Cannabis Patient Care - November 2021

Cannabis Patient Care November Issue

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25 nurse focus october/november 2021 | cannabis patient care Through no fault of their own, doctors are unaware of the po- tential risks and benefits associated with medical cannabis— keep in mind that doctors are still not being taught about can- nabis, 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 informa- tion 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 us- ing immunotherapies in more and more tumors, and with more in- triguing success stories," she said. "It's even more risky for doctors not to understand at least the drug interaction risk and the immu- nosuppression 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 communi- ty 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 in- sulting when it comes to medical cannabis treatment options. Wohlschlagel shared a story about a young patient with recur- ring 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 won- derful pediatrician with much experience in the use of medical cannabis in children. She continued to stay in contact in a sup- portive nurse's role. After about one year, the child's oncologist/ hematologist did not believe it was the cannabis, instead claim- ing 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, be- cause 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 Germa- ny—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 med- ical 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 submit- ted 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 dis- cussions 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 ev- erything. 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 profes- sionals 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 con- sider de-scheduling. I mean, reducing the scheduling at a mini- mum, 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-de- signed 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, pa- tients, and other advocates will push that change to happen soon- er rather than later and benefit many patients with cancer. References (1) the_school/faculty-staff/nagarkatti_prakash.php. (2) the_school/faculty-staff/nagarkatti_mitzi.php. (3) 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) 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) 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.

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