Breast cancer survivor Nicole DiMonda and her husband, Jaime Brambila, share their story of life and death decisions and how they turned to cannabis for help.
The question of whether cannabis can be a treatment for cancer has intrigued researchers for years. But as more and more patient and doctor anecdotes about using cannabis for cancer treatment begin to surface, there is a growing expectation that this ancient medicine may actually be able to do more.
One of those stories of cannabis treatment for cancer comes from cancer survivor Nicole DiMonda, who, along with her husband, Jaime Brambila faced life and death decisions and turned to cannabis for answers.
They are the owners and founders of Grace Health and Wellness, a cannabidiol (CBD) product manufacturer and cannabis biotechnology company based in Connecticut. Cannabis Patient Care featured part of their story earlier this year in their monthly newsletter in an article titled "Medical Cannabis as an Adjunct Therapy to Cancer Treatment: One Patient’s Journey from Diagnosis to Remission" (1). In addition, DiMonda and Brambila recently announced plans in their pipeline for an approved cannabis botanical drug—see sidebar "Continued Research."
But there’s more to tell about their journey, their discoveries about the medical use of cannabis, and their hopes for others facing similar medical challenges as they both advocate for more help from mainstream medicine.
Jaime Brambila and Nicole DiMonda are thrilled to announce their continued research efforts on how cannabinoids can play a role in cancer treatment. Their latest endeavors include pre-clinical trials as well as a research project with the University of Connecticut focused on identifying the specific chemotypes in their cannabis strains that are producing anticancer effects. They are currently seeking funding opportunities to support these research initiatives. For more information please contact them at firstname.lastname@example.org or visit their website gracehw.com.
DiMonda was diagnosed with stage IV breast cancer after her husband discovered a lump in her breast following an accident at home. That diagnosis led to a revealing pathway about how mainstream medicine works… or fails to work.
Doctors repeatedly missed how bad her cancer was. “I was initially diagnosed with Stage I and II cancer at first,” DiMonda said. “Then we decided to go to New York because my initial diagnosis was in California in Orange County where we lived at the time. That’s how we ended up actually going back to the East Coast. When I got to New York, the diagnosis was Stage IV.”
The advanced cancer had already damaged three of the vertebrae on her spine, requiring surgery. “The outlook wasn’t very good because initially they said it would be six rounds of chemo,” DiMonda said. “I was going to have extended radiation, a possible mastectomy, and it ended up that it was three rounds of chemo only.”
In a quick decision process, she and Brambila considered using cannabis for her treatment, in part because of what they learned about CBD from their customers.
Customers were telling them about how good CBD was for various ailments. Brambila and DiMonda began a deeper dive into what medical cannabis could do, how it works and why, and began creating new CBD formulations. “A lot of making our own products really stems from my experience with the patients with our delivery service,” DiMonda says. “We made a decision that we were not going to focus on the recreational. We wanted to focus on the medicinal. We wanted to help people. And with my diagnosis, it became a huge goal of ours to make sure to allow people to understand that there are options.”
Brambila said that their CBD company was formed because they had a vision of responding to people’s despair. “Seeing people suffering and trying to figure out something that would work for them—we knew that cannabis was really great for them.”
DiMonda is in remission right now, taking cannabis as part of a targeted therapy routine. “My protocols are still the same because of the type of cancer that I have, because it’s metastatic,” she said. “I have to keep up with treatments, even the regular treatment that I have to use, which is every three weeks I go for a particular cocktail.”
What both Brambila and DiMonda witnessed as she went through treatment using cannabis was how mainstream medicine was resisting cannabis, even as doctors saw how it helped cancer patients like her.
The U.S. Food and Drug Administration (FDA) still has not approved cannabis as a treatment for cancer or any other medical condition (2). The closest that the FDA is willing to go—and, by extension, what mainstream medicine is willing to explore—is to remind a patient that commercially available cannabinoids, such as dronabinol and nabilone (made with synthetic THC) are approved drugs for the treatment of cancer-related side effects, and that cannabinoids may have benefits in the treatment of cancer-related side effects.
But the science about cannabis is evolving, and evidence supporting medical cannabis is accumulating.
A study in the Journal of Psychoactive Drugs found that, in comparison to pharmaceutical drugs, medical cannabis users rated cannabis better on effectiveness, side effects, safety, addictiveness, availability, and cost. Due to the medical use of cannabis, 42% stopped taking a pharmaceutical drug and 38% used less of a pharmaceutical drug (3).
Cannabis can stimulate appetite, help with sleep and nausea, and reduce pain. But even as advocates and cancer patients like DiMonda offered more and more evidence of its benefits, mainstream medicine has taken a hands off approach to cannabis for the treatment of cancer.
Legalization of medical use of cannabis is still spreading (4), and it is hoped that movement will have some effect on at least keeping conversations about cannabis for cancer going.
While legalization of medical cannabis continues, Brambila believes legalization of recreational consumption is actually having a chilling effect. “The legalization movement started with trying to get people access to cannabis as a medicine,” he said. “We’ve lost a lot of that with (recreational) legalization now. There needs to be more information out there to take cannabis as a serious medicine.”
Working in California had its advantages because people there were more open to discussing medical cannabis. Now working in Connecticut, DiMonda sees that there is a sort of California-cool coming to the East Coast. “I think that sort of openness is finding its way here,” she said. “People are becoming a lot more aware and they are also more interested. You are finding shops that are popping up a lot more here. I think that legalization will change a lot of this so that people can start discussing it openly. Now, there is still the risk of arrest.”
Education is the key, Brambila said. “The stigma and the conservative views around cannabis are really fueled by misinformation, and just no understanding of the medical aspect of the endocannabinoid system,” he said (5). “Through building that awareness, we really hope that it also affects the legislative process. We should destigmatize it so people don’t feel ashamed of using it. People don’t feel ashamed of walking into a dispensary or seeking advice for taking medicinal cannabis. That’s the part where we want to change things.”
Bambila said that they wanted to figure out the dynamic between the standardized care and how cannabis would enhance that. “We found that it works great together. One is not better than the other. We don’t advocate for only cannabis use. We take the integrative medicine perspective. Every compound has a therapeutic relevancy as long as it’s used correctly,” he said.
The prognosis for DiMonda’s type of cancer is that she is going to be in treatment for the rest of her life. “We’ve really, I guess, turned the page on that because of the outcome that she’s had,” Brambila said. “That’s really what we want to advocate in terms of research is that cannabis can actually be a solution, maybe a doorway into people not having to deal with a chronic disease like metastatic cancer in their lives.”
Mainstream medicine continues to be conflicted about cannabis. DiMonda’s oncologist, a researcher working at Memorial Sloan Cancer Clinic, which is one of the top cancer clinics in the country, was happy that the cannabis treatment was having an effect. But she still did not buy in to using it, DiMonda said. “My oncologist was not really changed at all by the results,” she said. “She thinks the results were wonderful. However, she will stick to her treatment protocol. What we found is that most of the time doctors are so regimented in the treatment that (cannabis) doesn’t really expand their world. Some people hear the story (of our use) and they absolutely love the story. But as far as changing people’s minds, it’s been very difficult.”
Brambila said working with such a highly regarded oncologist was a “very interesting dynamic for us,” because this particular oncologist specializes in triple negative breast cancer, identifying targets within the cancer cells to develop therapies. Triple negative breast cancer is a type of breast cancer that tests negative for estrogen receptors, progesterone receptors, and excess HER2 protein (6)—a protein that plays a role in the regulation of cell growth and differentiation.
This kind of cancer does not respond to hormonal therapy medicines. “We explained the science (of cannabis) to her,” he said. “I think because of her research background, it’s very difficult for a true researcher to just look at a single event and say ‘OK, well, there’s some potential here.’ They really look at the results in numbers and want to see statistics. What she explained to Nicole is that her outcome is really within the one percent of her patient population, which means her outcome is really rare.”
Oncologists are waiting for better data. The Journal of the American Medical Association reported that cannabis in oncology may have potential for use to treat nausea and pain, and work as an antitumor agent. “However, much of the data are based on animal data, small trials, or are outdated,” the report concluded (7).
But there is even more to consider when faced with mainstream medicine pushback on cannabis for cancer.
“Generally speaking, doctors are still completely backwards in terms of how they approach this, whether or not they would support it,” DiMonda explained. “And in many cases, it also creates a really big problem because we know that CBD and THC can interfere with certain medications. What’s happening now is you have people who are taking it, but they’re not telling their doctor because their doctor is either not on board or doesn’t know anything about cannabis. That becomes a big risk.”
For example, for people who are getting immunotherapy done for certain types of cancer, CBD does interfere and can effectively neutralize the immunotherapy treatment they are receiving.
Here’s why: The reason patients with autoimmune conditions could benefit from cannabis has to do with its ability to “down-regulate” or suppress the immune system. This suppression of the immune system is a contradictory goal to immunotherapy. Although cannabis may continue to offer benefits during cancer treatment, studies show it can significantly decrease overall survival and time to tumor progression when combined with immunotherapy (8).
Brambila said the way that he and his wife look at this is that everybody using cannabis for medicine are all in one big clinical research trial. “Most of the information that gets to doctors really comes from the bottom up, not from the top down,” he said. “Patients will share their good experiences with their doctors. And that’s how you get some sort of perspective change. But that’s why we need education.”
The U.S. Department of Veterans Affairs (VA) have been circling around the issue of allowing medical cannabis to be used. While the VA cannot deny veterans benefits due to medical marijuana use, VA providers cannot recommend or prescribe cannabis since the Drug Enforcement Administration still classifies it as a Schedule I drug (9). “I think veterans are petrified because if their use gets back to the military, there are consequences,” DiMonda said.
Doctors working with veterans, many of whom are suffering from PTSD, just “throw a cocktail of pills” at the problem. “It’s like Skittles,” DiMonda said. “It’s ‘OK, here’s a blue pill. Here’s a yellow pill. Here’s a white one. This is all going to make you feel better.’ But we know what it’s doing—it’s slowly killing them.”
Brambila said that sort of multiple drug treatment is designed to make the veteran patient numb. “They’re meant to desensitize them from their humanity, really, because they don’t feel anything,” he said.
Some of the cannabis-as-medicine education is coming from other countries, because these cases of cannabis use are not simply anecdotal stories changing the minds of doctors, but carefully charted results of actual procedures and processes that include cannabis.
Take Israel, for example, where cannabis is offered to all cancer patients. “It’s part of the protocol now,” DiMonda said. “That is such a huge deal because simply having that to rely upon makes the experience with chemo and your relationship with cancer completely change for the better.”
In 2012, some two-thirds of Israeli cancer patients authorized to use cannabis report long-term, symptomatic improvement from the plant, according to clinical data presented at a conference of the Israeli Oncologists Union (10).
Investigators at the Sheba Medical Center in Tel Aviv, in conjunction with the Israeli Cancer Association, assessed the efficacy of cannabis therapy over the course of one year in 264 patients with cancer. Their findings showed that 61% of the respondents reported a significant improvement in their quality of life as a result of medical marijuana, while 56% noted an improvement in their ability to manage pain. In general, 67% were in favor of the treatment, while 65% said they would recommend it to other patients.
The study concluded that cannabis is an effective treatment for certain symptoms of cancer, and recommended that the treatment should be offered to patients in earlier stages of cancer.
There is also legislation being passed in Chile and Argentina, Brambila said, as a result of grassroots movements there. “That really gave way to taking into consideration the medical aspect of cannabis in those countries,” he said. “They haven’t waned from that.”
The couple’s cannabis enterprise, Grace Health and Wellness, aspires to be a phytopharmaceutical company. “That idea came from the multifaceted approach that we saw which was producing good results with people,” Brambila said. “We feel that plant medicine should be something that should be researched, and should be identified and created and made into medicines that are sold in the open market. We really want to develop those therapies so that people can find alternatives.”
He said that cannabis should be part of a legalization-and-access social movement. “If we don’t do that, we’re going to lose a lot because we’re not listening to the feedback of the medical outcome anymore,” he added.
DiMonda had a theory. “If we could find a politician where it’s either the politician or a family member who might have an illness, and they openly turn to cannabis, that’s when I think that you will finally have more doors opening. Right now, politicians are afraid to discuss any of this.”
She had a final word for those cancer patients considering cannabis—don’t be afraid. “That’s the biggest thing I tell people is don’t be afraid. You have a 50/50 shot. It can work or it can’t. The risk of that gamble is minute. If it’s going to help, try it.”