“You realize you can use marijuana now,” my friend said over the phone. “You realize it can help you through this, right?”
I was driving home from the clinic where I’d just been diagnosed with breast cancer. The cancer wasn’t just in my breast. It had probably been growing in my body for a long time without my knowledge, the doctor told me. The disease had already colonized at least one lymph node, and perhaps spread further. Maybe I was metastatic. Maybe I’d die soon. Maybe I wouldn’t. We didn’t know.
My friend was calling because he loved me, and he’d read my tweets that day. He was, and is, a recreational marijuana user. Not a Cheech, not a Chong. A daily smoker and vaper, but one of the most active creative people I knew.
I had not smoked pot since my teens. My friend knew I didn’t approve of the skeevy dispensaries popping up all over Los Angeles at the time. We argued about the booming, legally-dubious market for cannabis. We sparred over the pop-up “collectives” and creepy “care centers” now filling real estate left vacant after the big economic crash. My friend knew I thought they were bogus, and that I didn’t believe in the “medical” part of “medical marijuana.”
“Xeni, you know that people with cancer—-I mean, people like you, because you have cancer now–You know you can use this to help with the pain and nausea and stuff, right? And that we will help you get through it?”
I listened to his voice over the phone as I drove home from the diagnosis. I was still in that first, awful wave of shock that follows.
Thanks, but I’ll be fine, I said. I got this.
But I wasn't fine, and I didn't “got this.”
Photo by Karen Marcelo, 2012.
My life had long been profoundly affected by substance abuse and addiction—in myself, and in loved ones. The displays outside the cannabis dispensaries where I lived in Venice promised to cure everything from sleeplessness to slow sex drives to bad hair. Bikini-clad young women wiggled their butts outside the adjacent pot doc storefronts. They wore sandwich board signs promising to get stoners “legal” in a half hour for $40, and they yelled flirty come-ons at tourists strolling down the boardwalk. How could that be medical? I wanted nothing to do with it. I didn’t believe there was a true therapeutic use for cannabis. I believed “medical” was a fig leaf to help black market capitalists sell more drugs to addicts.
I got this, I told my friend. I don’t need and won’t need marijuana. And I appreciate your offer of help, but I’ll be fine. Besides, I really don’t feel any different than a few hours before I was diagnosed. I’m fine.
God, I was so naive. And I was so wrong.
The next two years of my life were a nightmare of treatment, terror, and drugs. Lots of drugs. Chemotherapy cocktails pumped into my veins to kill the malignant cells. Opioids to kill the pain that followed surgeries. Anti-emetic pills, some of which cost hundreds of dollars out of pocket per dose (thanks, insurance!), to help with post-chemo nausea and vomiting — except often, they didn’t help, and we’d have to try another drug. Then, there were still more drugs from my doctors for anxiety and depression during treatment, and PTSD after treatment. Drugs to push away the now-not-entirely-unreasonable fear of death that exploded in my brain each day, manifesting in the form of panic attacks that left me crying, screaming, or paralyzed by grief. I longed for the normal, pre-cancer life I once knew. I knew it was gone forever.
Being a cancer patient means drugs. Each of these drugs came with its own attendant set of risks and adverse effects. There are helper drugs you have to take to allow you to tolerate the life-saving drugs. Drugs for your drugs for your drugs for your drugs, prescribed in a seemingly endless chain, a pharmaceutical Rube Goldberg machine that, if you're lucky, helps the doctors save your life and helps you want to keep living it.
Marijuana would end up being the least heavy substance in my life. And it would end up helping. A lot.
The conceptual walls I’d built against pot crumbled the night after my first chemo infusion. The anti-emetics they gave me at the infusion center didn’t work on me. I vomited all over my house a few hours after the nurse unhooked my wrist from the IV full of toxic liquid (that first round contained a compound originally distilled from mustard gas, not kidding). I don’t remember much about that night, but I do remember my mom holding my head while I dry-heaved into a bucket.
We spoke with my oncologist the next day. We experimented with various drugs, but nausea, lack of appetite, and breakthrough barfing were constant companions. Managing these symptoms is more than a matter of comfort. It’s a matter of survival. If you can’t eat, you’re losing fluids while puking your guts out, and you can’t sleep, you have a real problem. You may not make it to, or through, the next infusion. And these infusions were an attempt to save my life.
Fuck it, I told my friend. Let’s try pot.
Photo: Xeni Jardin
With the help of that friend, and others who work with marijuana, I obtained professionally prepared edibles from a chef-turned-cannabis-candy-queen in Los Angeles. Each packet was labeled with dosage information. They were prepared in a clean, hygienic, responsible way — and that’s really important when you’re a cancer patient, because your immune system is compromised.
Another friend helped me access oil extracts and various strains of herb that could be inhaled in a vaporizer for different symptoms, in different intensities, at different times.
At certain times, the inhaled vapor was more comforting or effective. At others, the edibles made more sense. My doctors and nurses couldn't help me figure this out. My recreational pot-smoking friends had no idea how to help. Most of my fellow breast cancer patients had limited knowledge of cannabis use during treatment. I did manage to find expert guidance, but most cancer patients who are lucky enough to access pot don't have access to reliable instructions on exactly how to use it.
This is the brand of edible cannabis I used during my primary cancer treatment, and continue to use now.
I learned that nibbling on these dosage-specific, THC-intensive pot cookies and candies before and during my chemotherapy infusion could help pre-empt the nausea that followed. I learned that vaporizing when I got home from a chemo infusion could further help keep nausea and vomiting at bay, and relax my brain enough to rest. I was honest with my medical oncologist about my desire to use cannabis to help manage symptoms. I continued to use the pharmaceutical medications she prescribed, but cannabis became an additional tool in our arsenal. She wrote a doctor’s letter for me to bring to the pot dispensary (such a letter is required for legal use in California). I love her for many reasons, including this.
As my treatment progressed to surgeries, and then to weeks of daily radiation, I learned that cannabis could also truly help with pain, anxiety, and insomnia. The doses I used to counter nausea and vomiting were very high. The doses to help me eat when my body was repulsed by food were not as high. The doses to help calm my brain activity and replace fear with a gentle, “high” comfort were lower still–and candies or herb that contained more cannabidiol (CBD) than Tetrahydrocannabinol (THC) cut through the anxiety without the high at all.
While recovering from my first surgery, I discovered that vaping pot or eating marijuana candies at the same time I took my prescribed opioids seemed to amplify the effectiveness of the pills. With pot, I could take less Hydrocodone or Oxycodone. This was great, because opioids carry a high risk of abuse or dependency and made me depressed, constipated, and ragey. With pot, I could use the pain meds for a shorter course. I could get more relief from my pain, and be up walking and not "drugged" sooner.
How could different forms and strains of this one plant, used in various ways at different doses, do so much to help with such a wide spectrum of treatment side effects? I don’t know. I just knew, and know still now, that it really helped me.
I use cannabis now in low doses at night to help with chronic insomnia that results from ongoing treatment. I vape, and I use edibles. I do not drink, or use recreational drugs. The medical use of cannabis did not make me want to use pot all day, all the time, nor did it lead to drinking or the compulsion to use or abuse other drugs.
I met people in the cancer treatment waiting rooms whose cancer resulted in the inability to chew and swallow food. Some of them had undergone surgery to remove part of their mouths, tongue, or throats. I met many fellow patients who struggled to get to the next chemo or radiation session because they could not eat. I have known and loved many women with advanced metastatic cancer who suffered without end, with far greater intensity, from the kinds of symptoms I have described to you here. I learned that the ability of end-of-life patients to connect with loved ones in their final days was sometimes cut short by the incredibly high doses of opioids they were given to reduce the unbearable pain that comes with late-stage cancer.
All of them could be helped by marijuana.
Some of them, I helped with marijuana.
May our nation soon come to its senses. May more people with cancer be able to safely, legally, affordably access this powerful drug, and find relief in it. Cancer patients should not have to navigate the world of barely-legal pot doc storefronts or dispensaries designed for druggies. Cancer patients should have easy access to cannabis, if they want it. No law or social stigma should stand in their way. Period.
May our scientists soon be more free to research and unlock the anti-cancer potential in cannabis. We’re just beginning to scratch the surface of that potential. If America's laws allowed for a climate more hospitable to cannabis research, perhaps cannabis could one day be used not just to control side effects, but to control or cure cancer in medical settings. The chemo drugs I received were originally isolated from plants, so it's not a far-fetched idea. To begin to unlock the true healing potential of cannabis, we need more peer-reviewed research, more clinical trials, and an end to prohibition.
The medical part of marijuana may still be a joke at the shady dispensaries that cater to stoners. And it's true that a lot of people in the cannabis business are making a lot of money from pot use that has nothing to do with life-and-death medical struggles. But for cancer patients, the “medical” part of marijuana is no joke. Cannabis is a magic plant. And it helped save my life.
Previously at Boing Boing
• How I use medical marijuana: vaporizers, science, weed, and cancer
• My Dinner with Marijuana: chemo, cannabis, and haute cuisine
• My Dinner with Marijuana: chemo, cannabis, and haute cuisine
