Survey Reveals Providers' Thoughts on Cannabis for Pediatric Cancer Patients

Doctors who care for pediatric cancer patients receive frequent requests for medical marijuana to help relieve children’s pain, nausea, lack of appetite, depression, and anxiety. But how often is cannabis actually prescribed in these cases?

In a new study based on survey responses from 288 interdisciplinary providers in Illinois, Massachusetts, and Washington, researchers found that 92 percent of providers are willing to help children with cancer access medical marijuana. In fact, only two percent believed that medical marijuana was never appropriate for a child with cancer.

However, the study found that providers who are actually legally eligible to prescribe medical marijuana are less open to endorsing its use. This is mainly due to concerns around federal prohibition, institutional policies, and a lack of scientific evidence and standards on the medication’s formulations, dosing, and potency.

The findings, published in the journal Pediatrics, highlight the need for rigorously designed clinical trials on the use of medical marijuana in children with cancer.

“It is not surprising that providers who are eligible to certify for medical marijuana were more cautious about recommending it, given that their licensure could be jeopardized due to federal prohibition,” said co-author Kelly Michelson, M.D., critical care physician at Ann & Robert H. Lurie Children’s Hospital of Chicago.

“Institutional policies also may have influenced their attitudes. Lurie Children’s, for example, prohibits pediatric providers from facilitating medical marijuana access in accordance with the federal law, even though it is legal in Illinois.”

Michelson is also an associate professor of pediatrics and director of the Center for Bioethics and Medical Humanities at Northwestern University Feinberg School of Medicine.

The findings show that nearly a third of providers receive one or more requests for medical marijuana for relief of nausea and vomiting, lack of appetite, pain, depression, and anxiety. The majority of providers (63 percent) were not concerned about potential substance abuse in children who receive medical marijuana. Their greatest concern was the absence of standards around prescribing medical marijuana to children with cancer.

“In addition to unclear dosage guidelines, the lack of high quality scientific data that medical marijuana benefits outweigh possible harm is a huge concern for providers accustomed to evidence-based practice,” said Michelson. “We need rigorously designed clinical trials on the use of medical marijuana in children with cancer.”

Most providers consider medical marijuana more permissible for use in children with advanced cancer or near the end of life than in earlier stages of cancer treatment. This is consistent with the current American Academy of Pediatrics (AAP) position that sanctions medical marijuana use for “children with life-limiting or seriously debilitating conditions.”

Source: Ann & Robert H. Lurie Children’s Hospital of Chicago