should provide more thorough data for doctors to make decisions.

"Ensuring that physicians have a sufficient knowledge on which to base their medical recommendations is essential to providing high quality care," he said.

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Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, and The Los Angeles Beat, among many other publications and websites.