State legislatures are following suit; medical
cannabis is legal in 23 states and the District
of Columbia, and more than a dozen other
states allow some patients access to certain
potency levels of the drug if a physician
documents that it’s medically necessary, or if
the sick person has exhausted other options.
A large number of these patients have cancer,
and many who gain access to medical
marijuana report that it works.
“A day doesn’t go by where I don’t see a
cancer patient who has nausea, vomiting, loss
of appetite, pain, depression and insomnia,”
says Dr. Donald Abrams, chief of
haematology-oncology at San Francisco
General Hospital and a professor of clinical
medicine at the University of California, San
Francisco.
Marijuana, he says, “is the only anti-nausea
medicine that increases appetite.”
It also helps patients sleep and elevates their
mood—no easy feat when someone is facing
a life-threatening illness. “I could write six
different prescriptions, all of which may
interact with each other or the chemotherapy
that the patient has been prescribed.
Or I could just recommend trying one
medicine,” Abrams says.
A 2014 poll conducted by Medscape and
WebMD found that more than three-quarters
of U.S. physicians think cannabis provides
real therapeutic benefits. And those working
with cancer patients were the strongest
supporters: 82 percent of oncologists agreed
that cannabis should be offered as a treatment
option.
Dr. Benjamin Kligler, associate professor of
family and social medicine at Albert Einstein
College of Medicine, says there has been
enough research to prove that at a bare
minimum cannabis won’t actually harm a
person.
In addition, “given what we've seen
anecdotally in practice I think there's no
reason we shouldn't see more integration of
cannabis in the long run as a strategy,” he
says. “We have this extremely safe, extremely
useful medicine that could potentially benefit
a huge population.”
Some years ago, Dr. Gil Bar-Sela, director of
the integrated oncology and palliative care
unit at the Rambam Health Care Campus in
Haifa, Israel conducted two rounds of phone
interviews with 131 cancer patients who used
cannabis while in chemotherapy; just less
than 4 percent of participants reported that
they experienced a worsening of symptoms
when they started using cannabis and the
majority said it helped, according to the
resulting paper published, in Evidence-Based
Complementary and Alternative Medicine in
2013.
But self-reported data like this is limited when
it comes to proving the clinical impact of
cannabis.
Patients may be biased in their opinions that
cannabis is effective, may not accurately
document their use of the drug, or may
confuse the effects with those of the cancer
treatment. In addition, symptoms such as pain
are subjective and difficult for a physician to
measure.
A paper published recently in JAMA analysed
the findings of 79 studies on cannabinoids for
a variety of indications, including nausea and
vomiting from chemotherapy, appetite
stimulation for patients with HIV/AIDS,
chronic pain and multiple sclerosis, among
other conditions.
This review, which accounted for 6,462
patients, found most who used cannabinoids
reported improvements to symptoms
compared with patients in placebo groups.
However, the researchers say these
improvements
were
not
statistically
significant.
The analysis also indicated that cannabinoids
had limited impact on symptoms of nausea
and vomiting, and a number of patients
reported adverse effects from the drug,
including dizziness, disorientation, confusion
and hallucinations.