Cancer and Cannabis 101
Does Cannabis Cure Cancer?
Dr. Evangelos Litinas realized the benefits of medical marijuana after Excedrin merely helped to relieve his recurring migraines but cannabis eliminated them. On March 3, Dr. Litinas advised a house full of caregivers, patients, and others from the medical cannabis community at Bloom City Club that, even though dosing is important to think about with any new medication, the average cannabis patient should not get hung up on exact doses as cannabis use is safe. “Once you have an initial understanding of how cannabis works in your body, you can experiment until you find the dosage that works best for you. Realize that you are healing yourself.”
Dr. Litinas, who is the chief medical officer and in-house physician at Ann Arbor’s Om of Medicine medical marijuana dispensary, was the guest speaker at the monthly meeting of Women Grow-Southeast Michigan chapter.
Where’s the Data? The World Isn’t Waiting for Us to Find It
To make his point about the data, he noted the long recorded history of cannabis use in medicine and for other purposes: “Five thousand years ago it was used as food and in textiles in Central Asia. In 2700 BC in China it was used for pain. A written report in 1800 BC in ancient Sumeria included 30 citations where it helped for grief, epilepsy, nausea, and other ailments.”
Even in the United States, where opponents of marijuana charge that it hasn’t been tested, its use has been recorded favorably. According to Dr. Litinas, cannabis first showed up in official medical records in 1851 when it was listed in the third edition of the Pharmacopoeia, the encyclopedia of medications. It appeared in every revised edition until 1942 when it was taken out of the twelfth edition “because of politics.”
Today it is classified in this country as a schedule 1 medication, which means that it is seen to have no accepted medical use, it is unsafe to use, and its potential for abuse is considered on a par with heroin and LSD, all of which discourage scientific studies and research in the United States. But, Dr. Litinas reminded listeners, the rest of the world isn’t waiting around for the United States to rediscover the validity of science. As marijuana’s use as a safe and effective medicine becomes accepted in the science, business, and political communities of other countries, they are embracing the possibilities and we are falling behind:
- Israel, South Africa, Netherlands, Great Britain are among the countries that already are conducting research.
- Universities are beginning to do research as well.
- In the late 1980s, researchers in Israel discovered THC and receptors.
- In the 1990s, the genetic code was discovered so that we could clone receptors.
Why the Fuss about Receptors?
As Dr. Litinas explained it, a receptor is a protein-based molecule that causes a change in the electrical activity of a cell when a chemical from outside the cell binds with it. Currently we know of two subtypes of cannabinoid receptors:
- CB1: found mainly in the brain
- CB2: found mainly in the immune system and gastrointestinal tract
Chemicals and chemical compounds in the body can play many roles, from being structural components of cells, to helping in the metabolic breakdown of other chemicals and compounds, to aiding in the communication process of the body. The chemicals THC and CBD help cells to communicate in the endocannabinoid system (ECS).
Moving to the State of Homeostatis
A person who is healthy is in a state of homeostasis, which means that the variables in the body that must be regulated in order to keep internal conditions stable and relatively constant are healthy. The endocannabinoid system is one of those variables. According to Dr. Litinas, the THC:CBD ratio is an important factor to consider in helping your patients to choose the right medication, though the best ratio is hard to determine because what works for one person might not work for another, even in patients with similar conditions:
If the goal is to increase pleasure, you would want the ratio to be high in THC. If the goal is to decrease pain, you want to start with high CBD. When helping your patient choose a medication, consider the patient’s condition and overall experience while on cannabinoid treatment.
For the most part, Dr. Litinas advises his patients to start slowly, “with an initial small dose of between 1 and 10 mg of cannabinoids, on a day when they have nothing else to do and can experience the effects of the medication and figure out a good dosage in a safe environment. While determining the initial dose, consider the patient’s age and body weight, the condition of the liver, and the medical condition the patient is trying to treat.”
Another factor he considers in choosing the right medication is the plant strain’s genetic background. “For the majority of patients, Indica strains are more sedating, relaxing, and great for evening or night use. Sativas are more energetic and uplifting, good for daytime use. Hybrids are somewhere in the middle.”
How Effective Is Cannabis in Fighting and Managing Cancer?
The effectiveness of cannabis in fighting and managing cancer is different for every patient.
Dr. Litinas works collaboratively with patients to choose their dosing levels and dosing schedules:
- “At low doses of from 20 to 60 mg, cannabis can alleviate the ill effects of chemotherapy and radiation. By inhalation or ingestion, it can help to decrease nausea and vomiting and increase appetite, which, in turn, will help patients keep their medication and nutrition in their bodies, helping the treatment progress faster. Low doses also help with pain and inflammation and dealing with normal feelings of depression and anxiety arising from the severity of the diagnosis. Doses may be administered from once a day to 3 to 4 times a day.”
- “At high oral doses, cannabis can be used to treat (kill) the cancer cells themselves. Using the Rick Simpson’s Oil protocol, the patient has to consume 1 full gram of RSO per day, for a 60- to 90-day cycle, depending on the type of cancer. Normally they take 2 or 3 doses per day, although a single dose per day can also be advantageous. Whether to start slowly or go straight to the full gram is a decision that should be made on an individual basis. The patient will likely have psychoactive experiences for the first two or three weeks. In week 4 they will begin to lessen.”
Methods of Administration
Dr. Litinas discussed the four major methods that patients use to administer their medication:
- inhalation (smoking/vaporization): “Up to 30 percent can make it into the system. The effects may be felt within seconds and start diminishing within the first hour; most patients feel no effect after four hours.”
- ingestion (eating): “Up to 20 percent can make it into the system but its potency increases by 3 to 4 times because of how it is metabolized in our liver, but effects take on average 60 to 90 minutes to be felt. The maximum effects will be felt 2 to 3 hours after administration; the patient should stop feeling any effects 8 to 10 hours after eating.”
- sublingual (tinctures): “Fast-acting but not long-lasting. Take under the tongue. You’ll feel the initial effects in five minutes, the final effects in four hours.”
- dermatological (creams/salves): “Place it straight onto the affected area for localized symptom relief. For a child, the use of a patch can be advantageous.”
A less commonly used method, suppositories, “has advantages such as high bioavailability—upwards of 60 percent makes it into the patient’s system—and ease of use, especially for patients who cannot swallow or have cancers located in the lower GI tract.”
According to Dr. Litinas, “The fact that there is not one ‘best’ way of administration means that a patient can consume it in many different ways and in different combinations, with different results and efficacy depending on the condition or desired effect. This is a great advantage of medical cannabis in relation to many other traditional pharmaceuticals.”
- Example 1: A patient who wakes up with pain can start the day by smoking and eating at the same time. For the initial 90 to 120 minutes, inhalation takes care of the pain. As its effects are leaving the body, the edible is coming aboard and the patient is covered for the next 8 to 10 hours. If any pain breaks through, a quick inhale will take care of it. After 6 to 8 hours, the patient eats again to maintain an appropriate cannabinoid level throughout the day.
- Example 2: A patient has insomnia and usually gets up every 2 to 3 hours. The patient eats an hour before sleep, and smokes to go to sleep. When the patient would usually be waking up, the edible will take effect and the patient remains asleep.
Dr. Litinas urges every patient to keep a medication diary, with times, doses, and results experienced.
Talking to Your Physician
If you are a cancer patient and are scared to bring up the idea of cannabis therapy with your physician, what do you do? Dr. Litinas says just start an honest conversation.
Begin with general questions on cannabis. If you feel comfortable with your physician’s responses and attitude, you can continue to explore this option. But educate yourself before talking to your physician so that you can cooperatively decide on a health plan. Understand that a lot of medical professionals either do not know about cannabis, or work in institutions that do not allow physicians to prescribe any schedule 1 medications.
Women Grow, founded in 2014 in Denver, Colorado, is a for-profit entity that serves as a catalyst for women to influence and succeed in the cannabis industry as the end of marijuana prohibition occurs on a national scale. Women Grow monthly Signature Networking events connect aspiring and current professionals in the cannabis industry. www.womengrow.com. For more information about the Ann Arbor Chapter, contact Dori Edwards, Ann Arbor Chapter co-chair at firstname.lastname@example.org.
Bloom City Club, sponsor of the monthly Women Grow meetings, is a cannabis education and provisioning center. It is an organization of successful professional business women dedicated to providing the highest-quality medical cannabis, outstanding customer service, and the most valuable information to its registered medical patients. For more information, contact Colleen Tracy, General Manager, email@example.com, (734) 585 0621, www.bloomcityclub.com.
Om of Medicine, a member and sponsor of Women Grow, is a medical cannabis provisional center that was founded to help patients safely and securely obtain laboratory-tested, high-grade medical cannabis. Om’s approach integrates patient education, one-to-one private consultations with highly trained staff members, and a drive to have the most up-to-date clinical research and medical information for its patients. For more information, contact firstname.lastname@example.org, (734) 369 8255, www.omofmedicine.org.
Ken Wachsberger, editor of Bloom Blog, is an author, editor, political organizer, and member of the National Writers Union.