Cancer & Cannabis Awareness - Part 1

None

Episode Transcript

(00:01):
From the WA and M Studio onthe campus of Florida A and M University.
This is Mary Forum Radio, aweekly conversation on the education and research
of the medical marijuana being conducted atBAMMUTI. Hi. I'm Heidi Outway,
your host for this conversations on Cannabisvirtual form, brought to you by the
Medical Marijuana Education and Research Initiative atFlorida and University. In this conversation,

(00:25):
we're talking about the increase in peopleturning to medical cannabis as a treatment for
cancer. So let's talk and learnabout this subject with our guests. Doctor
Johnny Bernard is a Board certified radiationoncologists specializing in treating cancer with radiation.
Doctor Bernard has published numerous articles researcharticles on cancer and he's a qualified physician

(00:50):
under Florida law who now integrates medicalcannabis for his patients. Doctor Bernard,
Welcome to the Forum. Thank you. Doctor Mandief Singh Diva is a professor
of pharmaceutical sciences at Florida and MUniversity. He is a recognized leader on
drug delivery and has published nearly twohundred articles and given nearly three hundred presentations

(01:12):
worldwide. In his role as aSection leader of Pharmaceutics at FAM you he
is now leading research on cannabis andcancer. Doctor Mande, Welcome to the
forum. Oh, thank you somuch. Glad to have you. And
our other guest is Sephanie Siiel,a cancer survivor who will be sharing her

(01:33):
remarkable story about using cannabis as atreatment. She now holds a Master of
Science degree in medical cannabis and she'sworking to pioneer medical cannabis therapies for young
adult cancer patients. Stephanie, Welcometo the forum. Thank you to everyone
joining us on this live program.Please share post and tag a friend on

(01:55):
Facebook to have them join this conversation. If you're watching on YouTube, share
the links so others can join usas well. During the forum, we
want you to send us your questionsin the comment box and we'll do our
best to have our guests to answerthem. We also want you to tell
us what you think about this formby completing the survey that will be posted
in the comments on YouTube and Facebook. After the live program, your name

(02:19):
will be entered into a drawing onNovember ninth, twenty twenty three to win
a one hundred dollars gift card providedby one of Mary's partners. Now let's
start this conversation on cannabis. Sohere in Florida, medical marijuana is legal
and cancer is a qualifying condition.So doctor Bernard, tell me what prompted
you to get involved in recommending medicalcannabis as a treatment for your cancer patients.

(02:45):
So, Heidi, I actually didnot believe in cannabis at all as
medicine until I started working with cancerpatients. But a lot of my patients
were using in it and it wasillegal at the time, but they were
using it to help with various differentissues that they were dealing with, such
as cancer pain, or helping toincrease appetite, or helping with nausea vomiting,
and they were getting very good resultsfrom using it. And I kept

(03:07):
hearing the same story from patients overand over again throughout the years until I
slowly but surely became a believer init as medicine and wanted to help them
do this legally once it became legalin Florida. Interesting, thank you for
sharing. So, doctor man Deep, I want to hear about the research
you're doing regarding medical canvas here inFlorida. Yeah, sure, so it

(03:30):
so happened. I was very intriguedwith cannabinis and wanted to just ride out
in my lab and see all thehype I'm hitting is true or not.
So I know, got in someCBD in my lab, and some companies
gave me the gift, and Igot some CBG in my lab and started
testing them against cumber cells. Andin my lab, I have a variety

(03:53):
of cumber cells the breast cancer lunkand so I have also resisted cumber cells
in my life to and when Istarted testing them, I was really amazed
that how CBD and CBG and CBCthey could overcome resistance of Doxa Rubison resistant

(04:14):
breast cancer cells. That a cellline which has a thirty micromolar ic fifty
gives the number thirty for Doxa Rubisin CBD or CBG, but doing at
five micromolar or two micromolar like aone hundred, several fours of improvement.
So that's how I started, andI then I went deeper into it,

(04:35):
but the into neuropathic pain, workwith resistant tumors, then work with delivering
the nabiness by different routes. Itcould be oral, it could be parental,
and it could be topical or transnernal. So journey started and now I've
published a few papers and a lotof work and thinking to do it kinderical

(04:57):
trial in the future. Everything goeswell, yeah, that would be fascinating.
We were going to talk about thattoo, and Stephanie I shared earlier
that you're a cancer survivor and youhave this remarkable story. Can you share
that with our listeners and view todo. Yes, to be clarified that
I'm a cancer thriver as I'm stillliving with cancer actively today. So as

(05:19):
of November, I'll have had metastaticscervical cancer for five years. November thirteenth,
twenty eighteen, I was diagnosed metastaticand incurable as I had several tumors
throughout my appsmen, the largest beingseventeen centimeters attached to my left ovary.
It was inoperable and radiation was notgoing to be an option, so I

(05:41):
began chemotherapy twenty four hours after mydiagnosis and they gave me the standard opiates
and Benzo's combination that they send patientshome with, and the entire weekend was
completely detached. Associative can't remember muchother than the feeling terrible because of how

(06:04):
beat up and nauseous my body fellon the opiates especially, and how dissociate
I just felt from all emotions oranything at all good or bad from the
benzos. Because of the diagnosis Ihad, I knew that it was going
to be a marathon, not asprint, and in order to get through

(06:26):
that, I was going to needsomething that actually allowed me to be present
in my life and you know,enjoy being present in my life because you
know, I'm not dealing with nauseaor vomiting or everything else. I had
already had some experience with cannabis.I wasn't truly really a recreational user,
but I did have a roommate thatwas a veteran with PTSD who had started

(06:47):
as a coalition in southern California andbe her roommates. He would use it
to help him with his PTSD insleeping, and he fully educated me on.
He's the first person that I learnedabout and a cannabinoid system from and
educated me in the different ways thatit worked throughout the body. So when
I got diagnosed, I immediately decided. After that first weekend with pharmaceuticals that

(07:12):
it was not going to be forme, and if I was going to
get through this, that I neededto try something else. And I immediately
just like dove in and found outas much research as I could about cannabis,
and by my next cycle, Ihad settled on doing one to one
throughout the day, so one toone THHD to CBD that I was able
to get at a local dispensary becauseI'm in Massachusetts and the medical dispensaries had

(07:35):
just opened that first year in twentyeighteen, and one happened to be right
around the corner for me, asluck would have it, So the one
to one THHD is what really completelychanged everything for me. Where I wasn't
dealing with nausea, I was eating. There were times where I would truly
forget that not only was I aterminal patient, but that I had just

(07:58):
had treatment because I was able tobe so present with my daughter and with
my niece and my nephew and withmy family, and the quality of life
that I was able that I havebeen able to maintain for five years is
one of the main reasons why I'vebeen able to keep such a strong outlook
while dealing with being in treatment forsuch an extended amount of time. Yeah,

(08:22):
doctor Bernard, thoughts on that remarkablestory and your experiences here in Florida,
very remarkable story. So, anytimeyou have a person who has medistack
disease, you're always concerned about thelength of time a patient has, even
though as humans we all have somepredetermined length of time, but you've become

(08:45):
more concerned about it instead of medistackdisease. But the fact that she's been
able to live with that for solong is truly amazing. Yeah. And
doctor Mandeep in your research, Imean, are you seeing evidences of cannabis
allowing patients with cancer, patients withthese type of diagnoses actually live a higher

(09:07):
quality of life as Stephanie is rightnow. Well, I mean, since
I'm not a practicing position like Arenard, but there are a lot of anecdotal
data out there. But that's thebig issue we have that they are not
too many clinical studies being done withpatients or there's not enough documentation available to

(09:31):
put forward to the public. Hey, this really helps you. But working
in my lab with the animal studieswhich have tumors in them, and I'm
more interested in timbers which are resistantto therapy, to tax all to doctor
Rubisin or all these antigencia drugs.How do we treat because that is the

(09:52):
bigger problem than wild type humors.And we found that in our combination we
use of the cannabinoids. I believein the entology of fact as you know,
Stephan, you mentioned, combination iswhere it works the best. And
we are learning a lot more aboutnew combinations. So I found that when
I use the right combination, thetumor does not grow anymore. It's just

(10:13):
like stalled while the control is growingand growing and growing, and that tumor
side is stalled for the rest ofthe time period. So that shows that
this needs to go to clinical trial. But you know, the big pharma
is not interested much in that becausethere's a lot of you know, discussion

(10:33):
about is this really a drug orjust really a over the counter remedy or
anecdotal abutage. So kill more studiescome out and more clinical data is generated,
there won't be a big forma jumpingonto it. They are talking about
it, they're thinking about it,but they haven't taken a jump yet.

(10:56):
But I feel that there's a bigneed of more clinical then to be available
to the public or to be published. We need to do more studies to
be done. And also whatever datawe have got out there scattered, you
can put them all together. That'llbe a great thing for the public.
So all these things are hindering thebenefit the public can really get get to

(11:20):
them. Yeah, so, doctorBernard, you know when you're recommending cannabis
to your cancer patients. You know, Stephanie mentioned that she's found what works
for her. How do you workwith cancer patients here in Florida who come
to you and say, hey,I want to try this. What's the
process for them when they come toa qualified position in Florida. So the

(11:43):
process to obtain a card is exactlyas you said, Hatty. They have
to see a physician who's qualified understate law to actually evaluate them for the
card. So I am one ofthose positions, and we have over twenty
five hundred physitions throughout the state ofFlorida, and you can find those physicians
on the state website. If yougoogle know the Facts m m u R

(12:09):
Medical Marijuana East Registry, it'll comeup and you can search for a physician
there. I'm located in the PalmCoast area. Patients can be referred by
their physician or they can come directlyto the physician, and most physicians would
like some sort of medical records toconfirm diagnoses, but as physicians, can

(12:31):
also diagnose ourselves, but that wouldbe the first step to make sure that
they have a qualifying condition under Floridalaw. There are conditions specifically specified in
Florida law, such as cancer,PTSD, HIV, AIDS, Parkinson's,
Crohn's disease, multiple sclerosis, youknow, things that are very very debilitating

(12:54):
to most people. But then theyalso have a section called other debilitating conditions
as well, such as things likearthritis or migraines. And conditions have to
be similar to the ones that arealready in the law. So people with
anxiety and depression that's similar to PTSD, So people who have epilepsy is a

(13:18):
qualifying condition. People who are notdiagnosed with epilepsy but have seizures that would
be like that, so they couldget it as well. So there are
a lot of because of the wayFlorida law has structured conditions that could potentially
qualify people as long as it's similarto something that's already in the law.
Right, so they get the registrycard that says if they're allowed to go

(13:39):
to a Florida dispensary and pick aproduct. And so I'm going to kind
of lean to Stephanie a little bitbecause Stephanie, I'm sure that where you're
located, it's kind of similar.Where you get the quality, you have
a qualifying condition, you go toyour dispensary, But then how do you
know what to get? Oh,I'll never forget my first trip to my
dispensary. It was so overwhelming,even with all the research and the decent

(14:03):
amount of knowledge that I had beforegetting in there, Like, I can't
imagine what it's been like had Igone in there completely blind. I had
lucked out that the very first,you know, patient advocate that I had
spoke to was extremely well educated andknowledgeable, and he took ninety minutes with
me to help break down help mefind a strain that was going to be

(14:24):
high in the terpenes that I waslooking for, and helped break down everything
that I didn't understand as well withall of the different concentrates and you know,
making sure that I was staying awayfrom high THHC. So that like
my I wouldn't overexpose myself to potencytoo soon and really you know, pushing

(14:45):
me towards full spectrum, entourage effectand whole flower. Yeah, so doctor
Man, deepen your research. Youknow we were talking about you know,
the you talked about CBD, CBG, We talked about the endoc nabinoid system
and all these terminologies. So inyour research, can you share if there

(15:05):
were different modes of giving cannabis toyou know, in your lab research that
you saw a difference or you know, how do how do you test it
in your lab? You know,the different types of cannabis. Is it
oil? Is it? I knowrents can't smoke, so I'm just curious

(15:26):
how do you get it in thereso you can do your test well?
You know, to start off it, cannabinoids are absorbed very poorly. They
have a poor bibailability, so youhave to you know, the oils or
sort of the market to be takensublingual. There's a lot of compliance issue

(15:48):
with that, and and also there'sa stability issue that moment you expo open
the bottom, exposed it to air, the oxidation will start. So you
have to be very careful that youdon't store the bottle for months and think
that it will be effective after thirtydays as it is today, because you're
going to keep losing its value.The moment you open up, it goes

(16:11):
in and it starts his job.So so that part is there. However,
they have come with synthetic CBD synthaticCpG, which is now available,
so the trend is to go towardssynthatic. Even one of the TSC on
the markets are synthetic, because they'rethe synthetic you're saying synthetic, I think

(16:32):
that they have mid in a laboratoriesand technically by chemical reactions all the structure.
We know all the structures about canabinoids, so you can make the same
molecule. That's like we have onthe market synthetic taxol. So now they
make it by a different method,but we had for a long time synthetic
taxol. Same way we have syntheticcannabinoids being coming out. However, from

(16:57):
all the formulations of the market,I think gummies have the best probably outcome
for oral absorption if you compare,because gummies somehow protect some degradation in the
GID. So that's one way.However, you know a lot of studies.
They're done with the patients in Kindergarttrial that gave out our ip route's

(17:21):
commonly used for a lot of patients. You can give it the interpet on
nearly. It's that way if youwant to give mixture of cannabinoids. You
know, there are a lot oftransdermal delivery systems being developed, but the
one on the market are over thecounter, so they are not really very
well studied. But I know alot of dermal farmat companies are trying to

(17:44):
make patches which can really deliver goodamount of cannabinoids across the skin into the
bloodstream. However, it's important touse a cannabinoid which is effectively lower those
right, So, and that's themost important part we're linking into. That's
why the combination of two or threecan amonoids, which can reduce the overall

(18:08):
effective dose required, will be abetter way to work with a transferment delivery
system. Well, there's another wayto give it to Interrannasally, if you
have brain tumors, the best routeto give it from a nose to the
brain through the olfactory and the trigeminalroute. So that's another area where you

(18:30):
can look into having an interrannasal sprayor in tornasal gel or whatever you want
to make it a familyation which cango in the olfactory region and take it
to the brain, so that thepatients with brain tumors, especially children for
that there's no cure for some tumors. Maybe this can help. But all

(18:51):
these thing have not caught up yetthat much. These are things we are
doing in research to develop better formulationto different routes available to us. And
maybe you can make supportatories of canabinoidsfor systemic absorption. Also that probably I
see some of these on the marketsand products, but again you need a

(19:12):
very good formulation development team to addressthe issues of refining the absorption and the
kinetics of those products. For allthese ideas, we are toying with innoval
laboratories and have published with some ofthese strategies. Or you can make a

(19:32):
delivery system in some nanoparticles you know, and deliver more effectively. So all
these are things you know, wehave been trying to work and other scientists
are trying to work while working inthis space. Yeah, doctor Bornard,
did you want to add anything aboutthat, about the different modes of delivery
and also the dosing question. Imean, we hear a lot of that
from folks who write in or respondto the show asking about dosing, and

(19:56):
Stephanie, I want you to talkabout that as well, Doctor Bernard,
did you want to add anything tothe conversation about dosing and the methods of
delivery? Say, you know,we already have intranasal sprays that people can
purchase from the dispensaries, and suppositorieswere available when we first started, but

(20:17):
there was not a lot of demandfor it, so most of the dispensaries
actually don't have it at this particularmoment, but they are available, we
just may not necessarily have them inour dispensaries. So there's pretty much any
way that you can think of itbeing done being done. IV therapy is

(20:37):
not available at the moment, butI do hear there's a company that's developing
a method to be able to doIV CBD. It has a lot of
issues with being able to be smallenough to go through an IV, but
there's a company developing a method forthat as well. So a lot of

(20:59):
different options there, and the dispensariesalready. Yeah, and Stephanie, I
would imagine that depending on someone's cancer. Whatever that is, dosing is going
to have a big impact on howthey feel. So can you talk a
little bit about your experience with dosingand then also the modes of delivery that
you found effective. So my modesof delivery definitely have changed. One of

(21:21):
just through the surgeries that I've had. Prior to my surgeries, I used
to enjoy doing tinctures like under thetongue or edibles. Now my absorption it
doesn't work as well, So Iprefer dry or vaporizing or just smoking a
pre roll myself. And for me, I find smoking the full flower gives
me a longer effect throughout the day. So I'm able to smoke a pre

(21:44):
roll in the morning and then I'mnot needing to medicate again until twelve thirty
one o'clock around lunchtime, and thenI'll and it's probably going to be for
in one day, I'm probably smokingone gram, like one gram of sativa
to get through the day, andthen I'm going to smoke maybe half a
gram at night to sleep sometimes noteven always. And did you have to

(22:08):
figure out the dosing yourself. Didyou work with your physician to determine the
dose? For me? It wasworking with myself and really paying attention to
what made me more productive. Whatwas you know, what's giving me an
appetite? What days am I eatingmore? What days I eating less?
What days are taking longer to recover? And you know, and sticking with

(22:33):
that. When I first started,I tried not to get too attached to
specific strains because I knew that,you know, they might not have that
the next time I go, andrather finding like the formulations that work for
me, or knowing what turf beings, and I'm finding that worked for me,
like mercying and beta care aphelina ortwo that I absolutely love having like

(22:53):
in my strains. And I mean, and I'm such a you know,
I find me adding beta, carryoff link dowerating like I'm throwing clothes in
my smoothies and a nissa and anythingI can so to just up that,
you know, encourage that entourage effect. And you know you'll you'll catch me
drinking, you know, making amango lossy thirty minutes before I'm going to

(23:14):
smoke, so that immercy and themango is going to improve the effects of
what I'm about to smoke as well, because we can enhance that entourage effect
through the foods that we're ingesting aswell. Yeah. So Stephanie, you
know, you got a master's ofscience and you have some viewers and listeners
who are you know, dealing withall kinds of you know, illnesses and
they're considering cannabis. So it wouldbe great if you know, you could

(23:37):
share with us, you know,some of the resources that you use to
kind of self educate yourself, andwe can share that with our viewers and
listeners on social media and get thatout to them. So thank you all
for this conversation. So Stephanie,doctor Bernard, and doctor Mandeep I really
want to thank you for being ourguests on this Conversations on Cannabis virtual form

(23:57):
brought to you by the Medical MarijuanaEducation and Research Initiative at Florida and Muniversity.
Thank you to everyone watching this program. Tell us what you think about
this form by completing the survey thatwill be posted in the comment box on
YouTube and Facebook after this live program. If you complete the survey, your
name will be entered into a drawingon November ninth, twenty twenty three,

(24:18):
twenty twenty three, to win aone hundred dollars gift card provided by one
of Mary's partners. We also wantto encourage you to go to the Florida
Department of Health Office of Medical MarijuanaUse website to learn how to obtain a
legal medical marijuana cart in the stateof Florida. And we also encourage you
to go to Florida and Muniversity's Merrywebsite to learn more about this initiative,

(24:40):
its educational programs, and additional informationabout cannabis use in Florida. Thanks everybody.
The views and opinions of our invitedguests are not necessarily the views and
opinions of Florida Agricultural and Mechanical Universityor the Medical Marijuana Education and Research Initiative.