Donald Abrams is a San Francisco oncologist who has instigated significant cannabis research, including early studies on the safety of combining cannabis with HIV therapy or opioids. He laid out the potential of cannabis in cancer care in a recent piece titled “Should Oncologists recommend cannabis?” In a word, yes. Amidst Abrams’s summary of the science, he makes a number of often overlooked observations. Cannabis for cancer care is not new – the oldest example in which it may have been used is the Siberian Ice Maiden, the 2700-year-old remains of a Siberian woman who had breast cancer and cannabis on her corpse. Moving to the modern day, pure THC has been approved since 1986 for nausea related to chemotherapy, and recent research supports the use of cannabis rather than isolate THC for nausea. Interestingly, however, early studies did not show that THC helped patients gain weight. (And, in fact, recent research indicates that regular cannabis use can lead to lower BMI.) Through Abrams’s interaction with patients, he has found that many people prefer inhaling cannabis to the modern anti-emetic drugs (like Zofran/Ondansetron), thanks to fewer or more manageable side effects with cannabis. Pain is often what drives people to try cannabis. There is reasonable evidence that THC numbs peripheral neuropathic pain. CBD has less clinical evidence for pain but appears best for pain secondary to inflammation. Doctors often cite the lack of clinical trials as reason to distrust cannabis, but “[t]he absence of evidence… is not evidence of absence of effect.” Although clinicians worry about recommending cannabis in the absence of specific guidelines, Abrams maintains that cannabis “is both safe and effective and really does not require a package insert.” There is much to learn about cannabis therapeutics, but uncertainty is not cause for withholding medicine.