title: Patterns of use of medical cannabis among Israeli cancer patients: a single institution experience.
abstract: BACKGROUND
  The use of the cannabis plant (Cannabis sativa L.) for the palliative treatment of cancer patients has been legalized in multiple jurisdictions including Israel. Yet, not much is currently known regarding the efficacy and patterns of use of cannabis in this setting.
  
  
  OBJECTIVE
  To analyze the indications for the administration of cannabis among adult Israeli cancer patients and evaluate its efficacy.
  
  
  METHODS
  Efficacy and patterns of use of cannabis were evaluated using physician-completed application forms, medical files, and a detailed questionnaire in adult cancer patients treated at a single institution.
  
  
  RESULTS
  Of approximately 17,000 cancer patients seen, 279 (<1.7%) received a permit for cannabis from an authorized institutional oncologist. The median age of cannabis users was 60 years (range 19-93 years), 160 (57%) were female, and 234 (84%) had metastatic disease. Of 151 (54%) patients alive at six months, 70 (46%) renewed their cannabis permit. Renewal was more common among younger patients and those with metastatic disease. Of 113 patients alive and using cannabis at one month, 69 (61%) responded to the detailed questionnaire. Improvement in pain, general well-being, appetite, and nausea were reported by 70%, 70%, 60%, and 50%, respectively. Side effects were mild and consisted mostly of fatigue and dizziness.
  
  
  CONCLUSIONS
  Cannabis use is perceived as highly effective by some patients with advanced cancer and its administration can be regulated, even by local authorities. Additional studies are required to evaluate the efficacy of cannabis as part of the palliative treatment of cancer patients.
authors.affiliation: Institute of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Barliz
authors.initials: B
authors.lastname: Waissengrin
authors.affiliation: Institute of Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Damien
authors.initials: D
authors.lastname: Urban
authors.affiliation: Institute of Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Leshem
authors.affiliation: Institute of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Meital
authors.initials: M
authors.lastname: Garty
authors.affiliation: Institute of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: idow@tlvmc.gov.il.
authors.forename: Ido
authors.initials: I
authors.lastname: Wolf
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D064086:Medical Marijuana / Q000627:therapeutic use*; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology*; D010146:Pain / Q000188:drug therapy* / Q000503:physiopathology*; D010166:Palliative Care / Q000379:methods; D008517:Phytotherapy / Q000379:methods*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D064086:Medical Marijuana
keywords: Cannabis; cancer; chemotherapy; pain; palliative care