Taking Matters into Her Own Hands: A Nurse’s Journey to Self-Educate on Medical Cannabis Benefits and Risks

Cannabis Patient Care, October/November 2021, Volume 2, Issue 3
Pages: 20-25

Kristin L. Wohlschlagel, RN, shares a wealth of information on medical cannabis from various patients she interviewed, her own personal experiences, and more.

Kristin L. Wohlschlagel is a registered nurse. She identifies herself as a nurse who understands that we need conventional treatments, standard of care treatments, and that cannabis has a place for symptom control and potentially as a therapeutic. She strongly believes cannabis should be researched and studied. There should be lots of support for patients to educate themselves in at least the basics of medical cannabis—and so, Wohlschlagel took matters into her own hands and started seeking out researchers in other countries to understand what the current research was revealing about medical cannabis and then she started compiling data from patients she was working with. Here, Wohlschlagel shares her journey to understand medical cannabis, how it translates to breast cancer patients, and her plans to continue educating herself and others.

Spotting “Bigfoot”

Kristin L. Wohlschlagel has been an RN for 16 years, becoming an oncology nurse in rural Hawaii right after graduation. She explained that the first year of her oncology nurse work was very hard so she soon transferred to be an ER nurse where she remained for 6 years. After that, Wohlschlagel went on to hospice and oncology supportive care nursing for patients that needed care at home. In 2016, she started hearing more about medical cannabis from some of her patients, who reported that it helped with nausea and sleep—her stance was always that it was fine as long as their doctors were aware.

There was one patient in particular that changed Wohlschlagel’s perspective quite dramatically. She explained that this patient was in hospice and there would be meetings for the group of nurses on the care team. “We would discuss patients that were struggling to get their symptoms controlled,” she said. “We were giving this particular patient more and more medicine to control symptoms and it got scary, so much so that we were having to deliver the medicines every day because the pharmacist and doctor were afraid the patient would just overdose in desperation to find relief.”

Then something remarkable happened. “The nursing team noted that the patient wasn’t using as many of the pills. They were being left in the box, so the nurses asked what was being used and were shown a little bottle of homemade cannabis oil. The patient said it helped more than the other things that were brought,” she said. “A couple of months later, it was noticed that the patient’s abdomen that had been swollen with cancer had begun to shrink. And the next thing I knew the patient was gone from hospice care. I never heard more about that patient again, but I made a note of what kind of cancer it was.”

This particular case was a form of neuroendocrine cancer. Wohlschlagel is always careful to point out that not all neuroendocrine tumors shrink on THC. But this experience opened her mind to the possibilities of cannabis medicine. Shortly after that experience, she had to take time off work for a back surgery. “I had begun to look online for information about the use of cannabis. First, I was worried about drug interactions because this patient was swallowing this oil, not smoking it. And I knew that when you swallow chemicals, you increase the risk of drug interactions through the liver because a lot happens in the liver. I was looking online for resources. I couldn’t find anybody telling me what were safe doses or when drug interactions would happen,” said Wohlschlagel.

Next, she started digging into the scientific articles discussing the interaction potential. “I noted that some of these articles I was reading were written by scientists in Spain, Israel, or other countries. They were studying the potential for anticancer use of cannabinoids. Well, I felt a chill go up my spine because I had witnessed something that I felt was like seeing Bigfoot. You are afraid to talk about it, and question if you believe you really saw what you saw, but once you see it, you can’t unsee it,” she said.

Wohlschlagel reached out to those scientists and told them what happened with that patient. The scientists explained that there was a little bit of research on that type of cellular cancer in a different setting—prostate cancer. “The fact that they could point me to research showing that THC or a similar chemical that binds to the same receptors in the same ways was able to push back on that neuroendocrine differentiation of cancer cells in prostate cancer studies in the lab—it really hinted that what I saw with that patient might be scientifically explained if they all paid attention. So, with that, I didn’t assume that cannabis was the cure for all cancers, but I realized that this was worthy of my study,” said Wohlschlagel.

Continued Education and Social Media Outreach

Armed with this new information, Wohlschlagel decided to become a medical cannabis patient in Hawaii to help recover from her back surgery in 2017. She used it to sleep because it relieved her back and leg spasms and got support from people who understood how to dose carefully. Medical cannabis helped her sleep and get off all the pain pills and muscle relaxers she was initially prescribed.

Her desire for more education was still growing, so in April 2017 Wohlschlagel attended her first cannabis conference hosted by Patients Out of Time. It was there she met many researchers, doctors, and like-minded nurses who were interested in learning of the potential medical cannabis had to help patients. One nurse practitioner, Eloise Theisen, was particularly helpful in mentoring her about the use of cannabis in patients with cancer.

Wohlschlagel decided to start interviewing every patient that she could who had shared stories of medical cannabis success on social media pages, such as Facebook. She quickly discovered that there were a lot of Facebook groups focused on particular forms of cancer and the use of cannabis. “There were big websites that were kind of wild and crazy, truly. They were just focused on the use of cannabis oil and implied that they were all success stories. I encountered bullying happening that if a person tried using cannabis like they’d read and then if it didn’t work instead of accepting that cannabis might not have been capable of working in that case, the patient would be told, ‘oh, you must have eaten too much sugar. You didn’t have the right strain. You need to do this. You didn’t use enough. You need a gram a day.’ It was quite scary! There were also many kind people—medicine makers and advocates—all trying to help. And many tried to help raise awareness about these problems. But the overwhelming situation was what I described. If a patient admitted they were using conventional treatments, there was often chemo shaming. And these people who had 'failed' in the use of cannabis, in their opinion, they just left. They were ashamed or dealing with metastatic cancer and they left. Their voices were being missed,” said Wohlschlagel.

“I didn’t have a negative attitude about cannabis, but what I witnessed was a lot of problems happening because of the fact that there were no medical professionals that understood cancer seeming to rise up and help. So, I began to just put myself out there. I joined a couple of the groups quietly and would do what I could to encourage the women to understand, for example, breast cancer,” explained Wohlschlagel. “Breast cancer is not breast cancer is not breast cancer. There are subtypes. And then there are subtypes within subtypes. And in most cases, they really need to do conventional therapies.”

Wohlschlagel said she doesn’t mean every single conventional therapy, every single time, but patients really need to consider the hormonal aspect if they have hormonal breast cancer. “If they have HER2 positive breast cancer, there’s a monoclonal antibody treatment that is usually very effective. That drug is called Trastuzumab or Herceptin and it may work a lot better if combined with at least some chemotherapy, especially Taxol type. And I found that these patients believed that they had to do one thing or the other and never consider how it might all work together,” she said.

Actually, Wohlschlagel said it’s not surprising because there was nobody telling patients this information or answering questions like: Can you use these things together? Is it safe? Is it logical? Is it supported by even a little bit of science?

As Wohlschlagel continued speaking with these patients and documenting as much information as she could, she began to gather large amounts of anecdotal evidence that in some subtypes of some cancers there seemed to be a pattern of response. “These people could explain their pathology report to me or share it with me. They could tell me how many milligrams of THC they were getting, where they kept track of how many grams of Rick Simpson Oil or other cannabis medicines they used in a month or so. I began to study these so I could estimate. And patterns of response began to show up,” she said.

Drug-Drug Interactions

Wohlschlagel’s interviews with real-world patients also brought to light the potential for drug to drug interactions. She found that there was a significant drug interaction with commonly used CBD oils and a particular breast cancer drug called Ibrance (palbociclib) and likely similar medications such as Kisqali (ribociclib).

“I accumulated over 100 cases where women on the drug Ibrance had started using CBD oil heavily because they could,” explained Wohlschlagel. “These patients thought more CBD was better because it didn’t make them horribly high. A couple of weeks later, their blood counts dropped in significant ways, particularly their neutrophil counts. That was actually the blood cell that was counted every two weeks when patients were on Ibrance because that drug could reduce neutrophils. Suddenly, the neutrophil counts dropped, and there was a big warning on Ibrance against using anything that would inhibit one particular metabolic pathway. That pathway was called CYP3A4. People know that pathway is also called the grapefruit pathway.”

Wohlschlagel explained that people often get prescription bottles with warnings against use with grapefruit or other inhibitors of CYP3A4. What people don’t realize is that CBD could inhibit that same pathway and would likely do so much more potently than THC because of the complexity of the molecules and how much processing is needed by the liver. Stunned by these findings, Wohlschlagel presented her data at the Cannabis Science Conference in 2018 and shared her poster with researchers in Spain and Israel.

Wohlschlagel is quick to point out that she is not a PhD or molecular biologist. She is a nurse just trying to do right by patients. “The scientists in Israel and Spain appreciated what they called ‘getting feedback from the bed to the bench.’ The lab bench normally sends info to the bed,” she said. “In this case, the bed was informing the bench, meaning I was working with real humans. They were working with lab animals. They appreciated learning what I was seeing and they applauded my efforts, generally speaking.”

However, they were all in agreement that more research was called for—ideally, clinical trials. Wohlschlagel pointed out that research on that level has been slow to come by because of the federal status of cannabis as a schedule I drug in the US. She continued on her own path of interviewing as many patients as she could to gather anecdotal evidence and learn as much as she could.

Educating Patients and Medical Professionals

By 2017, Wohlschlagel was getting contacted every day by people who were curious about the benefits of cannabis for their cancer treatments. “It wasn’t an officially endorsed thing, but I knew it was important because I realized that people were lost out there,” she said.

The best-case scenario was when a patient’s doctor also got on a call with her. “When it was really good, it was because their doctor was willing to get on the call with me. Their doctors would sometimes send people to me and ask me to talk to them about cannabis,” explained Wohlschlagel. “I spoke to doctors and patients from around the world. But the key here is that I tried to do my best to learn from all the patients and the cannabis medicine makers who would share their stories.”

In her current role, Wohlschlagel usually takes on more of a safety discussion related to medical cannabis. She explained that there is a benefit to a team approach with their doctors and if the patient wants to talk about cannabis as an anti-cancer therapeutic, she reviews and discusses it with the doctors first whenever possible. “I never claimed that medical cannabis was an anticancer therapeutic miracle drug from God,” she explained. “But patients ached to have guidance, especially to understand safe use for symptom management. In the case of people running out of treatment options or perhaps putting all their eggs in the alternative basket, I explain to them more about their cancer, what they might be missing in conventional treatments, some new breakthroughs—risks and benefits as best as I can assess and educate. But if there is anecdotal data and at least some research showing the type of cancer may be at least somewhat vulnerable to cannabis therapies, I do discuss it with them. Reviewing both risks and potential benefits so they can then make an educated decision.”

Wohlschlagel felt strongly about the role medical cannabis could play in cancer symptom management rather than as a replacement for all conventional treatment options. “In the realm of symptom management, if we can help someone reduce their need of opiate pain medicine by using carefully dosed THC formulations, maybe with a little CBD, that is very beneficial,” she said. “I saw people that were able to repeatedly reduce the amount of opioid pain relievers they needed as well as spasm reducing medicines like muscle relaxers, sleep aids, and nausea medicines.”

She further explained that just like every pharmaceutical we effectively use, there are going to be side effects and cannabis is no different. “It’s just that sometimes, cannabis’ side effects are making you sleepy, relaxed, or forget about your worries. Some people experience that consistently,” she stated. “That can be a gift for a patient going through cancer or cancer treatments. If they can sleep, forget about their worries and their pain or disease and their nausea, and then they get up in the morning. They might even be a little hungrier than they would have been, and they’re going to eat again. That’s a wonderful gift. And it doesn’t take a lot of cannabis medicine to do that.”

“Cannabis medicine was profoundly helpful in at least reducing, I would say, generally 30–50% of a patient’s pharmaceutical use if they got good support from a doctor or nurse,” said Wohlschlagel.

Again, she stressed that medical cannabis is not a cure-all for breast cancer specifically, or cancer in general. Every patient and every type of cancer is different. “When it comes to cancer treatments, I have witnessed tumors shrink on cannabis. I have witnessed patients get worse with tumors growing rapidly on high doses of cannabis,” Wohlschlagel said. “There’s no test that I can offer patients to find out if their tumor is vulnerable to THC or not. It’s complicated and when I would see patients who were successful with the use of cannabis, it typically was in a form of cancer where researchers had already indicated so in what we call preclinical research.”

Wohlschlagel explained that preclinical research means testing that’s before human trials, usually on animals or cells in dishes. In some of that research, there was evidence that a particular type of cancer might be vulnerable to THC—meaning the tumors could potentially shrink. “When I saw that over and over in certain subtypes of cancer, I looked and I kept track. And if it was successful, the patients needed to use approximately 80 to 100 milligrams of THC a night,” she said “That’s about 20 times more than most people would comfortably use at night to go to sleep. So, there was a lot of variability in the journey a given patient got to or took before they got to that dose.”

Questions of product quality and consistency also played a role in a patient’s experience. How were the products made? Were they low or high potency? Was the product you purchased last week the same as the one you’d get next time? These were all important questions that patients might not even realize they should be asking. When Wohlschlagel tried to broach these subjects on the social media groups she often was met with backlash and accused of being a “pharmaceutical shill” or worse, so she ultimately left most of those groups.

However, Wohlschlagel has not been deterred from sharing her information with others despite the trolls on social media. “When I presented at the Cannabis Science Conference, I met with scientists, doctors, and pharmacists and we all agreed that cannabis could be so beneficial for people for symptom management. But that if we didn’t start educating about drug interaction risk and immunosuppression risks with immunotherapy cancer treatments, that cannabis could be locked up again as unsafe,” she said.

Indeed, the risk of cannabis use with immumotherapy is scary, especially if patients are unaware or afraid to be open with their doctors about adding cannabis to their treatment regime. “Doctors Mitzi and Prakash Nagarkatti had already documented the cannabinoids could be useful in autoimmune diseases and some leukemias. They also showed that it reduced the immune attack,” explained Wohlschlagel (1,2). “Cannabinoids dampened down the immune response and it didn’t kill the immune cells, but it definitely shifted them to be calmer. Basically, that’s how I explain it to a patient. Cannabinoids reduce helper T cells and increase regulatory T cells—and this is not what you want to do if you’re using an immunotherapy.”

“Doctors should be learning that there are cannabinoid receptors in our bodies,” she added. “They should know what our own endogenous cannabinoids do as well as what the cannabis plant can and can’t do. If a tumor is not vulnerable to those high doses of cannabinoids you’ve been using—if it’s not working and you’re going to be going on an immunotherapy, or you’re already on an immunotherapy, please, please, please be careful.”

Wohlschlagel also explained that the size of your dose plays an important role when it comes to immunotherapy. “If people were using less than 40 or 50 milligrams total of THC and/or CBD, it didn’t seem to interfere as much. But maybe over 50 milligrams, that was when we saw interference with immunotherapies,” she said. “I started spreading the word and suggesting that patients go down to half of that. That allows a patient to use 5 milligrams of THC here and there throughout the day, keeping their total down to under 20 or 25 milligrams or as low as possible for symptom management and reduce the risk of immunosuppression.”

For success stories, Wohlschlagel has seen remarkable cases of patients with subtypes of cancer that already had strong preclinical research for THC-rich cannabis behind it, such as HER2 positive breast cancer. “It’s not 100% of the time that it would work, but I noted that most of the women with breast cancer I was interviewing that were success stories were those with HER2 positive breast cancer,” she explained. She added that using the cannabis medicine along with Taxol and Herceptin seemed to possibly result in better than expected outcomes.

For the patients that did see success with medical cannabis, Wohlschlagel noted that the product types they used varied from patient to patient. “Most patients who really have plenty of access to products will use an edible form at bedtime and use an inhaled route during the day. Some will use sublingual sprays and lozenges, but those are not as available. But for symptom management, the inhaled route acted quickly,” she said. “Patients can easily judge the dose they need because with the inhaled route they only have to wait five or 10 minutes to know what the effects are going to be. Whereas with an oral preparation, you don’t feel it usually for about an hour until it hits the liver and gets pumped to the blood. However, when you inhale it, the cannabinoids are delivered immediately to the bloodstream through the lungs and you feel it and quickly figure out what amount made you feel best.”

There is still a major stigma associated with medical cannabis use. Wohlschlagel commented that sometimes she sees family members of patients who are very comfortable talking about cannabis for their parent or loved one, but the person who’s the patient is really resistant.“Whenever possible, especially if the patient’s out of treatment options, they’re metastatic, the treatments aren’t working, or they can’t tolerate the conventional treatments, we definitely can discuss cannabis use in bolder ways. Sometimes they want to do what in football would be called a Hail Mary pass. I’ll just gently explain it all knowing that then they’re making an educated decision and if they choose not to, now, it’s an educated choice, but it’s usually started by stigma,” she said. “Part of it was the stigma, the worry about addiction, the worry about the taboo around ‘weed.’ But over and over it was often because they had tried an edible form of cannabis that was too potent and had a horrific experience. So, it’s not just the stigma; it’s also the lack of good guidance.”

Offering patients guidance on medical cannabis is another role that Wohlschlagel plays in the cannabis industry, providing education and dedicated phone calls as a consultant. If these patients are not doing conventional treatments, Wohlschlagel makes sure they understand what the current treatment options are.She said that some people turn away from conventional treatments or never even give it a try because in the past they witnessed a loved one suffer through chemo right until death.Oftentimes these patients are determined that they’re not going to do that, and they don’t even understand that the doctor’s offering a non-chemo treatment for them or a less chemo intensive treatment. So, I just try educating them about that, I make sure it’s a priority. Then I discuss the pros and cons of immunosuppression risk and high dosing, and the drug interaction risk, especially with CBD preparations,” she said.

Wohlschlagel gently explains how to use medical cannabis for symptom management, which she says can still take an hour of discussion because it’s all new to most of her patients. She added that it’s very rare for someone to contact her for symptom management if they’ve been heavy cannabis users all their lives. “It’s the cannabis naive patients that need a lot of education, and they usually need a caregiver, child, or sometimes a spouse or partner to also listen in. I’ll do joint conference calls or they’ll be on speaker phone, so everyone’s making notes and learning,” she said.

“They want my opinion, which is hard as a nurse, but I share what my experience has been,” said Wohlschlagel. “It’s generally about an hour long phone call and then usually a follow up call within two weeks that is another 30 minutes. Those calls get redone about every two months, if we’re lucky. They’ll chat with me and let me know what they’re doing or what products they got.”

Wohlschlagel stressed that for patients that have success with cannabis and see their tumors shrink, they cannot just stop taking it. “For example, patients with HER2 positive breast cancer who were unable to get conventional treatments because of a heart condition, but had metastatic HER2 positive breast cancer—in those situations where high doses of cannabis for them was successful, they understand that they can’t just stop it after 90 days, like a Rick Simpson Oil protocol might imply,” she said. “Rick Simpson protocol doesn’t actually tell them to stop. It tells them to go on with the maintenance dose, and they don’t know what a maintenance dose is. Nobody knows. But I can tell them that we measured what they were using when they started getting tumor regression on scans, that’s likely going to be in the 80 to 100 mg THC per night range. And if that’s what they were using, then they probably need to use that indefinitely to suppress it until doctors and scientists can discuss what’s next or a new treatment like a vaccine for their cancer comes around or something. So, there’s a lot of potential for patients to use it if it works long term.”

She added that every year she gets several patients who may have worked with her in the past and were successful but then at some point they stopped. “These patients see the cancer come back and they just thought it was cured, even though I told them it wasn’t. That ‘cure’ word is really dangerous, especially in the setting of cannabis,” said Wohlschlagel.

Medical Professional Support

Wohlschlagelsees medical professionals both supportive of medical cannabis use and against it. Much like the patient side, education is greatly needed for medical professionals across the board, especially as cancer patients start using repurposed drugs.

“More and more doctors are supportive. Now, my fear is that I’m repeatedly encountering patients who ask about using cannabis or they are told it’s fine, but those same patients are being put on immunotherapy. So, they’re actually being told by the doctor, it’s fine. You don’t have to worry about it. Even in clinical trials sometimes people are being told it’s okay. I’m stressing that these patients need to be careful,” said Wohlschlagel. “Now it’s almost like some doctors are going the other way: They’re trying to be so open minded and supportive, but they don’t understand the rest.”

Through no fault of their own, doctors are unaware of the potential risks and benefits associated with medical cannabis—keep in mind that doctors are still not being taught about cannabis, the endocannabinoid system, or cannabinoids in medical school. If they don’t seek out this education on their own, how would they know? Wohlschlagel does her best to share information and research whenever doctors ask.

“It’s almost shifting the other way, which scares me even more in the sense that while I love that doctors are open and there’s less stigma, we’re hitting a point in time in cancer treatments of using immunotherapies in more and more tumors, and with more intriguing success stories,” she said. “It’s even more risky for doctors not to understand at least the drug interaction risk and the immunosuppression risks with large daily doses. It’s also getting more complicated because patients are now coming to me on all sorts of things because they’re reading about repurposed drugs.”

“I’m becoming more and more alarmed that this persistent lack of understanding among our medical providers and the community at large, especially during these polarized times, that just keeps patients at risk,” she added.

On the flip side, there are still doctors who are rude and insulting when it comes to medicalcannabis treatment options. Wohlschlagel shared a story about a young patient with recurring leukemia and Graft Versus Host Disease who eventually had success with medical cannabis and was back in remission. Wohlschlagel had encouraged the family to meet with a wonderful pediatrician with much experience in the use of medical cannabis in children. She continued to stay in contact in a supportive nurse's role. After about one year, the child’s oncologist/hematologist did not believe it was the cannabis, instead claiming the remission was more likely an act of God so the family stopped treatment, the leukemia returned, and the patient died shortly thereafter. “That was another paradigm shift for me, because that was a clear cut example that if that doctor who treats children with leukemia would have looked online, they would have seen intriguing clinical research from Israel and Germany—even Doctors Nagarkatti in the US,” she said. “These are not fringe scientists doing this research. And that doctor might have paused, but what he did instead was tell the family to stop medical cannabis treatment. I was alarmed at the possibility that not continuing the cannabis resulted in the leukemia recurrence so my colleague, Liz Sherwood, and I submitted a poster to the CannMed Conference at UCLA the next year. We also submitted a poster to the CannMed Conference at UCLA the following year that focused on breast cancer and cannabis. That and other posters are published free for any doctors, scientists, patients, or families to see.”

To see Wohlschlagel’s posters, please check the links cited in the references (3–5).

“I am not promoting the reckless use of cannabis, but I want to show what happened because of our lack of coordinated open discussions and research that needs to move forward,” she said.

Hopes for the Future

In the future, Wohlschlagel wants to see more education and research regarding medical cannabis.“I want doctors to learn the fact that we have endogenous cannabinoids in medical school,” she said. “That we have cannabinoid receptors and they’re not there just to make us high. Absolutely not. They’re involved in everything. They’re involved in embryo development, inflammation, immunity, function—I mean, almost every cell potentially could have cannabinoid activity that’s just now being examined well. I then want them to understand the drug interaction risks in cannabis.”

She added that she wants doctors and other medical professionals to understand that there may be potential anticancer benefits with medical cannabis, especially in cancers that are hard to treat or when the treatments are really hard to tolerate and not always very successful.Above all else,Wohlschlagel wants more research.“I just want research to happen. I want the federal government to not block this. I need them to consider de-scheduling. I mean, reducing the scheduling at a minimum, if not de-scheduling it. We need to remove the barriers to research absolutely,” she said. “We want research institutions who want to do clinical trials—especially on glioblastoma, brain tumors, pediatric brain tumors, pediatric leukemia, and HER2 positive breast cancer—to have clinical trials that are well-designed and reaching out to people who’ve been in the trenches. Not just doing it without consulting those who’ve accumulated knowledge. But I want that to be possible without their fear of being defunded for Medicare because these organizations that might do these clinical trials are scared to death that they’re going to get in trouble.”

Education and research are not big asks, but they are slow to come by in the US. Hopefully, efforts such as Wohlschlagel’s, patients, and other advocates will push that change to happen sooner rather than later and benefit many patients with cancer.

Sidebar:
Beyond Cannabis: Diet Matters When Talking Cancer Treatment

Wohlschlagel shared that her experience working with cannabis and patients led her to studying more cancer biology and human biology because we make our own cannabinoids from the oils we eat, namely omega-3 and 6 fatty acids. She explained that there is a link to getting your diet wrong and cannabinoid receptors being present on some tumors—at least there is a suspicion by researchers that there is a link.

“That's where some of the scientists are looking,” she said “Now I make sure that if a person isn't really a candidate to use a lot of cannabis, every patient learns about eating the fat properly. I explain to them that you've been eating this, this way. You've been having a lot more omega-6 fat than omega-3 fat. It's very typical in our American Western diet. Scientists have said that if you do that, you skew the cannabinoid system in the body.”

“The endogenous cannabinoid system has been found to produce much more of the omega-6 cannabinoids and much less of the omega-3 cannabinoids and similar chemicals that may provide anticancer benefits. At least one form of cancer has been found to almost always have a cannabinoid receptor number 2 attached—HER2 positive breast cancer. That's also a cancer that seems to occur more often in countries which use a lot more of the omega-6 fatty acid called linoleic acid and is very inflammatory, aggressive, growth factor driven. This is one of the breast cancer types where Spanish researchers could really identify clearly anti-cancer potential with THC and likely synergize with conventional treatments,” said Wohlschlagel.

As part of her consultancy with patients, she also examines their nutritional patterns. She says she assesses their intake of omega-3s and 6s. “If I don't think a person would benefit from a lot of cannabis, I'm going to really make sure they understand that this is not saying that the cannabinoids don't matter. But we could look at their dietary fats and return them as the scientists guide us to a more balanced intake and that will likely affect the cannabinoid production and that might give them benefits without using cannabis,” she added.

Sidebar:Advocacy Efforts

Wohlschlagel also played a role in some advocacy efforts in Hawaii for patient rights and increased plant counts for home growers. She told us that the legislative committee shared that it was her testimony that changed their minds. “I'm proud of that,” she said.

A year after that legislative meeting, she was asked to present from a patient advocacy perspective to a group of more than 100 FBI agents in a resort town on the island of Hawaii. “There were FBI agents who were skeptical, but there were also a bunch of them who thanked me after for opening their mind to the fact that there may be real medical reasons that people use cannabis,” she said. “Patients should not be so stigmatized, they should not be so suspicious. The FBI were literally going to require patients who went to a dispensary and got a cannabis product, that the only way they could legally drive with their cannabis products in the car was if they were in a sealed package from the dispensary. It couldn't have been broken. I pointed out what if they have a pain pill prescription in their purse that's been opened at home and used, but it's carried in their purse in case they're away from home and they need it. Are you going to tell them they can't use it without that little red tamper proof tape on it from the pharmacy? No. Well, then why are you treating cannabis patients this way? If they're impaired and they're driving under the influence just as if it were alcohol, that's a problem. But don't just discriminate against patients who might have a package of cannabis or cannabis products in their purse. That was my goal for that meeting.”

References

(1) https://sc.edu/study/colleges_schools/medicine/about_the_school/faculty-staff/nagarkatti_prakash.php.

(2) https://sc.edu/study/colleges_schools/medicine/about_the_school/faculty-staff/nagarkatti_mitzi.php.

(3) https://www.researchgate.net/publication/328560750_Cannabis_Medicine_Treatment_for_Terminally-Ill_Three-year-old_Female_with_Relapsed_Pre_B-Cell_Acute_LymphoblasticMyelogenous_Leukemia_and_ModerateSevere_Graft_Versus_Host_Disease_A_Case_Report_and_Nur.

(4) https://www.researchgate.net/publication/336281388_Breast_Cancer_and_Cannabis_Cautions_and_Considerations_when_Recommending_Medicinal_Cannabis_for_Patients_with_Breast_Cancer_Potential_benefits_and_risks_of_managing_Breast_Cancer_Symptoms_and_Treatmen.

(5) https://www.researchgate.net/publication/327382069_Cancer_and_Cannabis_Initial_Observations_of_an_Oncology_and_Hospice_Nurse_Potential_benefits_and_risks_of_managing_Cancer_Symptoms_and_Treatment_Side_Effects_with_Medicinal_Cannabis_Considering_the_us.