Most oncologists feel unprepared to recommend medical cannabis for cancer treatment, study says
A new survey among oncologists or cancer doctors in the United States has found that majority say that they do not know enough about medical cannabis.
The study, which was published last week in the Journal of Clinical Oncology, found that most oncologists feel unprepared to treat their patients using medical marijuana. Despite this, however, nearly half of the respondents said that they have recently recommended the drug to their patients.
The researchers mailed 400 randomly selected medical oncologists in 2016 and asked them questions about their level of knowledge about medical cannabis, their prescription practices, and whether they recommend, discuss, and feel sufficiently informed about the drug. The respondents were also asked about their views on the comparative effectiveness of medical cannabis when it comes to several conditions, as well as the risks involved in comparison to prescription opioids.
The authors wrote that the overall response rate was 63%. Meanwhile, only 30% of the doctors surveyed felt that they were sufficiently informed to make recommendations with regard to medical cannabis treatment for their patients.
Despite the fact that majority felt they lacked sufficient cannabis information, 80% of the oncologists had conducted discussions with their patients about medical cannabis and nearly half – 46% – recommended medical cannabis to at least one patient in the past year for the treatment of pain and other symptoms associated with cancer.
And among those who claimed that they had recommended cannabis, 56% admitted that they did so even without having sufficient knowledge about the drug.
The problem: lack of rigorous research and trials on medical cannabis
The authors noted that one of the biggest reasons why doctors are not sufficiently informed about cannabis is because there is not enough research about it. The classification of cannabis as a Schedule I drug in the U.S. – which places it as a dangerous and strictly prohibited drug – makes research and clinical studies difficult to conduct.
The authors of the study also wrote that the results reflect how cannabis policies in certain states have outpaced research. There are already 29 states in the country that have legalized medical cannabis and have adopted medical cannabis programs, allowing doctors to recommend the drug to cancer patients. Because of the lack of rigorous clinical studies, doctors are left to make assumptions from available studies – including studies using animal models and studies on similar prescription drugs.
According to Dr. Ilana Braun of Dana-Farber Cancer Institute in Boston, Massachusetts, who led the study, the big takeaway is that we simply need more research.
The study also found that patients are interested to know what their doctors think about cannabis as a treatment option. The oncologists revealed to the researchers that conversations regarding medical cannabis were almost always initiated by the patients themselves or by their families, and not by the doctors.
Lack of trials is not the only reason
When it comes to the use of medical cannabis as a treatment for cancer, a lack of trials isn’t the only problem. There’s also the fact that the drug is not yet studied in medical school.
According to two Harvard Medical School students, medical schools have yet to include cannabis in their curriculum. Andreas Mitchell and Suhad Gondi wrote in an op-ed for Stat News that most physicians-in-training are not being equipped to have informed conversations about medical cannabis with their patients, let alone recommend the drug as a treatment option.
Moreover, a 2017 study said that there are only 9% of medical schools that currently teach their med students about medical cannabis. It also found that about 90% of medical residents and fellows did not feel prepared to recommend medical cannabis.