As of March 2019, 33 states and Washington, D.C. have legalized medical marijuana, and 11 of those states (including D.C.) have also legalized recreational marijuana for adults over the age of 21. However, so long as marijuana continues to be a Schedule I drug at the federal level, it remains a thorny topic of discussion between physicians and their cancer patients. Though federal restrictions continue to limit the amount of research done on medical marijuana, patients' appetite for guidance from their physicians is growing.
Cancer patients' growing appetite for information
In our 2019 Cancer Patient Experience Survey, cancer patients ranked "information about medical marijuana" 2nd out of 13 support services they believed would've been most valuable during their experience with cancer. What's more, 83% of respondents to the American Society of Clinical Oncology's (ASCO) national opinion survey of nearly 5,000 adults in the United States indicated support for the use of medical marijuana among people with cancer. However, despite this clear interest, only 7% of cancer patients from ASCO's survey said they had discussed medical marijuana with their doctor—leaving thousands of patients in the dark on the potential benefits or risks of medical marijuana consumption. In the absence of clear direction from providers, patients are looking elsewhere for information.
Providers restricted in how much guidance they can give
Physicians have long kept their distance from navigating the legal and ethical minefield associated with medical marijuana. Federal restrictions limit research on marijuana's clinical safety and efficacy. To date, researchers have not conducted any large-scale clinical trials on marijuana—largely because of the onerous review processes and controlled nature of a federal Schedule I drug.
Given the absence of clinical research, physicians lack the requisite knowledge to have informed discussions with their patients—with 30% of them reporting insufficient knowledge to make recommendations on medical marijuana.
What does the limited research say about medical marijuana in oncology?
Though clinical research is limited, anecdotal evidence—along with a small set of studies, including recent research from the National Institute of Health—hypothesize potential reduction in pain and opioid use, as well as decreased nausea and vomiting and increased appetite for chemotherapy patients.
Creating space for a dialogue about medical marijuana is key
With studies and surveys showing that the majority of cancer patients are not receiving guidance from their care team about medical marijuana, oncologists and cancer programs need to be more proactive about broaching the subject with their patients. Some steps providers can take to support their patients include:
- Stay up to date with available literature on marijuana's benefits and risks;
- Know your state's marijuana legislation and the options for patients who obtain it legally;
- Encourage patients using medical marijuana to acquire it legally and through a reputable source;
- Inform patients of the limited research and what this means;
- Determine if your state offers any education or certification program for physicians;
- Reassure patients that they should feel comfortable telling you about medical marijuana use, so that you get a holistic picture of their treatment; and
- Review our blog post, What providers should know about the medical marijuana legal landscape.
Interested in what else patients are looking for from their cancer program?
Explore the results from The Cancer Patient Experience Survey in which we asked over 600 cancer patients diagnosed within the past five years about their priorities and preferences for care.