To Weed or Not to Weed, That is the Question

When it comes to cancer treatments, there are a great many theories and an abundance of opinions about options, from pharmaceuticals to nutraceuticals and most anything in-between. There’s an enormous number of different cancers out there, and each and every patient has a unique circumstance – his or her own body. Despite all the research over the past century, treating cancer is still only part science, and a great deal part art. 

With multiple myeloma, the induction treatment is pretty cut and dried, black and white. The standard is pretty much the “RVD” regimen – Revlimid, Velcade and the steroid dexamethasone. For patients, the only real decision is to either do it or to not. There’s not really a gray area.

However, with subsequent treatments after induction therapy, it mostly gets gray, and there’s not much black or white, even with established protocols. Stem cell transplants are a good example.

First off, “stem cell transplant” is a bit of marketing magic and branding – take my word as a marketing professional. When I first heard it, I thought, “Oh, cool, high-tech and all that, a cutting edge therapy.” Then, I started looking into it a bit.

For multiple myeloma, the stem cell transplants are autologous transplants, meaning the patient receives his or her own stem cells, not those from a donor – stem cells are harvested from the patient very early in the process and then stored to be introduced back to the patient later. Those stem cells are introduced back to the patient so that her immune system can be rebuilt – stem cells will make bone marrow, and bone marrow will in turn make red blood cells, white blood cells and platelets. Now, why does the patient need to rebuild her immune system? Well, she needs to rebuild it from scratch because the chemotherapy received to kill off cancer cells also destroys all her left over stem cells and bone marrow, wiping the immune system completely out. Collateral damage. 

So, you see, the stem cell transplant process isn’t so much a “transplant” as much as it is a chemotherapy bath that will injure all internal organs, kill cancer cells and completely wipe out all bone marrow and stem cells. The “transplant” literally takes ten minutes to reintroduce stem cells and then three weeks for them to begin lay the foundations of a new immune system rebuild.

But, I’ve digressed.

Back to the gray area. With a stem cell transplant, the gray area is with regards to timing. The objective of the stem cell transplant process is to get rid of as much cancer as possible, with the hope of enabling the patient to be on a reduced level of toxic medicines, so called “maintenance doses.” But, if you ask three doctors when a transplant should be performed, you’ll very likely get three different answers – there’s just not enough longitudinal data on longevity, etc. to have a clear, cut-and-dried decision. 

Personally, for me, dealing with that type of ambiguity has been difficult. It’s easy to make a binary, yes/no-type of decision. It’s much more stressful (and even frustrating) to make decisions when there are so many options, all of which could be the right choice (and all of which could be the wrong choice). However, I’ve got to come to grips with this type of ambiguity, because it’s likely going to be that way for the rest of my life. 

Where a lot of gray area exists is in non-traditional treatments for cancers. For example, some cancer patients swear by alkaline water, hypothesizing that cancer cells don’t like alkaline environments. Others swear by the medicinal properties in the antioxidants of tea, particularly green tea. 

For me, green tea isn’t an option, as researchers at the University of Southern California found that some green tea compounds, notably the EGCG compound, appeared to actually block the anticancer action of Velcade. Now, I wouldn’t want to block the efficacy of that drug, now would I?

But, what about cannabis? 

Cannabis (aka, marijuana) is perhaps the buzziest thing in the United States, and there’s no pun intended. Market analysis of cannabis suggests that if it was recreationally legal in all 50 states, the industry would be valued at over $70 billion annually. Is that a lot? Consider this: it would be bigger than the United States wine industry.

Uh, that’s pretty big.

But, nobody really knows anything about cannabis as it relates to health. Despite what you might read or hear preached to you by advocates, the efficacy of medicinal marijuana is one giant gray area, with no real scientific proof one way or another. Lots of claims; no real proof. And, for what claims there are, they mostly center around the treatment of symptoms, like anorexia, chemotherapy-induced nausea and vomiting, pain, insomnia, and depression, and not the root cause of a disorder or disease. 

I actually started ingesting cannabis edibles before my diagnosis. I was having problems sleeping – not getting to sleep, but staying asleep. After about 60-90 minutes of sleeping, I would wake up, usually feeling hot, and then I would have difficulty getting back to sleep once my brain started getting busy about all I needed to accomplish the next day, etc. 

[By the way: unbeknownst to me before my diagnosis, night sweats are actually a symptom of several different cancers, in addition to perhaps being a symptom of having too many blankets on the bed.]

I wasn’t about to try an opioid for sleep – not my style. So, after having become a bit of a go-to-resource for retail media when talking about retail cannabis, I decided to get a medical marijuana card and try it as a sleep aid.

For those of you unaware of medical marijuana cards (no longer needed in California as marijuana is legal to buy recreationally at licensed – and taxed – dispensaries), it’s the biggest joke ever. It’s not about medical care. It’s about taxes. 

To get my card, I called an 800-number, where I spoke to a physician’s assistant. I told him I was having trouble sleeping and guess what? He suggested I would be an excellent candidate for a medical marijuana card. All I had to do was pay $35 and I’d have a card allowing me one year of legal, hassle-free purchasing of marijuana products. No prescription, mind you. All my “medicine” would be self-prescribed – the dosage, the frequency, the type (edibles, oils, flowers to smoke, etc). It’s state-sponsored permission, not medical prescription.

Anyway, I didn’t care. I’m not a smoker, so I went the edible route. Simplistically, there’s two parts of cannabis – THC is the psychoactive ingredient that gets you “high,” while CBD is a non-psychoactive ingredient, what many people like for treating inflammation and other physical ailments. You can buy products that are one or the other, as well as both. I started with edibles like mints, chocolate-covered blueberries, cookies and gummies, all of them with THC. I started with 3 mg of THC, then worked up to 5 mg and then 10 mg. I wouldn’t say I was ever “high” from a dose, but, truthfully, I wasn’t really awake to really know. I’d take my edible right before bed, and it would take an hour or two to work its way fully into my system. By the time I’d wake up hot, I’d throw the blanket off, roll over and go back to sleep. It seemed to work for me.

I tried pushing my dose up to 20 mg and I didn’t really like that. Those psychoactive effects I felt. One night, I could feel this little air bubble going up and down my esophagus, and I couldn’t think about anything else. Kind of freaky. Also, I didn’t know if I was dreaming or having conscious thought. I swore Lori said something to me and I replied back, but then she didn’t reply back – was all that in my head, or did it happen? It was all just a little too weird.

That episode made me cut back down to less than 10 mg a night. Until, of course, I tried it again to confirm my first result. And, confirmed it was – the exact same type of experience. No more 20 mg nights for me.

So, there I was, ingesting 7-10 mg of THC and 5-8 mg of CBD a night. That was pre-diagnosis of multiple myeloma. Soon after my diagnosis, however, my friend Paul shared with me a 2016 published study from a team of Italian researchers entitled, “Cannabinoids synergize with carfilzomid, reducing multiple myeloma cells viability and migration.” 

Now, Paul knows his way around the life sciences, having built several successful biotechnology companies from scratch. He stumbles across studies all the time that state something along the lines of, “we found that something that we think worked, but we’re not really sure why.” What he really liked about this study is language in the study abstract: “ … we also found that the CBD and THC combination is able to reduce expression of the β5i subunit as well as to act in synergy with CFZ to increase MM cell death and inhibits cell migration. In summary, these results proved that this combination exerts strong anti-myeloma activities.” 

The researchers used the words “proved” and wrote about the specific mechanism that produces a synergy between CBD, THC and carfilzomib (a selective proteasome inhibitor drug marketed under the trade name Kyprolis, developed by Onyx Pharmaceuticals, and very similar to the drug I’m on, Velcade). It’s rare for such strong, definitive language to used, and as it captured Paul’s attention, it quickly captured mine too.

The study has been referenced a great number of times since being published in 2016 – 21 citations by my uneducated count – and while there have been no published reports of human trials, there seems to be some promise.

Most importantly, there’s really no downside. I won’t get into the effects of THC on the developing brains of children and teenagers. But, from where I sit, a 55 year-old with multiple myeloma and brain that’s probably developed as much as it’s ever going to develop, the adverse side effects of THC and CBD are pretty limited. Legal pot is taxed, so it’s expensive. And, if I take too much THC, I might run the risk of giggling too much, falling asleep or developing a nasty nacho cheese Dorito habit and all that comes with it, like day-glo orange stains on all my clothing.

But, if it helps me fight cancer – the hell with it, it’s a risk I’m going to take.

My current go-tos are Kiva Peppermint Pattie Terra Bites (5 mg THC per serving) and Camino Sparkling Pear Gummies (2 mg THC and 6 mg CBD per serving).

They’re tasty, particularly the peppermint patties – my experience is that a great may cannabis edibles taste like … well … dirt and weeds. I have to make sure both of these packages are upstairs and away from me during the day, because they taste so good I might be tempted to nibble on them throughout the day. I should probably just stick to them at night, before bed.

Probably.