Majority of oncologists in the United States have discussed or suggested the use of medical marijuana in cancer patients, although they are not confident about its benefits.

Results of a survey published May 10 in the Journal of Clinical Oncology showed that 80 percent of medical oncologists have discussed using medical marijuana with cancer patients, and 46 percent said they recommended it clinically.

The survey was conducted November 2016, where the researchers randomly sampled 400 medical oncologists. Only 63 percent of them participated in the study.

The study was meant to examine the oncologists' beliefs, knowledge, and practices regarding medical marijuana. Majority of the respondents viewed medical marijuana as helpful in managing pain and more effective in treating anorexia and cachexia, a cancer-related adverse event characterized by muscle weakness and sudden loss of weight.

"Better understanding the views, practices, and knowledgeability of oncologists regarding medical marijuana will help us understand both how important of an issue medical marijuana is in cancer care today and where the holes in scientific evidence, education, and policy are most pronounced," said lead author Dr. Llana Braun, the chief of Division of Adult Psychosocial Oncology at Dana-Farber Cancer Institute in Boston.

Discrepancy In Beliefs And Practice

The authors reported that there is a discrepancy between the doctors' knowledge of medical marijuana and their practices. Seventy percent of the participants said that feel unprepared to make clinical recommendations for the use of cannabis in the medical settings.

The use of medical cannabis is legal in 30 states including the District of Columbia, and cancer is a qualifying condition for its use except for one state.

Currently, there are no randomized controlled trials conducted to provide scientific evidence on the safety and efficacy of whole plant cannabis in cancer patients. Thus, oncologists have to rely on research conducted by pharmaceutical companies or to draw conclusions based on other patient outcomes.

"Ensuring that physicians have a sufficient knowledge on which to base their medical recommendations is essential to providing high-quality care," said coauthor Eric Campbell, a professor at the University of Colorado School of Medicine. "Our study suggests that there is clearly room for improvement when it comes to medical marijuana."

The study also found that patients mostly are the one to initiate discussions about medical marijuana. Dr. Jerry Mitchell, a medical oncologist at the Zangmeister Cancer Center in Ohio, said getting asked about marijuana is not surprising given the popularity of its byproducts.

Preclinical studies on the effects of cannabinoids in mice and rats have shown decreased tumor growth and activity, reduced risk and possibly treatment of colon cancer, cancer cell death in metastatic breast cancer, pain relief, and effective control of nausea and vomiting due to chemotherapy.

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