cannabis and chemo

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How I Got Through Stage 3 Cancer Treatment with Cannabis

Most people can name the worst day of their life. Mine was the day I was diagnosed with stage 3 colon cancer at the age of 37.

Sara Payan

03.21.21

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Most people can name the worst day of their life. Mine was the day I was diagnosed with stage 3 colon cancer at the age of 37. Time stood still as I heard the diagnosis come over the phone. 

My mother, as it happens, is a cancer researcher and an oncology nurse. It also just so happened that she did the clinical trials of the chemotherapy regimen that I was about to undergo (FolFox5). This meant that I was very aware of the good, the bad, and the ugly that the next six months would bring. 

Back then, my mom had told me a little about the potential for cannabis to help alleviate the symptoms of cancer and its treatment. Now I wanted to know more. 

After some deep research, I decided to use medicinal cannabis to manage my symptoms. This was instead of, not in addition to, taking other pharmaceuticals. Why? Because anti-nausea drugs and opiates can be life-threatening for someone with colon cancer. Plus, they’re constipating. I also had serious concerns about using the benzodiazepines the doctors gave for anxiety. 

Almost ten years later, my experience changed me so much that my career now involves helping cancer patients make empowered choices about using cannabis during treatment.

Chemotherapy’s side effects take a huge toll on daily life. Having to get so much sicker to get better impacts your body, of course, but also your mind. Cannabis can help manage physical and mental symptoms and can prevent further damage, like chemotherapy-induced neuropathy.

Human beings are walking chemistry experiments. This means that we all react differently to cannabis.

Human beings are walking chemistry experiments. This means that we all react differently to cannabis. It’s up to each of us to discover our personal preferences and doses. For example, CBD may make you sleepy while THC wakes you up. Or it could be the other way around. 

Journaling is a great way to track the types of cannabis you’re trying, and document their effects on you. The goal is to find the lowest dosage that creates the desired effect in your body. 

Don’t let anyone try to sell you 5 or 10mg of THC if you’ve never tried cannabis before. Start with 1 to 3mg THC and move up from there. But don’t give up after trying your very first product. 

Curious about how cannabis can help with chemo’s most common side effects? Let us break it down for you. 

Note: Each type of chemotherapy has its own particular side effects, and some of us are more sensitive to drug treatments than others.

FATIGUE

Cancer treatments can leave you wiped out or overstimulated. Try using a sativa-based low dosage (2.5 – 5 mg THC) sublingual product. (Sublinguals are tinctures or dissolvables that go under the tongue.) Edibles (like mints and gummies) or drinks like hot teas or cold beverages can also lift your mood without being too sedating. Remember to start your dose low and increase from there. 

INSOMNIA

Insomnia is a common chemo symptom. If you’re having problems falling or staying asleep, products that have CBN with a little THC really help. These include sublingual tinctures, teas and mints. Try a variety of products to figure out what works for you. And if one stops working, mix it up. For example, use a tincture for a week, then switch to a mint or honeyshot for sleep, then go back to the tincture. 

If you feel a little “stoned over” in the morning, take down the dose. In either case, if you have anxiety around sleep or inflammation with pain, a 1:1 ratio of CBD and THC may be more appropriate. One of my favorite sleep products is Tranquili-Tea, which blends other relaxing herbs with cannabinoids.

NAUSEA AND VOMITING 

After my first day of chemo, using THC in edible or sublingual form helped me to not use anti-nausea drugs. For me, that was huge, since the antiemetics prescribed to treat nausea have constipating side effects that, for a colon cancer patient, can be deadly. Note that though CBD ratios help with nausea, they can also act as an appetite suppressant, which is problematic if you’re already having issues with eating. 

DECREASED APPETITE

THC is the cannabinoid that gives you “the munchies,” so eating small amounts of it will awaken your appetite. Patients who are particularly sensitive to THC can try the non-euphoric cannabinoid THCA. If you do need some CBD in your regimen around meal times, try a 1:1 CBD to THC ratio in an edible format. Introducing THC can counter CBD’s appetite-reducing properties. Also, choose a product whose flavor you enjoy, to further inspire the munchies.

ANTICIPATORY NAUSEA AND ANXIETY 

The night before or the day of chemo can cause anxiety and anticipatory nausea. Higher CBD ratios such as 25:1 CBD to THC in a tincture or edible takes down the jitters and nausea while keeping you clearheaded. Kikoko’s mints are great for this if you’re sensitive to higher doses. Start at just 1mg THC combined with CBD, so you don’t have to worry about getting too high in the chemo suite.

CONSTIPATION FROM OPIOIDS

Sometimes cancer patients need opioids for pain management. But their constipating effects and withdrawal symptoms can be challenging, not to mention the very real chance of addiction. Fortunately, THC amplifies the analgesic effects of opiates, thereby letting you reduce your dose. THC can smooth out withdrawal effects as well, including restlessness, pain, and sleeplessness, all of which often disappear once you add cannabis into the mix. For colon cancer patients, anti-anxiety drugs and opiates can be deadly due to the threat of constipation, which can cause sepsis.

MOUTH, TONGUE AND THROAT PROBLEMS

Chemotherapy targets rapidly dividing cells in the body without discerning which cells are cancerous, and which cells are not. Normal cells that divide quickly include cells in hair follicles, nails, the mouth, digestive tract, and bone marrow. So good cells get zapped too, which can cause upset bowels and diarrhea. This is also why some people lose their hair and nails during treatment. You might also experience mouth, tongue, and throat discomfort during chemotherapy. Cannabis is great for soothing pain, taking down inflammation and helping the healing process. Tinctures or drinks rich in CBD can be especially helpful.

CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY (CIPN)

Platinum salts called oxaliplatin and cisplatin are used in chemotherapy, alongside other chemotherapeutic agents. These are important, but they can cause neuropathy—weakness and pain, usually in the hands and feet, because of damaged peripheral nerves. Some feel it during the first round of chemo, others later in treatment. We all feel it in different intensities and have varying recovery times.

One study found that CBD prevents neuropathic pain and thermal sensitivity, while not negatively affecting nervous system function or the efficacy of the chemotherapy treatment. When patients take it before, during, and after treatment, they report not getting neuropathy, experiencing it to a lesser degree, and bouncing back much faster with less residual pain and numbness. It’s best to take a sublingual or drink with high doses of CBD (20mg or more). 

SKIN CHANGES

Chemotherapy can cause dry skin and inflammation from the radiation. Luckily, the skin loves cannabis. Topicals are completely non-euphoric, which makes them great to use any time, especially for those who need symptom relief without any “high” effects. Often, I’ll suggest that a patient apply the same high-CBD tincture that they take for anxiety or pain. Or I’ll tell them to buy a topical balm. It’s the CBD that reduces inflammation and the THC that helps mitigate pain. Together, they help skin heal so much faster.

ANXIETY AND DEPRESSION

After chemo, you may experience anxiety, depression, and residual pain. This is completely normal and it will pass. Healing from chemotherapy is a long process. Cannabis can help now too. THC, at reasonable doses (typically 10mg or less), helps lift depression. CBD, along with a very low dose of THC, is usually best for anxiety. 

Perhaps most importantly, be kind to yourself. As survivors, we must be patient with ourselves and take a restorative approach to recovery. It takes time to learn how to be ourselves in a whole new way. Remember the “three P’s”: being positive, present, and proactive. We can be not just survivors, but thrivers too.

About the Author: Sara Payan

Sara Payan is a nationally recognized & award-winning cannabis educator, speaker, public policy advocate, writer & consultant. She is the Public Education Officer for The Apothecarium in San Francisco, a member of the San Francisco Cannabis Oversight Committee & for three years (2016-2018) was vice-chair of the San Francisco Cannabis State Legalization Task Force. Her experience as a stage III colon cancer survivor and her civil rights background fueled her passion for creating safe access to cannabis through education and creating compassion programs to provide free cannabis for the critically and chronically ill with low income. Learn more about Sara: http://www.sarapayan.com & www.plantedwithsara.com. // Photo of Sara courtesy of Jennifer Skog, MJ Lifestyle.

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