Delivery Methods and Dosing:Making the most of your medicine

Medical Cannabis and Cancer

Special Guest: Molly Stewart, Mission Services Director atCancer Community Center

Host: Becky DeKeuster, M.Ed, WCM Education LiaisonProducer: Ben Gelassen, WCM Digital Marketing Specialist

An introduction for patients, families,and caregivers

Cancer Community Center

FREE:• Buddy program• Support groups• Learning opportunities• Movement & meditation• Complementary therapies• Creative expression & social

opportunities

Calendar & more information at cancercommunitycenter.org

Cancer in Maine

Cancer is the leading cause of death in Maine (34% of all deaths)

Source: Maine Cancer Surveillance Report 2014. Department of Health and Human Services/Maine CDC Division of Population Health. PDF last accessed 10/23/16.

Maine’s cancer incidence rates are higher than US average rates

Cancer in Maine

In Maine, males had significantly higher incidence and death rates than females

Source: Maine Cancer Surveillance Report 2014. Department of Health and Human Services/Maine CDC Division of Population Health. PDF last accessed 10/23/16.

However, these rates were declining at a faster pace for males than for females

Cancer in Maine

Source: Maine Cancer Surveillance Report 2014. Department of Health and Human Services/Maine CDC Division of Population Health. PDF last accessed 10/23/16.

Cancer in Maine

Source: Maine Cancer Surveillance Report 2014. Department of Health and Human Services/Maine CDC Division of Population Health. PDF last accessed 10/23/16.

National Cancer Institute

Source: National Cancer Institute. Cannabis and Cannabinoids. https://www.cancer.gov/about-cancer/treatment/cam/patient/cannabis-pdq#link/_13

Preclinical studies of cannabinoids indicate potential in these areas:

Antitumor activity

Stimulating appetite

Pain relief

Nausea & vomiting

Anxiety & sleep

Breast cancer cells in a lab specimen, before (L) & after (R) application of CBD.

Source: Pacific Medical Center

How Does Cannabis Help?

Image source: David Guzman, “The Endocannabinoid System”

The endocannabinoid system

Receptors found on cells throughout the body

Purpose appears to relate to homeostasis, wherever in the body the receptors are activated by either endo- or phyto-cannabinoids

Exogenous CannabinoidsCannabis Indica

Cannabis Sativa

What Symptoms Might Cannabis Help?

Your ECSHOMEOSTASIS

DepressionVisceral Pain

Appetite

Digestive MotilityTHC

CBD

CB-1

CB-2

Fever & Chills

“Chemo brain” & fatigue

CBN

Promising Cannabinoid Research

Source: www.pubmed.com and http://norml.org/library/item/gliomascancer?category_id=560

- breast carcinoma- prostate carcinoma- colorectal carcinoma- gastric adenocarcinoma- skin carcinoma- leukemia cells- neuroblastoma- lymphoma

- lung carcinoma- uterus carcinoma- thyroid epithelioma- pancreatic adenocarcinoma- cervical carcinoma- oral cancer- biliary tract cancer

(cholangiocarcinoma)

Preclinical/non-human studies have shown cannabinoids to potentially treat:

But Remember….

Brain cells with Alzheimer’s being grown in a Petri dish (www.discovermagazine.com)

Female cannabis flowers are covered with small crystals which contain dozens of active therapeutic compounds

Methods of Administration

Inhalation Ingestion Topical30 sec – 1 min.

Smoking/Vaping

Easy titration

Wide variety:Tincture, foods,

beverages

5 to 10 min20 to 120 min.

Can be helpful for neuropathic pain,

psoriasis

Can be difficult to titrate

No psychoactivity

Flower & concentrated oils

What About Cannabis Oil?

Also called “Rick Simpson Oil,” “Full Extract Cannabis Oil” (FECO), or “Phoenix Tears.”

TinctureEdible

Typically made with alcohol, glycerine, hempseed oil

1 ounce flower yields ~1 fl oz tinctureDose: Measured in drops

OilEdible

Typically made with alcohol, CO2, butane, or other solvents

1 ounce flower yields 2-4 grams oilDose: Measured in grains of rice

Cannabis Side Effects

Cannabis has no known LD50

No known negative

drug interactions

EuphoriaMotor coordination problems

Short term memory lossRed eyes

Dry mouthLow blood pressureHeart palpitations

Anxiety/panic/paranoiaHallucinations

Remember, while unpleasant, too much cannabis alone is not fatal. Time, water, food, and a relaxing environment all help.

Remember: Start low,Go slow!

What is the process?

1. Talk to your primary or specialist doctor

Any MD, DO or NP can certify

Some work for practices or groups that do not allow them to certify. Their patients must go to a cannabis specialist doctor.

Be prepared to educate

What is the process?

2. Choose a provider

• Grow at home• Designate a dispensary• Designate an individual to be

a cannabis “caregiver”

A quality provider should:

• Offer many options (product & potency)• Be able to coach and explain products clearly• Lab test all products• Give receipts, track inventory, charge sales tax• Use no pesticides• Make you feel safe

Resources

www.pubmed.comhttps://cancercommunitycenter.org

“The place to go when you don’t know where to begin.” www.safeaccessnow.org

Delivery Methods and Dosing:Making the most of your medicine

Thank you for your time and attention!

What are your remaining questions & concerns?

www.mainewellness.org@wellconnectmewww.facebook.com/mainewellnessInstagram: @mainewellness