Developing Training on Medical Cannabis Education for Oncology Fellows With Deepa Rangachari, MD

Oncology Data Advisor: Welcome to Oncology Data Advisor. Today, we're here at the ASCO Annual Meeting, and I'm joined by Dr. Deepa Rangachari. Thanks so much for coming on today.

Deepa Rangachari, MD: Keira, thanks so much for the invitation. Again, my name is Deepa Rangachari. I am the Director of Hematology/Oncology (Heme/Onc) Graduate Medical Education and the Hematology/Oncology Fellowship Program at the Beth Israel Deaconess Medical Center (BIDMC) in Boston, Massachusetts. I'm really delighted to be with you today to talk about some of our recent work.

Oncology Data Advisor: Yes, absolutely. So, you have a presentation here about education for medical cannabis use for oncology fellows. For background, what are the uses of medical cannabis for cancer patients?

Dr. Rangachari: I think medical cannabis is an area where there is an incredible amount of interest, both on the part of patients, but also in the health care community. There are an increasing number and array of reasons why people may be curious about its use for their care. Some of the most common reasons that medical cannabis use is either invoked by patients or being considered by health care providers include things like management of symptoms, either cancer-related symptoms or cancer treatment–related symptoms—things like nausea, decreased appetite, pain, trouble with sleep, and mood disturbances.

Separately, there's also interest in whether medical cannabis or cannabinoids can in any way impact oncogenesis or the development of cancer. This is sort of separate from symptom management, but there is also some curiosity about whether cannabis might be relevant to treatment of cancer as well.

Oncology Data Advisor: Great. What is the need specifically for Oncology Fellows regarding medical cannabis education?

Dr. Rangachari: Well, it's interesting. I think Oncology Fellows are a captive audience, in part because I am a Fellowship Program Director and do a lot of curriculum development and mentorship work with that population. I think it is a ready population that represents the future of our workforce. They are individuals in whom we are very interested in understanding their needs and their knowledge and thinking about how we could design a curriculum targeted towards their needs.

That being said, I think what we have likely uncovered in terms of the needs of Hematology/Oncology Fellows is that their needs reflect the needs of the greater oncology health care community in general. As a practicing Medical Oncologist myself, who's been out of training for more than a decade now, I think the things that we learned about our Fellows and their needs apply equally well to me and my peers and colleagues as they do to them. I would consider that a starting point rather than the sole benefactors of this effort.

Oncology Data Advisor: How did you go about designing this curriculum and then implementing it?

Dr. Rangachari: This was truly an interdisciplinary effort. I first want to acknowledge the vision and passion of our two primary authors, Dr. Rushad Patell and Dr. Poorva Bindal. Both Rushad and Poorva are graduates of our Heme-Onc Fellowship Training program at BIDMC. The inspiration for the curriculum and the needs assessment was really born out of day-to-day encounters that we were having with patients in our own clinics. Then from there, as we realized our own blind spots or lack of understanding or awareness, we realized that there was a much larger community of people who had this need, to better serve our patients.

But certainly, as medical oncologists, classical hematologists, or experts in hematologic malignancies—which is what Rushad, Poorva, and myself are—we actually had no substantial expert content expertise in the use of medical cannabis. So, we collaborated with expert colleagues from hospice and palliative medicine who served as our content experts. Individuals like myself were able to serve as medical education experts so that we could design a curriculum that was both evidence-based and factually accurate while still being rooted in the principles of learning science and evidence-based education.

Oncology Data Advisor: How did the trainees like using the curriculum? Did they find it useful?

Dr. Rangachari: We've had two pilots of the curriculum to date. Our initial entry was with three fellowship training programs around the country, and we more recently repeated the same endeavor with up to six fellowship training programs around the country just a week or two ago. I would say that the response to the effort has been really enthusiastic. I think people are aware that this is something that their patients may be very interested about, and which they as providers have a substantial amount of ignorance or discomfort about communicating. What we've learned so far is that the curriculum is feasible, that it meets an unmet need, and that people are enthusiastic to learn about this subject because it clearly is on the minds of the people whom we serve, who are our patients.

Oncology Data Advisor: Great. Do you have any future directions for it or for the ways that it can be implemented?

Dr. Rangachari: At this point, we are collecting data from our implementation efforts, and we look forward to publishing that experience shortly. But I think really for this to live on and to be scaled in a way that will allow it to be accessed by all of the people who stand to benefit from it, we're going to really need to have a different platform than what we have right now. Right now, we are personally conducting webinars with interested parties and fellowship programs around the country. We are very optimistic and hopeful that we might be able to pitch this curriculum, for example, to the ASCO digital education community or some other place where it could live more sustainably, be updated, and be shared with a much broader community.

Oncology Data Advisor: That's really exciting. My last question for you is, since the theme of ASCO this year is "Partnering with Patients," do you have any advice for oncology trainees about how they can really focus on partnering with patients as they begin practicing?

Dr. Rangachari: I think that is truly a profound theme, and it's one that is sacred and must be at the heart of everything that we do, both in our day-to-day work, but also importantly, to your question in terms of how we are training and mentoring people. I think the most important thing is for trainees to understand and articulate their passions and to make sure, when they're not sure or when they are unclear of the direction that their career or other things are going, that it really comes back to what the inspiration is for those passions. This is almost always entirely rooted in wanting to somehow contribute to and elevate the human experience or to better serve our patients. I think it's all about passion and remaining centered in the idea that passion is inspired by the patients whom we serve.

Oncology Data Advisor: Absolutely. That is awesome advice. Thanks so much for coming by today and talking to me about this.

Dr. Rangachari: Thanks so much. It's a pleasure to be here.

About Dr. Rangachari

Deepa Rangachari, MD, is the Director of Hematology/Oncology Graduate Medical Education and the Hematology/Oncology Fellowship Program at the Beth Israel Deaconess Medical Center in Boston, Massachusetts. Additionally, she is an Assistant Professor of Medicine at Harvard Medical School. Dr. Rangachari specializes in the treatment of thoracic cancers, particularly in the use of targeted and immune therapies for advanced/metastatic lung cancer. She is passionate about advancing leadership in graduate and postgraduate medical education through curriculum development and mentorship.

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Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of Oncology Data Advisor.