Archive for the ‘Chemotherapy’ Category

A random-sample, anonymous survey of the members of the American Society of Clinical Oncology (ASCO) was conducted in spring 1990 measuring the attitudes and experiences of American oncologists concerning the antiemetic use of marijuana in cancer chemotherapy patients. The survey was mailed to about one third (N = 2,430) of all United States-based ASCO members and yielded a response rate of 43% (1,035). More, than 44% of the respondents report recommending the (illegal) use of marijuana for the control of emesis to at least one cancer chemotherapy patient. Almost one half (48%) would prescribe marijuana to some of their patients if it were legal. As a group, respondents considered smoked marijuana to be somewhat more effective than the legally available oral synthetic dronabinol [THC] Marinol; Unimed, Somerville, NJ) and roughly as safe. Of the respondents who expressed an opinion, a majority (54%) thought marijuana should be available by prescription. These results bear on the question of whether marijuana has a “currently accepted medical use,” at issue in an ongoing administrative and legal dispute concerning whether marijuana in smoked form should be available by prescription along with synthetic THC in oral form. This survey demonstrates that oncologists’ experience with the medical use of marijuana is more extensive, and their opinions of it are more favorable, than the regulatory authorities appear to have believed.

Fifteen patients with osteogenic sarcoma receiving high-dose methotrexate
chemotherapy were studied in a randomized, double-blind, placebo-controlled
trial of oral and smoked delta-9-tetrahydrocannabinol (THC) as an antiemetic.
Each patient served as his or her own control. Fourteen of 15 patients had a
reduction in nausea and vomiting on THC as compared to placebo.
Delta-9-tetrahydrocannabinol was significantly more effective than placebo in
reducing the number of vomiting and retching episodes, degree of nausea,
duration of nausea, and volume of emesis (P less than 0.001). There was a 72%
incidence of nausea and vomiting on placebo. When plasma THC concentrations
measured less than 5.0 ng/mL, 5.0 to 10.0 ng/mL, and greater than 10.0 ng/mL,
the incidences of nausea and vomiting were 44%, 21%, and 6%, respectively.
Delta-9-tetrahydrocannabinol appears to have significant antiemetic properties
when compared with placebo in patients receiving high-dose methotrexate.