Worth Repeating: What Does ‘May Recommend’ Mean?


Photo: Triple5Light

​Welcome to Room 420, where your instructor is Mr. Ron Marczyk and your subjects are wellness, disease prevention, self actualization, and chillin’.

Worth Repeating

By Ron Marczyk, R.N.

Health Education Teacher (Retired)

National Cancer Institute “Unexplains” Possible Cancer Cure To Nation

So, let me get this straight: We, the cancer patients in the U.S., “misinterpreted” the NCI website information on cannabis? It’s our error? We screwed up? We got it totally wrong? It’s our fault due to our poor reading skills?
We misunderstood the term physicians “may recommend” cannabis to their patients. How stupid of us!

Graphic: NCI

Thank God the NCI is now going to re-educate us on what we didn’t see about medical cannabis… I hear and obey!

“The PDQ CANCER information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes.”
Response: “Reviewed regularly and updated as new information becomes available.” This new information was changed in just 11 days. Wow! You guys are really on top of stuff! Will anything else change by this weekend?
I have a doctor’s appointment on Monday, and I hope no more of this anti-tumor information will be scrubbed and out of date by then?
Now, if only we could get you guys to study cannabis and cancer in clinical trials that fast!
“In writing cancer information summaries, PDQ Editorial Boards review current evidence. They do not make recommendations.”

Response: Except when we say “the health care provider may recommend medicinal cannabis for symptom management and possible direct anti-tumor effect”!
“Their work is editorially independent of the National Cancer Institute (NCI).”

​Response: So why did they change their “editorially independent” conclusions to match those of the NCI, the FDA and the DEA?

Wow! What a coincidence!
The only way to get this information is to log onto the NCI homepage, then search for “cannabis” and “cannabinoids.” If there is no other place where this information is published, then sorry, guys — you own it, it’s your baby; you guys gave birth to it, and now you are abandoning your own creation after 11 days. Shame on you! And…
If the NCI is totally disconnected from this PDQ editorial board, why doesn’t the editorial board get their own website, totally separate from NCI, so there’s no conflicting information and messages? Let them be independent, and let them state their own medical conclusions on cannabis and cancer.
“The summary on cannabis and cannabinoids does not represent a policy statement of NCI or NIH.”

Response: Then why is it on the NCI website? What is the grand purpose of the whole site in general? Aren’t you giving this information to physicians to use? If it helps a cancer patient to stop vomiting, relieves pain, gives appetite, helps sleep, and shrinks tumors, what is the problem adding the last phrase?
Again, if the answer is no, what is the purpose of this site? You are educating physicians about medical cannabis, but you don’t want them to use it?
“The summary statement represents an independent review of the literature; that review is not influenced by NCI or any other federal agency.”

Response: Please! I’m not as stupid as I look!

Photo: NORML

​“In light of the attention garnered by the PDQ summary statement on cannabis and cannabinoids, reviewers for the summary on the PDQ Complementary and Alternative Medicine (CAM) Editorial Board reexamined the recently posted statement and decided to change the wording…”

Response: The “attention garnered” was us, the cancer patients, jumping for joy! You filled us with hope! Finally, the truth!
“…in order to clarify the meaning that the Board originally intended to convey and to correct several possible misinterpretations. The changes made and the rationales for them are:

• In the General Information section, the wording was revised to make clearer that cannabis is not approved by the FDA for any medical use.”

Response: Your medical evidence is in direct conflict with the FDA’s Schedule I classification for cannabis. How about a little leadership here?
• In the General Information section, a sentence was replaced to add clarification. The CAM Board lead reviewers realized that the previous wording “could have been misinterpreted as being a recommendation for prescribing cannabis,” which was not the intent of the Board.

Response: OK, so let’s check the previous wording. Here is the exact quote that we “misinterpreted:”
“In the practice of integrative oncology the health care provider may recommend medicinal cannabis not only for symptom management for also for its possible direct anti-tumor effect.”
Let’s break it down word by word.

Photo: mattcastille.com

​“In the practice of integrative oncology the health care provider” [Translation] Physicians and nurses who treat cancer patients holistically may include diet, meditation, support groups, and medical cannabis for symptomatic relief.

“may recommend” (to their patients) [Translation] It’s now OK for physicians to discuss with cancer patients under their care the possible benefits cannabis may have on their illness, and prescribe it, as with any other life-saving medicine. (How else are they going to get it? Drug reps? Forget about it!)
Nurses who don’t prescribe but are involved in patient education would also be included.
Note to NCI: There has never been a single documented primary human fatality from overdosing on cannabis in its natural form, in any amount.
Can you say that about any other cancer drug?
“medicinal cannabis” [Translation] Safe, inspected, regulated cannabis. (I recommend vaporization or edibles.)
“not only for symptom management” (antiemetic effects, appetite stimulation, pain relief, and improved sleep) [Translation] You will stop vomiting your guts out from chemo, you will want to eat, your pain will decrease to the point where your opioid intake may be cut in half, and you will sleep like a rock — in other words, the major therapeutic effect: happy, hungry, sleepy!
“but also for its possible direct anti-tumor effect” [Translation] It kills cancer tumors directly, it slows their growth, it cuts off new blood vessels feeding the tumor, it stops tumors from spreading. IT MAKES CANCER TUMORS SHRINK. Finally, the truth!

Note to NCI: Nope, no misinterpretation here. Your original statement was crystal clear. It was spot on.
There is no way in hell I could fumble this clear, unambiguous statement “may recommend.” That means you may tell patients that cannabis may help improve their quality of life while undergoing cancer treatment, and cannabis may be part of the cure for your cancer!
“In addition, the current evidence for the anti-tumor properties of cannabis are discussed only in the context of laboratory studies, and not in research involving human subjects. It is discussed only in the summary section titled Laboratory/Animal/Preclinical Studies.”

Graphic: Americans for Safe Access

​Note to NCI: We are way past Phase 1 with animal models, so where is the bar set? What do we have to do to move to humans? You guys do medical studies, right? That is the business you are in? Experiments-R-Us?

How about the NCI, with FDA approval, is given full access to real medical cannabis that patients get from cannabis clinics and NCI takes over cannabis cancer testing directly. If we can’t trust NCI ,then who can we trust?
Cannabis would be given “orphan drug” status  and “fast tracked” into human clinical trials.
What’s the problem? Who or what is blocking this next step?
How about 20 experiments be set up on cancer and cannabis, today? How about we test this hypothesis once and for all? Isn’t that what the scientific method does — prediction and testing? Aren’t all great debates in science settled this way?
Are you recommending that physicians be able to prescribe cannabis to their patients just for antiemetic effects, appetite stimulation, pain relief, and improved sleep? If not, why are you educating us about this subject? And what is the purpose of this webpage?
If yes, then why aren’t you petitioning the FDA, and getting them up to speed about all the great benefits cancer patients could experience with its use?
If the NCI communicated directly with the FDA to fast-track cannabis for clinical trial, would they listen to you? If they would blow off the NCI and not take your recommendation, then who would they listen to?
I’m confused.
NCI is in the “public health education” business, right?
So what is your message?
Should cancer patients:
(a) Talk to their physicians about cannabis and bring this website to their attention? (b) Use cannabis as a cancer treatment on their own, even if it’s illegal? (c) Be resigned to the fact that there is a medicine that may help them, but they can’t have it, and cannot benefit from it? (d) Beg the FDA for clinical trials?
“In the practice of integrative oncology the health care provider may recommend medicinal cannabis not only for symptom management but also for its possible direct anti-tumor effect.”

The NCI said so.
You can scrub your website… but you can’t scrub our minds and memories!
You created and injected a positive meme into the cannabis/cancer culture.
This unit of social information then spread, just as genes transmit biological information. Your positive cannabis meme transmitted the following message:
Cannabis fights cancer. Cannabis shrinks tumors. 
Finally, the truth!

Graphic: NORML Stash Blog
“NCI apparently got a talking to from someone” ~ Radical Russ Belville, NORML

Editor’s note: Ron Marczyk is a retired high school health education teacher who taught Wellness and Disease Prevention, Drug and Sex Ed, and AIDS education to teens aged 13-17. He also taught a high school International Baccalaureate psychology course. He taught in a New York City public school as a Drug Prevention Specialist. He is a Registered Nurse with six years of ER/Critical Care experience in NYC hospitals, earned an M.S. in cardiac rehabilitation and exercise physiology, and worked as a New York City police officer for two years. Currently he is focused on how evolutionary psychology explains human behavior.