Majority would give a prescription to an advanced cancer patient in pain
By Serena Gordon
HealthDay Reporter
WEDNESDAY, May 29 (HealthDay News) -- Three-quarters of doctors who responded to a survey about medical marijuana said they would approve the use of the drug to help ease pain in an older woman with advanced breast cancer.
In a February issue of the New England Journal of Medicine, doctors were presented with a case vignette, as well as arguments both for and against the use of medical marijuana. Doctors were then asked to decide whether or not they would approve such a prescription for this patient.
The results now appear in the May 30 edition of the journal.
Seventy-six percent of the 1,446 doctors who responded said they would give the woman a prescription for medical marijuana. Many cited the possibility of alleviating the woman's symptoms as a reason for approving the prescription.
"The point of the vignette was to illustrate the kinds of patients that show up on our doorstep who need help. This issue is not one you can ignore, and some states have already taken matters into their own hands," said Dr. J. Michael Bostwick, a professor of psychiatry at the Mayo Clinic in Rochester, Minn.
Bostwick wrote the "pro" side for the survey, but said he could've written the "con" side as well, because there are valid arguments on both sides of the issue.
"There are no 100 percents in medicine. There's a lot of anecdotal evidence that this is something we should study more. Forgive the pun, but there's probably some fire where there's smoke, and we should investigate the medicinal use of marijuana or its components," Bostwick said.
Marijuana comes from the hemp plant Cannabis sativa. It's a dry, shredded mix of the plant's leaves, flowers, stems and seeds. It can be smoked as a cigarette or in a pipe, or it can be added to certain foods, such as brownies.
The case presented to the doctors was Marilyn, a 68-year-old woman with breastcancer that had spread to her lungs, chest cavity and spine. She was undergoingchemotherapy, and said she had no energy, little appetite and a great deal of pain. She had tried various medications to relieve her pain, including the narcotic medication oxycodone. She lives in a state where the use of medical marijuana is legal, and asks her physician for a prescription.
Dr. Bradley Flansbaum, a hospitalist at Lenox Hill Hospital, in New York City, said he sided with the majority for this particular case.
"I think there's some context that needs to be considered," Flansbaum said. "This was a woman with stage 4 cancer who wasn't responding to [anti-nausea medications]. I'm not saying let's legalize marijuana, but this is a woman at the end of her life, so what's the downside, given that there might be a benefit. In a different situation, medical marijuana might not be so well embraced."
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