Dr. C. Joseph Bennett, Navigating Cancer, 02/26/13

When I was in college, and on the debate team, there was a general rule that certain topics would always provide a more passionate argument than others. If you really wanted a good debate, pick one of these topics: religion, politics, abortion — all very sensitive topics, and seen differently by all of us.

Now, as a physician, another debate is raging in this country, this time concerning marijuana — specifically, the use of marijuana for medical purposes. Some physicians favor the use of marijuana for certain conditions or side effects of treatment, while others strongly advocate against the use of medical marijuana.

A wonderful review of this topic was recently published online in the New England Journal of Medicine.

Researchers from the Mayo Clinic in Rochester, Minn., reported there is a growing body of mainly anecdotal literature supporting the efficacy of marijuana, particularly for cases that are not responding to conventional pharmaceutical treatments.

In the United States, there are currently no vaporized inhalants as an alternative to medicinal marijuana, and the oral medications that have the active ingredient of marijuana are poorly suited to relieving distress due to their slow onset and unreliable response in patients.

Translated, this means the best way to get any medical benefits from marijuana is to smoke it. Although the patient may find the psychoactive effects of marijuana unacceptable, it may be beneficial, and should be recommended if conservative treatment options have failed.

However, there are two thought processes regarding the use of marijuana.

Researchers from the University of Florida College of Medicine in Gainesville, and the Institute for Behavior and Health in Rockville, Md., note there is little evidence suggesting smoked marijuana will improve pain, nausea or other symptoms. Other effects of smoking marijuana should be considered, including the mental side effects, the impact of smoking on pulmonary disease and the potential impact on tumor progression.

Prescription marijuana compounds, such as Marinol, do have some positive attributes, like oral administration, chemical purity, precise dosage and sustained action, and in many patients may have similar efficacy without the potential negative side effects of smoking marijuana. Based upon this, these researchers feel there is little scientific basis for recommending that a patient smoke marijuana for symptom control.

So yes, there is a lot of debate going on regarding the use of medical marijuana, along with the pros and cons of actually smoking the marijuana versus using the prescription compounds that contain ingredients found in marijuana. This debate is going on all over the country, and it will take many years to come to a conclusion.

Dr. C. Joseph Bennett is a board-certified radiation oncologist and a member of the Citrus County Unit of the American Cancer Society. Watch “Navigating Cancer” on WYKE TV at 7:30 p.m. Tuesdays and at 10 a.m. Thursdays. If you have any suggestions for topics, or have any questions, contact him at 522 N. Lecanto Highway, Lecanto, FL 34461, or email cjbennett@rboi.com.