Medical marijuana for the treatment of vismodegib-related muscle spasm

JAAD Case Reports

“Basal cell carcinoma (BCC) arises from loss-of-function mutations in tumor suppressor patched homologue 1, which normally inhibits smoothened homologue in the sonic hedgehog signaling pathway. Vismodegib, a smoothened homologue inhibitor, is US Food and Drug Administration (FDA) approved for metastatic or locally advanced BCC that has recurred after surgery or for patients who are not candidates for surgery and radiation. Common adverse effects of vismodegib are muscle spasms, alopecia, dysgeusia, nausea, and weight loss. Muscle spasms worsen with duration of drug administration and may lead to drug discontinuation.

We report a case of vismodegib-related muscle spasm that was successfully treated with medical marijuana (MM).

During the first week of vismodegib and radiation, the patient started MM, having heard of its indication in the treatment of muscle cramps. She smoked 3 to 4 joints daily of Trainwreck strain, containing 18.6% tetrahydrocannabinol (THC), 0.0% cannabidiol (CBD), and 0.0% cannabinol. Her muscle spasms resolved immediately. She continued MM for 3.5 weeks, until the cost of MM became prohibitive. She reported no adverse effects from MM. Complete resolution of muscle spasms was sustained through the remaining 3.5 weeks of vismodegib. Complete blood count, comprehensive metabolic panel, and lactate dehydrogenase level were monitored throughout the study with no significant changes. As of 18 months posttreatment, the patient had a complete clinical response of her BCC.

One marijuana joint contains, on average, 0.66 g of marijuana, although the definition of a joint is highly variable. With any MM formulation, patients should start at a low dose and gradually titrate to effect. Additional studies could confirm safety and efficacy and better specify the optimal cannabinoid subtypes, preparations, and dosages that may be most beneficial for vismodegib-induced muscle spasms.”

http://www.jaadcasereports.org/article/S2352-5126(17)30124-8/fulltext

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Medical marijuana in pediatric oncology: A review of the evidence and implications for practice.

Pediatric Blood & Cancer

“Medical marijuana (MM) has become increasingly legal at the state level and accessible to children with serious illness. Pediatric patients with cancer may be particularly receptive to MM, given purported benefits in managing cancer-related symptoms. In this review, we examine the evidence for MM as a supportive care agent in pediatric oncology. We describe the current legal status of MM, mechanism of action, common formulations, and potential benefits versus risks for pediatric oncology patients. We offer suggestions for how providers might approach MM requests. Throughout, we comment on avenues for future investigation on this growing trend in supportive care.”

https://www.ncbi.nlm.nih.gov/pubmed/28926679

http://onlinelibrary.wiley.com/doi/10.1002/pbc.26826/abstract

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Olivia Newton-John champions the use of ‘magical, miracle’ medicinal cannabis

Cannabis is a "magical miracle plant" says singer Olivia Newton-John.

“Let’s get medicinal, says Olivia Newton-John, who has spoken out about the use of medicinal cannabis on a recent visit to Australia. “I will do what I can to encourage it. It’s an important part of treatment and it should be available,” the singer, who announced a second battle with breast cancer in May, told News Corp Australia. The Australian entertainer said the drug – which is legal in her home state of California – had helped her during her second fight against cancer.” https://www.stuff.co.nz/entertainment/celebrities/96702731/olivia-newtonjohn-champions-the-use-of-magical-miracle-medicinal-cannabis

“OLIVIA NEWTON-JOHN TELLS HOW MARIJUANA IS HELPING HER BEAT CANCER”.“I use medicinal cannabis, which is really important for pain and healing,” “It’s a plant that has been maligned for so long, and has so many abilities to heal.”“I will do what I can to encourage it,” “It’s an important part of treatment, and it should be available. I use it for the pain and it’s also a medicinal thing to do — the research shows it’s really helpful.”” http://www.dailytelegraph.com.au/news/nsw/olivia-newtonjohn-tells-how-marijuana-is-helping-her-beat-cancer/news-story/12705dfadc0579a1139472271aa03bf8

 “It’s a magical miracle plant:’ Olivia Newton-John reveals husband John Easterling grows marijuana to aid her breast cancer battle… as star recalls her struggle to tell daughter Chloe about heartbreaking diagnosis. In an emotional interview with Karl Stefanovic on 60 Minutes, Olivia revealed that the controversial plant has helped her immeasurably in her cancer battle. ”It’s been a maligned plant all these years and it really is a magical miracle plant.”” http://www.dailymail.co.uk/tvshowbiz/article-4869940/Olivia-Newton-John-benefits-medical-marijuana.html

“OLIVIA NEWTON-JOHN TELLS ALL ON HER CANCER BATTLE & WHY WEED IS HER ‘HEALING PLANT'” http://okmagazine.com/photos/olivia-newton-john-cancer-weed-today-show/

“Olivia Newton-John on Being a Cancer ‘Thriver’ and Using Weed to Cope with Her Relapse: It’s a ‘Healing Plant’” http://people.com/music/olivia-newton-john-cancer-relapse-weed/

Olivia Newton-John credits weed for helping cancer battle http://pagesix.com/2017/09/21/olivia-newton-john-credits-weed-for-helping-cancer-battle/

“Olivia Newton-John’s cancer battle is going well… Thanks to cannabis oil!” http://lifestyle.one/closer/celebrity/news/olivia-newton-john-daughter-chloe-lattanzi-cannabis-oil-cancer/

“Olivia Newton-John is Using Cannabis Oil for her Breast Cancer—Here’s How It Could Help” http://www.health.com/breast-cancer/cannabis-cancer-treatment-olivia-newton-john

“Cannabis Oil Will Help Olivia Newton-John Battle Breast Cancer”  https://thefreshtoast.com/celebrity/olivia-newton-john-will-use-cannabis-oil-in-battling-second-breast-cancer-diagnosis/

“Olivia Newton-John Is Using Cannabis Oil To Treat Her Cancer”  https://www.inverse.com/article/32780-cannabis-oil-cancer-treatment-cannabinoid-chemotherapy

“OLIVIA NEWTON-JOHN USES MEDICINAL CANNABIS IN CANCER FIGHT”  http://www.wsfm.com.au/entertainment/the-feed/olivia-newton-john-uses-medicinal-cannabis-in-cancer-fight

Olivia Newton-John is using medical marijuana during her battle with breast cancer” http://www.kansascity.com/entertainment/article171116417.html
“Olivia Newton-John reveals marijuana helping her beat cancer” http://www.9news.com.au/national/2017/09/03/08/58/olivia-newton-john-backs-medicinal-cannabis

“‘I use cannabis’: Olivia Newton-John talks cancer treatment”  https://startsat60.com/health/big-issues/cancer/i-use-cannabis-olivia-newton-john-opens-up-on-cancer-treatment

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 “”I use medicinal cannabis, which is really important for pain and healing. It’s a plant that has been maligned for so long and has so many abilities to heal,” Newton-John told the Daily Telegraph in a recent interview. Newton-John does not have a problem with her supplies of cannabis oil as her daughter, Chloe Lattanzi, owns a cannabis farm in Oregon, and can be easily obtained in her home state of California, where the use of medical marijuana is legal. However, as many parts of the world are still pessimistic about the medical use of marijuana, Newton-John has declared that she will advocate for its use, including in her home country Australia, where obtaining permits to use it still requires a long process even after it was legalized earlier this year. “I will do what I can to encourage it. It’s an important part of treatment, and it should be available. I use it for the pain and it’s also a medicinal thing to do — the research shows it’s really helpful,” Newton John said.” http://www.christianpost.com/news/olivia-newton-john-news-70s-icon-reveals-advocates-use-of-cannabis-oil-to-deal-with-cancer-pain-197915/
 “Olivia Newton-John champions use of medicinal cannabis in breast cancer battle” http://www.ibtimes.co.uk/olivia-newton-john-champions-use-medicinal-cannabis-breast-cancer-battle-1637729
“Newton-John champions medicinal cannabis use after it helped her cancer battle” https://thewest.com.au/news/health/newton-john-champions-medicinal-cannabis-use-after-it-helped-her-cancer-battle-ng-b88588000z
‘It’s really important and should be available’: Olivia Newton-John speaks for the first time about how ‘medical cannabis’ is helping her beat breast cancer” http://www.dailymail.co.uk/tvshowbiz/article-4846664/Olivia-Newton-John-talks-cannabis-use-time.html
“Grammy-winning singer/songwriter and actor Olivia Newton-John has opened up about her use of marijuana. “I use medicinal cannabis, which is really important for pain and healing,”“I will do what I can to encourage it. It’s an important part of treatment, and it should be available.”” https://www.civilized.life/articles/medicinal-cannabis-olivia-newton-john/
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“Olivia Newton-John Admits to Using Home-Grown Medical Marijuana to Battle Cancer” http://popculture.com/2017/09/11/olivia-newton-john-medical-marijuana-breast-cancer/

 “Grassed Lightning: Olivia Newton-John is using cannabis instead of popping pills for breast cancer pain relief” http://www.mirror.co.uk/3am/celebrity-news/grassed-lightning-olivia-newton-john-11158137

“WEED ALL ABOUT IT.  Olivia Newton-John reveals she is drinking cannabis extract to ease her back pain as she battles cancer”  https://www.thesun.co.uk/fabulous/4454398/olivia-newton-john-reveals-she-is-drinking-cannabis-extract-to-ease-her-back-pain-as-she-battles-cancer/

“Olivia Newton-John Reveals She Was Unable to Walk After Cancer Relapse – and She’s Using Marijuana to Ease Pain” http://people.com/music/olivia-newton-john-cancer-update-couldnt-walk-australian-60-minutes/

“Olivia Newton-John uses medical marijuana to treat cancer”  https://www.buzz.ie/celebs/olivia-newton-john-drinks-cannabis-extract-numb-pain-cancer-253796

“Olivia Newton-John Talks Using Medical Marijuana In Cancer Treatment. “I use medical cannabis, which is really important to pain and healing. It’s an important part of treatment, and it should be available.”” https://www.thefix.com/olivia-newton-john-talks-using-medical-marijuana-cancer-treatment

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“I’m really hoping that you will have it accessible to people. Particularly for people who are in pain. It’s not just cancer, it’s many, many illnesses. In children with epilepsy, parents are going to jail for trying to help their children, by giving them medicinal cannabis. That has to change, and I think it will. I think people are realizing this has been a maligned plant but it’s a healing plant with lots of wonderful properties. It can help alot of people. And they’re doing alot of research into the healing properties of cannabis, it’s not just for pain but to cure things. So it’s a very exciting time in the research as well.” –Olivia Newton-John http://www.dailymail.co.uk/video/tvshowbiz/video-1537789/Olivia-Newton-John-wants-medical-cannabis-legal-Australia.html

 “A picture of health! Olivia Newton-John beams at the ONJ Wellness Walk and Research Run in Melbourne as she battles cancer for the second time” http://www.dailymail.co.uk/tvshowbiz/article-4892342/Olivia-Newton-John-cancer-fun-run.html

 “‘It’s a magical miracle plant:’ Olivia Newton-John reveals husband John Easterling grows marijuana to aid her breast cancer battle” http://www.dailymail.co.uk/tvshowbiz/article-4869940/Olivia-Newton-John-benefits-medical-marijuana.html
 “Actress and singer Olivia Newton-John believes in the ‘healing properties’ of medical cannabis and hopes it will become legal, including for children.” http://www.dailymail.co.uk/video/tvshowbiz/video-1537789/Olivia-Newton-John-wants-medical-cannabis-legal-Australia.html
Bright: Dressed in a lime-coloured ONJ Cancer wellness and Research Centre track suit top over a matching T-shirt in a lighter shade of green, she seemed fit and happy
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Physicians-in-training are not prepared to prescribe medical marijuana.

Drug and Alcohol Dependence Home

“While medical marijuana use is legal in more than half of U.S. states, evidence is limited about the preparation of physicians-in-training to prescribe medical marijuana. We asked whether current medical school and graduate medical educational training prepare physicians to prescribe medical marijuana.

Our study highlights a fundamental mismatch between the state-level legalization of medical marijuana and the lack of preparation of physicians-in-training to prescribe it. With even more states on the cusp of legalizing medical marijuana, physician training should adapt to encompass this new reality of medical practice.”

https://www.ncbi.nlm.nih.gov/pubmed/28892720

http://www.drugandalcoholdependence.com/article/S0376-8716(17)30441-6/fulltext

 

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Medical Marijuana Helps Kids With Cerebral Palsy, Israeli Study Finds

Medical marijuana plants (illustrative)

“Medical marijuana significantly improved the condition of children suffering from cerebral palsy, a study by Wolfson Medical Center near Tel Aviv has found. According to the interim findings, treatment with cannabis oil reduced the disorder’s symptoms and improved the children’s motor skills. It also improved the kids’ sleep quality, bowel movements and general mood.

“The THC’s effect is especially relevant to motor function, whether it’s Parkinson’s disease or other motor symptoms,” says Bar-Lev Schleider. “But the THC is also responsible for the psycho-active effect, so we picked a variety that also has a lot of CBD, which moderates the euphoric effect.”
One group of children was treated with oil with a 1:6 ratio of THC to CBD, while for another group the ratio was 1:20.
“According to the interim findings both oils are effective,” says Bar-Lev Schleider.”
http://www.haaretz.com/israel-news/.premium-1.811010

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Parent use of cannabis for intractable pediatric epilepsy: Everyday empiricism and the boundaries of scientific medicine.

Social Science & Medicine

“Cannabis is an increasingly sought-after remedy for US children with intractable (biomedically uncontrollable) epilepsy. However, like other complementary-alternative medicine (CAM) modalities, and particularly as a federally illegal, stigmatized substance, it is unsanctioned by mainstream medicine. Parents are largely on their own when it comes to learning about, procuring, dispensing, and monitoring treatments. Exploring how they manage is crucial to better assist them. Moreover, it can illuminate how ‘research’ done on the ground by laypeople variously disrupts and reinforces lay-expert and science-non-science divides. To those ends, in 2016, 25 Southern California parents who used, had used, or sought to use cannabis pediatrically for epilepsy/seizures were interviewed regarding their evidentiary standards, research methods, and aims when trying the drug. Parents generally described their work as experimentation; they saw their efforts as adhering to authorized scientific practices and standards, and as contributing to the authorized medical cannabis knowledge base. Findings subverted assumptions, based on an outdated stereotype of CAM, that cannabis-using parents do not believe in biomedicine. Indeed, parents’ desire for their children’s biomedical demarginalization, combined with biomedical dependency and a high caregiver burden, fueled a collaborative stance. Implications for understanding the boundaries of science are explored, as are norms for parent agency as ill children’s care managers, radicalization among people affected by contested illnesses, and the future of ‘medical marijuana.'”

https://www.ncbi.nlm.nih.gov/pubmed/28865255

http://www.sciencedirect.com/science/article/pii/S0277953617304756?via%3Dihub

 

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Use of medical cannabis to reduce pain and improve quality of life in cancer patients.

Journal of Clinical Oncology

“Early attention to pain and symptoms in those with cancer improves both quality of life and survival. Opioid medications are the mainstay treatment of cancer-related pain.

Cannabinoids are increasingly used as adjunctive treatments for cancer pain, but clinical evidence supporting their use as an “opioid sparing agent” or to improve quality of life is as yet unknown.

Our study sought to determine if the addition of cannabinoids (medical cannabis) resulted in the reduction of the average opioid dose required for pain control, and improve self-reported quality of life indices.

Patients with cancer pain benefited from the addition of cannabinoids.

The average opioid dose decreased following access to medical cannabis.

Self-reported ratings of several quality of life indicators showed statistically significant improvement.

Our study shows a signal that cannabinoids may reduce cancer patients’ reliance on opioids to control pain.

Further prospective controlled studies are needed to further elucidate the role of cannabinoids in the treatment of cancer pain.”

https://www.ncbi.nlm.nih.gov/pubmed/28148191

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Speechlessness in Gilles de la Tourette Syndrome: Cannabis-Based Medicines Improve Severe Vocal Blocking Tics in Two Patients.

ijms-logo

“We report the cases of two young German male patients with treatment-resistant Tourette syndrome (TS), who suffer from incapacitating stuttering-like speech disfluencies caused by vocal blocking tics and palilalia. Case 1: a 19-year old patient received medical cannabis at a dose of 1 × 0.1 g cannabis daily. Case 2: a 16-year old patient initially received dronabinol at a maximum dose of 22.4-33.6 mg daily. Both treatments provided significant symptom improvement of vocal blocking tics as well as of comorbid conditions and were well tolerated. Thus, cannabis-based medicine appears to be effective in treatment-resistant TS patients with vocal blocking tics.”

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Going to pot? The impact of dispensary closures on crime☆

Journal of Urban Economics

“Jurisdictions that sanction medical or, more recently, recreational marijuana use often allow retail sales at dispensaries. Dispensaries are controversial as many believe they contribute to local crime. To assess this claim, we analyze the short-term mass closing of hundreds of medical marijuana dispensaries in Los Angeles.

Contrary to popular wisdom, we find an immediate increase in crime around dispensaries ordered to close relative to those allowed to remain open.

The increase is specific to the type of crime most plausibly deterred by bystanders, and is correlated with neighborhood walkability. We find a similar pattern of results for temporary restaurant closures due to health code violations. A likely common mechanism is that “eyes upon the street” deter some types of crime.”

“Closing medical marijuana dispensaries increases crime, according to new study.  Contrary to popular belief, medical marijuana dispensaries (MMDs) reduce crime in their immediate areas, suggests a new report.”  https://www.sciencedaily.com/releases/2017/07/170711125704.htm

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Fewer Seizures With Cannabidiol in Catastrophic Epilepsy

Cannabidiol reduces frequency of seizures in patients with Dravet syndrome.

“Cannabidiol reduced the frequency of convulsive seizures compared with placebo in Dravet syndrome, a childhood epilepsy disorder with a high mortality rate and no approved treatment in the United States, reported a clinical trial in the New England Journal of Medicine.” http://jamanetwork.com/journals/jama/fullarticle/2645099

“Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome”  http://www.nejm.org/doi/full/10.1056/NEJMoa1611618#t=abstract

“EPILEPSY AND MARIJUANA: CANNABIS DRUG REDUCES DRAVET SYNDROME SEIZURES IN LARGE-SCALE CLINICAL TRIAL” http://www.newsweek.com/cannabis-marijuana-dravet-syndrome-epilepsy-clinical-trial-614982

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