I met Ms. Martin at Kendall Regional Medical Center. I was consulted on her case to help manage her pain after she was bitten by a dog. Upon questioning her about her past medical history, she informed me that she was in remission from her stage four lung cancer. I congratulated her and asked her what her treatment plan consisted of and she replied, “Two grams of THC for 90 days.” Ms. Martin was fortunate enough to have friends and family steer her in the right direction. She learned how to make her own suppositories to facilitate consumption of cannabis into her body in such high doses. It saddened me that she had to go through this process in fear as if she was a criminal receiving her “medicine” in an illegal manner. I educated her about the current law and how she should come see me in the office to get registered with the Office of Compassionate Use and get an ID card from the Department of Health. I told her she can start using the Dispensaries as she qualifies and needs a maintenance regimen. The research exists demonstrating the importance of the endocannabinoid system in immune function, pain management and appetite and the importance of Cannabidiol (CBD), one of the non-psychoactive cannabinoids use in maintaining homeostasis and balance in our nervous system. Imagine her Oncologist’s reaction when seeing her for a follow-up visit reviewing her scans to see her lung tumor was gone.  I asked her how she was feeling in the hospital without her cannabis.  Her pain was not controlled, she seemed anxious to be discharged. Again, I was reminded that no formal policies pertaining to cannabis use in a hospital or skilled nursing facility in Florida have been written nor addressed.

I recently met another gentleman who was referred to me by a Cannabis Certified Physician. He has had cancer in the past but was currently in remission. If a patient had a diagnosis of cancer but does not actively have cancer are they are candidate? What if they are using Cannabis in hopes of their cancer not reoccurring. For example, decreasing inflammation in the colon with CBD could lead to a reduction in the risk of colon cancer.  I wondered how many Physicians must be nervous to register patients because of the many questions they have with very limited guidance or education.

The National Institute on Drug Abuse (NIDA) published that “Recent animal studies have shown that marijuana can kill certain cancer cells and reduce the size of others.” A 1996 study discovered cannabinoids can block cell growth, prevent the development of the blood vessels tumors need to grow. Studies suggest CBD may kill cancer cells without harming normal cells.  A study done recently in St George’s University in London proved how effective cannabinoids can be in decreasing metastasis of aggressive tumors. The study found that the cannabinoids weakened the cancer cells making them more susceptible to radiation treatment. Another study in Molecular Cancer Therapies states “dramatic reductions” in fatal variations of brain cancer with specific cannabinoids were used in conjunction with radiation therapy.

More specifically, Bladder cancer rates are 45% lower in cannabis users. In 2011, the American Association for Cancer Research demonstrated CBD kills cells associated with Breast Cancer reducing the growth and spread of tumors with no effect on normal cells. Current research is underway evaluating glioblastoma multiform with a THC/CBD spray.

As medical professionals and patients search for natural alternatives to synthetic and toxic pharmaceuticals more has been discovered about terpenes in Cannabis. Alpha terpineol has been proven to be an anticancer agent besides being an antioxidant, antibiotic, antidepressant and anti-inflammatory. This was discovered by Dr. Saadia Bashir Hassan in Sweden in June 2010 published in Anticancer Research.  The results show that alpha terpineol inhibits the growth of tumor cells by inhibiting the NF-KB pathway.  An additional study in 2014 found alpha terpineol induces apoptosis (programmed cell death) in patients with liver cancer and suppresses tumor growth. In Science Direct in June 2015 found alpha terpineol kills cancer cells and inhibit tumor growth.  Now we just need the FDA and DEA to read the science and support cannabis research. In addition, these terpenes would be present in whole flower or full spectrum cannabis. However, currently Florida dispensaries focus solely on the CBD and THC contents.

The U.S. government as represented by the Department of Health and Human Services was granted a U.S. Patent (#6630507) stating medical marijuana has antioxidant properties and cites their benefits for patients going through chemo, radiation and other sources of oxidative stress. Besides the more recent evidence demonstrating Cannabis’ role in treating cancers, decreasing metastasis and size of tumors are the other therapeutic benefits of cannabis such as chemo induced nausea, decreasing pain and inflammation, increasing appetite, treating secondary symptoms such as neuropathy.

Michelle Weiner, DO, MPH

Spine and Wellness Centers of America