When I was diagnosed with Stage 3 colon cancer, I opted for my California medical cannabis card and used medical cannabis products for effective symptom management. This helped me avoid taking other medicines that could have caused further complications during treatment. There are so many things that I wish I knew then that I know now, but my expertise now helps other patients make decisions about their cannabis use.
My first experience at a pharmacy made me feel like I was doing something wrong and I was afraid to ask questions. When I asked questions, I got vague answers. In return, I’ve made mistakes in my self-medication, and while this wasn’t fatal, it was sometimes uncomfortable and inconvenient.
Part of the disconnection from my pharmacy experience was that I didn’t know how to find out what was working for me. We have a broad general knowledge of how cannabis – with its many types of drugs, chemotypes, and strains – manifests in the body. But humans are walking chemistry experiments, which means that there will be differences in our reactions. We need to find our personal patterns with cannabis (or any other ingested substance) by paying close attention to what we choose and how (or if) it helps to have a better understanding of cannabis use as a medicine.
Journaling is a great way to keep track of the cannabis strains you use and document their effects. What worked, what didn’t, and why – along with the amount of medication you took – are important things to track and refer to a pharmacy on your next visit. The key is to find the lowest dosage in the appropriate proportions that will produce the desired effect in your body.
The side effects of chemotherapy take an enormous toll on everyday life. The experience of getting so much sicker for better results affects not only your body but your mental health as well. Cannabis can help relieve symptoms emanating from both the body and mind and, in some cases, act as a preventative measure against further harm.
Here are some of the most common chemotherapy side effects, and how cannabis interacted with each of them:
(Please note that each type of chemotherapy has its own side effects, and some of us are more sensitive to these drug treatments than others.)
Cancer treatments can cause you to become obliterated or overwhelmed. Inhaling small amounts of uplifting sativa buds or using a low-dose (2.5-5 mg THC) sublingual sativa-based supplement (dissolved under the tongue) can lift your mood without being too sedating.
Insomnia is a common symptom of chemotherapy. If you’re having trouble falling asleep, inhaling indica flowers can help. If you’re struggling to stay asleep, an indica edible can keep you peaceful overnight. Remember, if you feel a little “stoned” in the morning, turn down the volume of the edible. In both cases, a 1: 1 ratio of CBD and THC may be more appropriate if there is fear of sleep or inflammation with pain.
Problems with the infectious and immune systems
It is important to note that using untested products, especially dried flowers, carries significant risks with a weakened immune system, although there have never been any deaths from cannabis use alone. Untested products may contain mold, fungus, or mildew, which can easily irritate someone with a robust immune system but can make or even kill someone with a weakened immune system. Many states require testing these days, but if the state you live in doesn’t, ask companies whose products you want to use if they will do testing and ask about the reports.
Nausea & vomiting
Using THC in an edible or smokable format during chemotherapy helped me avoid nausea medication after my first day of treatment. For me, it was huge because the anti-emetics banned for treating nausea have constipating side effects that can be fatal to a colon cancer patient. It’s important to note that while CBD ratios help with nausea, they can also act as an anorectic. This is problematic if you are already having trouble eating. Eating candied ginger also helps with nausea.
Smoking or eating small amounts of THC will help whet your appetite. For patients who are particularly sensitive to THC, I often recommend trying the non-euphoric cannabinoid THCA. If you need some CBD in your regimen during meals, try a 1: 1 ratio of CBD to THC in an edible or smokable format, as the introduction of THC can help counteract the appetite-reducing properties of CBD. I also always enjoy giving non-cannabis advice on this topic. The book that saved me during treatment is called “The Cancer-Fighting Kitchen” by Rebecca Katz. Addressing the nutritional challenges of treatment, this book offers great recipes to manage a range of symptoms and get you back to eating. I can’t praise it enough.
Forward-looking nausea and anxiety
The night before or the day of chemotherapy can cause anxiety and anticipated nausea. Higher CBD ratios like 18: 1 CBD to THC in an edible or tincture can help reduce jitter and nausea while keeping your mind clear.
Constipation from opioid use & opiate withdrawal
Another challenge during my treatment was opioid use. There were times when I needed them to treat pain, such as when I cut my colon again and removed the tumor, or because my neuropathy made me feel very uncomfortable. But the constipating effects were challenging, as were the withdrawal symptoms I felt when I weaned myself off after two weeks of opioid use after surgery. Using THC helped me lower my opiate consumption by increasing the analgesic effects of Norco, the drug I was taking, without causing any harm. It also smoothed out the withdrawal effects – the restlessness, pain, and insomnia went away when I started adding cannabis to the mix. Another great tool for preventing constipation is something you can make at home called a “power pudding.” It is a prune and bran home remedy and you can find many recipes for it online.
Mouth, tongue and throat problems
Chemotherapy targets rapidly dividing cells in the body and does not recognize which are cancerous or not. This is why some of us have intestinal disorders and diarrhea, or have mouth, tongue and throat discomfort from chemotherapy. Cannabis is great for relieving pain, relieving inflammation, and helping the healing process. Tinctures that are rich in CBD are especially helpful. However, if you experience mouth irritation, it is not a good idea to use an alcohol-based tincture as it will further irritate the mucous membranes.
Chemotherapy-induced peripheral neuropathy (CIPN)
The platinum salts used in chemotherapy – including oxaliplatin and cisplatin – along with other chemotherapy drugs are known to cause neuropathy in patients. Neuropathy is weakness and pain that is usually felt in the hands and feet thanks to damage to peripheral nerves. Some people feel it in the first round of chemotherapy, others later in treatment, and we all feel it with different intensities and with different recovery times. I haven’t had chemotherapy for seven years and I still have neuropathy. A 2014 study found that CBD prevented neuropathic pain and thermal sensitivity without affecting the functioning of the nervous system or the effectiveness of chemotherapy. Taken before, during, and after treatment, patients have reported that they do not develop neuropathy, experience it to a lesser extent, and rebound much faster with less pain and numbness remaining.
Chemotherapy can cause dry skin and inflammation from radiation. Fortunately, the skin loves cannabis. Subjects are completely non-euphoric, which makes them a great mediator to use anytime and ideal for those who need symptom relief without euphoric effects. Often times, I suggest a patient use the same high CBD tincture they are taking for anxiety or pain and apply it as a topical for radiation irritation. CBD relieves inflammation and THC relieves pain – and together it helps the skin heal so much faster. A topical ointment with a 1: 1 ratio of CBD and THC heals dry and inflamed skin with great emollient effects.
After chemotherapy, many patients may still experience side effects such as anxiety, residual pain, and depression. Healing from chemotherapy is a long process. The cannabis knowledge gained through treatment can also help address this phase of symptom management. Also, be nice to yourself. As survivors, we need to take a restorative approach to healing and learn to be ourselves in new ways.
Originally published in the print edition of Cannabis Now.