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Should You Consider Medical Marijuana?

medical marijuana
Wendy Baer, MD - Blogs
By Wendy Baer, MDPsychiatric oncologistFebruary 9, 2018
From the WebMD Archives

Lots of people dealing with cancer wonder about the potential benefits of medical marijuana, and the discussion about whether or not to use it comes up often in cancer treatment centers. The questions often fall into several categories: Does it treat cancer? Will it manage the side effects of chemotherapy, radiation or surgery? Can it quiet my worry about cancer?

One patient named Bill, an engineer, asked if he could use marijuana to treat his prostate cancer. He said that he had found some studies online from other countries that showed marijuana was used to cure people of cancer. Unfortunately, there’s no solid scientific evidence that marijuana holds curative powers. We would need a number of quality studies (which doctors call randomized controlled trials) involving a large number of people who have a specific kind of cancer and who are using a very specific type and dose of drug in order to prove that something is a cure for cancer – and that kind of research hasn’t been done on marijuana.

Another patient, Sara, struggled with nausea and low appetite during chemotherapy for breast cancer. She asked about using marijuana to help her low appetite and lack of energy. Many patients have reported benefit from using marijuana for nausea and vomiting. But because marijuana is a complicated plant (it has over 400 compounds) and people take marijuana in a variety of forms (smoking, eating, oil drops), it was hard for Sara’s doctor to recommend a specific marijuana remedy for her nausea. Prescription medications like dronabinol and nabilone are cannabinoids (one compound from the marijuana plant) that can be used for nausea, in addition to many other available medications for nausea. Because the prescription medication has a specific dosing guidelines, and there is regulation and quality control of medications, Sara’s doctor recommended she try one of the approved prescription cannabinoid medications first. Her doctor also got Sara to focus on a healthy diet and change from soda to ginger tea, which diminished Sara’s nausea.

Sam is a patient who had finished radiation for Hodgkin’s lymphoma but worried daily about the cancer coming back. He had an intense fear of recurrence. He had trouble relaxing in the evening, his stomach felt queasy most days, his back was tense all the time, and he was plagued with racing thoughts, especially at night. Sam asked his doctor about marijuana to manage the anxiety he was experiencing in cancer survivorship (many people develop worry after treatment ends, often related to the fear of recurrence). Given that Sam was struggling with fatigue and trouble concentrating at work, his doctor was reluctant to recommend marijuana because a known side effect of marijuana is fatigue and impaired thinking. Furthermore, Sam was very excited about getting off medications after cancer treatment. Given that Sam was experiencing intense anxiety, he decided to find a weekly therapist to treat the anxiety. There is research that weekly therapy can treat anxiety disorders with long lasting benefits.

Before taking medication, it’s important to be sure that the drug has proven benefits and to have an understanding of the side effects and alternative treatments. It may be some time before medical marijuana will meet this criteria. Until the federal government classifies marijuana as a legal drug,  researchers will have a hard time studying it for medical purposes. Although marijuana is legal for medical use in some states, that doesn’t mean it has proven medical benefit.

If you live somewhere where marijuana is legal and you do choose to use it, be attentive to how it helps you function over time. Are you able to do your work during the day, be present in your relationships, and rest well at night on this supplement? Do your friends and family notice the benefit too or do they see the use a problematic? Problematic marijuana use includes low motivation, confusion, falls, impaired driving, hallucinations, and addiction.

One day doctors may have the medical science needed to make evidence-based recommendations about marijuana use for cancer. The science will need to tell us what preparation of marijuana to use (like, smoking vs eating), what dose to take, how long to take it, and how to safely use it with other medications. Doctors and patients will also need businesses to provide a quality marijuana product, one that has oversight in preparation and quality checks to make sure what patients think they are buying is what is in the bottle or package.

The evidence we do have on marijuana so far is promising – research does suggest therapeutic effects for chronic pain, chemo-related nausea, and other ailments. But until we have a solid body of research that tells us how to best utilize marijuana for medical benefit, its full potential remains unknown.

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About the Author
Wendy Baer, MD

Wendy Baer, MD, is the medical director of psychiatric oncology at the Winship Cancer Institute of Emory University in Atlanta. Dr. Baer helps patients and their families deal with the stress of receiving a cancer diagnosis and going through treatment. Her expertise in treating clinical depression and anxiety helps people manage emotions, behaviors and relationships during difficult times.

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