From Mark Levine, the Doc with the Pink Tights
What’s He Smoking?

The topic I write about is usually stimulated by an event that has recently happened, a patient I have seen, or an article I have read.

Currently, I am a member of a team of researchers that is preparing a grant application to the Canadian Institutes of Health Research (the Feds) to support a program of research on cannabis in cancer patients.

Cannabis for medicinal purposes has been around for a number for years. It has been prescribed to cancer patients for pain, nausea, fatigue, and weight loss. To be honest, in my own clinical practice I never felt a need to prescribe cannabis as I felt alternative, more effective, methods were available to manage such symptoms.

As you are aware, Canada legalized recreational cannabis recently. This triggered a switch in my brain. I found it very interesting that there is so much hype about cannabis, with people expressing strong opinions both pro and con.

There is uniform consensus in the medical literature that there is a lack of evidence supporting that cannabis is beneficial for a number of cancer symptoms and that much more research is needed. It is very possible that there is a lack of information because not very many high-quality studies have been done. However, there are very interesting laboratory studies that suggest to me that cannabis should be able to work for some of these conditions.

I don’t have an opinion on whether cannabis for medicinal purposes is good or bad. However, for the last 37 years I have worked in a cancer centre where evidence drives treatment and care.

When a patient receives a chemotherapy drug at the Juravinski Cancer Centre (JCC), the drug has gone through very careful study in animals first, and then in patients, so that there is information on both its efficacy (does it work) and safety (side effects).

In addition, this includes information such as what dose to give; how the drug interacts with other drugs; and how to adjust the dose if the liver or kidneys are not working properly.

Health Canada has to have all this data before it approves a drug for regular use in the clinic. Do you know that no such information is available for medicinal cannabis?

As a clinician and researcher, I feel strongly that this type of information on cannabis must be available for my patients. Hence, my colleagues and I are excited about the opportunity to do the research that is necessary. Stay tuned.