Medical Marijuana

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What is medical marijuana?

Marijuana, also called cannabis and quite a few other names, is a plant grown around the world that has been used in herbal remedies for centuries. There are a number of biologically active compounds in marijuana, which are called cannabinoids. The two most-studied compounds in marijuana are:

  • delta-9-tetrahydrocannabinol (THC), which causes marijuana’s high
  • cannabidiol (CBD), which doesn’t cause a high

Each cannabinoid offers different benefits. Many people diagnosed with cancer feel that CBD is better at controlling pain than THC.

While marijuana is federally illegal in the United States, more than half of the states, as well as the District of Columbia, have passed laws legalizing the use of marijuana to treat certain medical conditions.

So medical marijuana means using marijuana or its cannabinoids for medicinal purposes.

What conditions is medical marijuana used for?

It’s extremely important to know that marijuana is not a treatment for breast cancer. People use marijuana to ease the side effects of treatment and pain caused by the cancer.

Still, because marijuana is federal illegal, research on marijuana to manage cancer treatment side effects is limited.

Anecdotal evidence suggests that marijuana may ease:

  • pain
  • nausea/vomiting
  • hot flashes
  • loss of appetite
  • anxiety
  • insomnia

caused by a breast cancer diagnosis and treatment.

“It’s important for people to know that anything they ingest that produces a change in their bodies is acting like a drug, and it has the potential for side effects, interactions with other drugs, as well as benefits,” said Virginia F. Borges, M.D., MMSc., professor of medicine and director of the Breast Cancer Research Program at the University of Colorado Cancer Center. She specializes in treating young women diagnosed with breast cancer. “People have to be as diligent about researching medical marijuana as they would be with any other supplement or drug they were taking. The hard reality is that because marijuana is illegal at the federal level, your treating doctor, who works under federal guidelines, isn’t going to be your primary source for information on this topic. Your doctor will only be able to report what she or he has observed in patients, and that may be very limited information depending on where you live.”

Because marijuana has been legal for both medical and recreational use in Colorado for a number of years, Dr. Borges has a number of breast cancer patients who use or have used medical marijuana to ease treatment side effects.

“I’ve mainly seen it used in conjunction with prescription drugs to control pain and other side effects in patients living with metastatic disease,” she said. “It’s rare that a person living with metastatic breast cancer would have only one side effect to manage. So, by adding in medical marijuana, it often allows me to cut back on the number of drugs I prescribe. With a high-quality source for medical marijuana and knowing how it affects an individual, using medical marijuana can put more control back in the hands of my patient. If someone is feeling good, she may only need to take one or two drops per day. If she’s not feeling good, she may need three or four drops per day. Many of the prescription drugs don’t have this flexibility. Any time you can give control back to a person when their living with cancer, it’s a good thing.”

What to expect when using medical marijuana

Medical marijuana comes in a variety of strains and each has different levels of active compounds and potency. This means the effects of medical marijuana will be unique to each person and can be hard to predict.

Medical marijuana products come in many different forms, including:

  • edibles, such as cookies, candy, mints, or brownies
  • dried leaves or buds for smoking
  • oils for vaporing or mixing into tea, honey, or other food
  • creams and other products that are applied topically
  • sprays or tinctures that are used under the tongue or along the gum line

Many oncologists would prefer that their patients not smoke anything. At the same time, many women diagnosed with breast cancer are trying to prevent weight gain/lose weight related to treatment. So, oils, sprays, or tinctures may be a better option than edibles or dried leaves or buds. Still, every person’s situation is unique and the best form of medical marijuana will vary from person to person.

Again, because research on medical marijuana and cancer is limited, information on side effects is also limited. Reported side effects of medical marijuana include increased heart rate, low blood pressure, dizziness, fainting, hallucinations, and paranoia.

Important things to consider before trying medical marijuana

  • Always tell your doctor about any vitamins, supplements, herbs, and over-the counter medicines you are using, including medical marijuana. If you live in a state where medical marijuana is legal and you’d like to talk to someone who is successfully using medical marijuana to treat breast cancer side effects, you may want to ask your care team if they can connect you with another patient.
  • Medical marijuana is NOT covered by insurance, Medicare, or Medicaid. The cost of medical marijuana can start at about $100 per month and can be much higher, depending on how much is needed. The bottom line is that medical marijuana can be expensive.
  • THC and CBD are present in different levels in different strains of marijuana. THC and CBD each offer different benefits. For example, CBD may be better at easing pain, while THC may be better at controlling nausea.
  • You will likely have to do a lot of research on your own to figure out the ratio of CBD to THC that works best for controlling your side effects. This can take quite a bit of trial and error. What works for someone else may not work for you.
  • You may have to go to several medical marijuana dispensaries until you find one that you’re comfortable with and has staff members that can answer all your questions about the levels of CBD and THC in the strains available. Depending on the laws in your state, some dispensaries may cater more to recreational users than medical users. Medical dispensaries tend to be more clinical and have staff members who are more likely to have experience helping people with cancer use medical marijuana to treat side effects. It can be helpful to call the dispensary and explain the side effects you’re having, as well as any experience you’ve had with marijuana, and ask if you can schedule a consultation appointment with a staff member. If you’re at all uncomfortable, go to a different dispensary.
  • Some doctors who regularly prescribe medical marijuana suggest asking the dispensary staff member some general questions before you start talking specifically about your side effects:
    • Is your marijuana grown using pesticides?
    • Are your items stored and handled properly to avoid spoilage and contamination?
    • Are your items tested for fungus and bacteria? What are the results?
    • Are your items tested for levels of pesticides?
    • What is your training and experience in recommending medical marijuana?
    • Have you worked with cancer patients before?
  • Some oncologists have recommended that their patients go to a medical marijuana dispensary, rather than an outlet that caters to recreational users. There is no research on whether recreational marijuana is just as safe and useful for cancer patients as the usually more expensive medical grade variety, though some dispensaries take extra care to ensure there are no pesticides or mold in their medical medical-grade cannabis.
  • If you work for the federal government, a federal government contractor, or an employer that conducts regular drug tests, you may face disciplinary action for using medical marijuana. Always check your employer’s medical marijuana policy before you start using it.
  • If you are part of a clinical trial, it is very much unknown how the compounds in medical marijuana may interact with any experimental drugs. It makes good sense to talk to the doctor coordinating the trial before you try medical marijuana.

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