Use of medical cannabis: perceptions of Israeli oncologists

Mirelman, Dan; Waissengrin, Barliz; Goldway, Noam; Sharon, Haggai; Brill, Silviu; Wolf, Ido

doi:10.1016/s1470-2045(19)30077-4

Cited by 23 publications

(14 citation statements)

References 8 publications

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“…In fact, with the progression of the diseases, several symptoms (anorexia, cachexia, fatigue, cognitive damage, anxiety, depression, neuropathic pain, sleep disorders) may appear because of malignancy or because of the treatment. Both hematologists and oncologists maintain that CBs may be considered as a therapeutic approach applicable for different tumor-related symptoms [87,88]. For instance, several studies demonstrated that THC treatment completely blocked vomiting in patients undergoing chemotherapy [89][90][91][92].…”

Section: Cbs Tumors and Treatment-related Symptomsmentioning

confidence: 99%

Pros and Cons of the Cannabinoid System in Cancer: Focus on Hematological Malignancies

et al. 2021

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The endocannabinoid system (ECS) is a composite cell-signaling system that allows endogenous cannabinoid ligands to control cell functions through the interaction with cannabinoid receptors. Modifications of the ECS might contribute to the pathogenesis of different diseases, including cancers. However, the use of these compounds as antitumor agents remains debatable. Pre-clinical experimental studies have shown that cannabinoids (CBs) might be effective for the treatment of hematological malignancies, such as leukemia and lymphoma. Specifically, CBs may activate programmed cell death mechanisms, thus blocking cancer cell growth, and may modulate both autophagy and angiogenesis. Therefore, CBs may have significant anti-tumor effects in hematologic diseases and may synergistically act with chemotherapeutic agents, possibly also reducing chemoresistance. Moreover, targeting ECS might be considered as a novel approach for the management of graft versus host disease, thus reducing some symptoms such as anorexia, cachexia, fatigue, anxiety, depression, and neuropathic pain. The aim of the present review is to collect the state of the art of CBs effects on hematological tumors, thus focusing on the essential topics that might be useful before moving into the clinical practice.

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Section: Cbs Tumors and Treatment-related Symptomsmentioning

confidence: 99%

Pros and Cons of the Cannabinoid System in Cancer: Focus on Hematological Malignancies

et al. 2021

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“…Wie dringend eine hochwertige Studie zur Anwendung von Cannabinoiden bei Tumorpatienten ist, macht ein gerade erschienener Bericht israelischer Onkologen klar. In Israel werden immerhin rund 10 000 Krebspatienten jährlich mit medizinischem Cannabis behandelt, wobei die Hauptindikation der Krebsärzte Appetitverlust ist [4]. Die Dosierung, so die Autoren, erfolgt jedoch wegen fehlender prospektiver klinischer Erkenntnisse überwiegend nach ei-genem Ermessen und eigener Erfahrung.…”

Section: Positive Erfahrungen Aus Israelunclassified

DGHO 2019: Cannabinol und Tumorkachexie

Bubenzer¹

2020

Onkologische Welt

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“…However, patients' expectations and doctor understanding of the efficacy of cannabis-based products do not always align. This research, like overseas studies, [216][217][218]242 demonstrates that doctors in an oncology setting understand there may be some evidence of efficacy for symptomatic relief in pain and nausea/vomiting, but little evidence for the curative properties of cannabis.…”

Section: Discussionmentioning

confidence: 73%

“…4 More recent trials of Epidiolex in refractory childhood epilepsy syndromes have provided further evidence for use in specific medical conditions. [60][61][62][63]23054,218 Almost half of GPs who participated in this study were aware of nabiximols, however the majority of those could not recall its constituents or its formulation. The majority of GPs were informed as to the potential side effects of using cannabis-based medications, likely reflecting knowledge of the adverse effects of recreational/illicit cannabis use.…”

Section: Discussionmentioning

confidence: 99%

“…216,217 In Israel, where cannabis may be prescribed to patients with palliative diagnoses, 90% described a paucity of knowledge surrounding its use, instead relying on their own judgements as a guide for dosing. 218 To understand what doctors in NZ have experienced through patient interactions as well as their knowledge surrounding the use of cannabis as a medicine during this period of legislative change a series of observational studies were undertaken.…”

Section: -72mentioning

confidence: 99%

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Framing the use of cannabis as a medicine in New Zealand: Regulatory, Clinician and Patient contexts

Oldfield¹

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A medicine is a substance developed for administration to humans for therapeutic purposes that achieves its action by pharmacological, immunological or metabolic means. Pharmaceutical medications undergo years of pre-clinical and clinical trials to establish their safety, tolerability and efficacy. Cannabis, whether in raw or processed form, sits predominantly outside this remit. Its use falls broadly into four categories; recreational, plant used for medicinal purposes, cannabis-based products marketed for medical purposes and pharmaceutical grade cannabinoid medications. The use of cannabis as a medicine involves complex interactions across social, health and political domains, at both a global and national level. New Zealand has attempted to address this with the implementation of the Medicinal Cannabis Scheme in April 2020. This research was undertaken to develop an understanding of what effect cannabis regulations have had on multiple jurisdictions enacting them and applying this to the New Zealand context, and to understand specific groups of patient-doctor interactions regarding the use of cannabis as a medicine. First, I undertook a meta-narrative qualitative review synthesising themes relating to the outcomes of cannabis regulatory change across multiple jurisdictions. Five super-ordinate themes were identified in the meta-narrative review; Normalisation, Gatekeeping, Economics, Community and Health, which were applied in framing the conclusion of this thesis. I then completed a systematic review / meta-analysis examining label accuracy and contaminants in cannabis-based products in regulated markets. Labelling accuracy ranged from 17 to ~86%. Contaminants included microbes, solvents, pesticides and adulterants. Meta-analysis of pesticide contamination showed that the overall proportion of contaminated samples was 0.25 (95% CI: 0.10 to 0.40, Heterogeneity: I2=79%, X12=4.74, p=0.03). Finally, I completed six observational studies within New Zealand to determine knowledge, beliefs and reported interactions of doctors and patients regarding the use of cannabis as a medicine in three medical disciplines; general practice (GP), oncology and neurology. Doctors reported that patients were requesting medical cannabis prescriptions (GP: 55%, Neurology: 63%. Oncology: 84% respectively), and informing them of using illicit cannabis for medical symptoms. All doctors were concerned about prescribing cannabis as a medicine due to lack of evidence and lack of understanding of the prescription processes. Despite this, the majority were willing to prescribe a funded cannabis-based product backed by evidence of efficacy in traditional clinical trials. Patients in all three disciplines indicated comfort discussing cannabis with GPs and specialists (GP patients: 91.7%, 92.1%, neurology patients: 88.2%, 90.6%, oncology patients: 85.8%, 88.2% respectively). All groups reported low levels of prescriptions received (<20%). Patients reported illicit use of cannabis for medical reasons (11.2%, 34.6% and 35.5% in GP, neurology and oncology patients respectively), with reported effectiveness of illicit cannabis for their condition ranging from 86.7 to 94.0%. Patients in all three fields wished to know the benefits, side effects and availability of cannabis-based products and had concerns regarding access and cost. The use of cannabis as a medicine remains a complex situation within the NZ context. Significant implementation issues remain for the Medicinal Cannabis Scheme to ensure the safety and wellbeing of patients in New Zealand.

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Use of medical cannabis: perceptions of Israeli oncologists

Cited by 23 publications

References 8 publications

Pros and Cons of the Cannabinoid System in Cancer: Focus on Hematological Malignancies

Pros and Cons of the Cannabinoid System in Cancer: Focus on Hematological Malignancies

DGHO 2019: Cannabinol und Tumorkachexie

Framing the use of cannabis as a medicine in New Zealand: Regulatory, Clinician and Patient contexts

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