CHAPTER 9
A WOMAN'S RIGHT TO HEALTH
On December 15, 2015, Amina Cordano went in for a routine check-up with her doctor and heard the last thing anyone wants to hear.
Cancer.
“My gynecologist found these abnormal cells. They said the cell cluster was very angry, they said it was angry looking,” Cordano explains. “And at that moment they made a decision, they were going to go in and do a biopsy of it. And a week later, on December 21st, I was diagnosed with stage 3 cervical cancer with both left and right pelvic lymph node involvement.”1 This optimistic and dedicated mother of two was determined to survive, no matter what her gynecologist and original oncologist told her.
“She was always smiling and very positive and upbeat, and she didn’t lose that. She didn’t get depressed, she didn’t get sad,” Cordano’s husband, Ray, explains. “Every day when she would go into chemotherapy, she still had a smile on her face and she was still upbeat.”
Cordano spent months researching. When she felt that chemotherapy on its own wasn’t going to help her, she found an integrative oncologist, Dr. Sean Devlin, who believed in cannabis medicine. Devlin connected her with Michael Masterman-Smith and his farm.
“Amina Cordano is one of the very first and favorite patients I worked with after leaving UCLA,” Masterman-Smith says.2 He put her on CBD-THC capsules for her regimen. The CBD was to stem her cancer and the THC to ensure that she eliminated the risk of toxic nausea and weakness that most people get from cancer treatments.
Cordano also took vitamin C IV therapy. She started on her regimen for two and a half months before going into battle with chemotherapy and radiation in March 2016, and she refused to medicate herself with all of the pharmaceuticals on offer.
At the time, her husband wasn’t convinced. “I thought it was voodoo or an easy escape out of Amina’s thoughts of cancer,” Ray Cordano explains. “With all of the bad publicity on CBD and THC—and I wasn’t highly educated on the difference between them—I was convinced it was no big deal. But once her original oncologist gave her all these prescription drugs and she said, ‘No, I’m not taking any of them and I’m doing CBD instead,’ I had to support her.”
A PET scan taken in March, three months after her original scan on January 7, 2016, showed that her tumors had shrunk on her cervix and in both of her lymph nodes by 25 percent. She showed me the slides of her PET results, and, as Masterman-Smith recounts, they are extraordinary for someone at her advanced stage of cancer.
The most difficult treatment protocol in the world
When cancer strikes, its effects are on the human body are hugely complex. Not only are cancer patients fighting the disease itself, but the typical approach to curing it is almost as bad, if not worse, than the disease itself.
Jennifer Lanksbury, the biologist from Washington, outlines how an individual’s chemotherapy and radiation fit into the big picture. Cancer patients are sent home after their treatments with explicit instructions about what’s going to happen, because it’s not just physically painful, as Lanksbury explains.3 Chemotherapy and radiation are both incredibly dangerous to patients and to their families, because people expel waste that is life-threateningly toxic. Those who receive chemotherapy can get secondary forms of cancer as a result.4 When those who have had radiation come into low-level contact with children, the elderly or pregnant women—through skin-to-skin contact or through simple activities such as cleaning the bathroom—they can actually cause cancer.5 Exposure to a parent taking chemotherapy can even change the genetic makeup of a child.6
All of the cancer drug risks compound on one another, and they could have deeply affected Cordano’s family, which is why she was so adamant about trying to find a better solution, one that would lower the chance of something going wrong.
“She didn’t need any of the prescription drugs. She was originally given fourteen different drugstore prescriptions for steroids, anti-nausea, anti-diarrhea. She didn’t need them. She did very little radiation,” Ray Cordano says. “The doctors were in awe. That’s when I became completely sold on the benefit of CBD and the magic of how it worked.”
Cordano and her husband don’t just believe in magic. They believe in science. That’s why she didn’t stop at CBD. “Because I had small children,” she says, “and I wanted to make sure that I hit it from all angles, I went ahead and decided to go in and do radiation and chemotherapy and hyperthermia as well.”
She credits her CBD therapy for how easy it was to go through the process and how the toxins moving through her body didn’t seem to affect her. She didn’t lose her hair, she wasn’t exhausted, she never threw up and, best of all, she was able to be present with her family every day.
“People in chemo with me were really curious about what I was doing and how I was fully functioning. I would go into battle Monday through Friday, all week long, doing chemo, doing radiation, doing hyperthermia. And then I was still able to flip burgers at my son’s barbecue on the weekend.”
A health solution bound to the female experience
Amina Cordano’s case may be an outstanding example of how to manage cervical cancer with CBD, but to Dr. Ethan Russo, it may not be as surprising as it first appears.
Ethan Russo is the director of research and development at the International Cannabis and Cannabinoids Institute in Prague, Czech Republic, and a board-certified doctor of neurology with a special qualification in child neurology. After eleven years with GW Pharma, the company that went on to develop Epidiolex (the CBD-based epilepsy medicine we’ve talked about already), Russo became medical director of Phytecs, a company devoted to the research and development of medicines, supplements and lifestyle approaches to optimizing the function of the endocannabinoid system. He has strong opinions on why this system needs to be critically assessed when it comes to women’s health.
“If we look at medical history in the US and Europe, cannabis was primarily used for obstetrics and gynecology and then treatment of pain, particularly migraine and neuropathic pain,” he says. Russo points out that cannabis used to be used extensively in the treatment of nausea during pregnancy and pain during childbirth, and that it has been proven through evidence-based studies to be safe for both mothers and infants. “There’s no evidence of human birth defects associated with the use of medical cannabis. But CBD uses in women’s medicine have fallen out of practice because of fears of the toxicity of cannabis, which are really unwarranted. Now, frequently, women wind up in the hospital getting drugs that we know are more dangerous and which are largely ineffective.”
Russo points out that our fears about cannabis intoxication in mothers-to-be are largely unfounded. He tells the story of a researcher, Melanie C. Dreher, PhD, who studied the use of cannabis as a traditional plant medicine among a population of Rastafarian women in Jamaica.7 Dreher found that women in this community who used what they call ganja were those who avoided alcohol and cigarettes, increased their nutritious food intake, decreased their levels of nausea and had healthier, bigger babies who, over the long term, maintained their health better than others in the same region.8 As Russo explains, “Dreher’s team found . . . that these women had very healthy infants whose development, if anything, seemed a little bit advanced compared to women of similar age who were not using ganja during pregnancy.”
Russo suggests that women who are under deep life stressors such as poverty may not be using cannabis recreationally, even though an outsider may assume that they are; in fact, using this medicine, which had a spiritual as well as a health value, made women better parents.
Dreher’s research, however, did not fit with our assumptions about cannabis medicine. “Her findings were published in the journal Pediatrics, a very reputable, very conservative source,” Russo says.9 “Unfortunately, after this, Dr. Dreher had difficulty getting further grant money for similar studies. It’s hard for the truth to come out, because often there are people opposing the dissemination of this kind of information that might seem to refute the conventional wisdom that cannabis was dangerous in pregnancy.”
In tracing the history of the use of CBD for gynecological issues, Russo also found that it was used as a successful treatment for uterine cancer as far back as 1872.10 Cannabis extracts have been used as a safe treatment of a wide range of conditions including problems with menstruation and menopausal symptoms, as Russo reports, for more than 9,000 years. The use of hemp (which likely refers to CBD rather than to the THC in Cannabis sativa because of the difference in properties associated with the plants at the time) has been found in doctors’ records in ancient Mesopotamian, Egyptian and Zoroastrian scripts for women in uterine pain and to prevent miscarriage. CBD was, over the course of centuries, given to female patients orally, rectally, vaginally, on the skin, in the eyes and by a form of steam inhalation similar to that of vaporizing CBD today.
As Russo explains, even Britain’s Queen Victoria, mother of nine children, was prescribed CBD. “Sir John Russell Reynolds was personal physician to Queen Victoria, and it has been widely acknowledged that she received monthly doses of Cannabis indica for menstrual discomfort throughout her adult life,” Russo says. “In 1890, after more than thirty years’ experience with the agent, Reynolds reported, ‘Indian hemp . . . is of great service.’”11
Dr. Reggie Gaudino tells the same story about Queen Victoria, and he questions why we have lost that knowledge and how it may be linked to the way in which we disempower women and their needs. What was once used as a means to help women in labor, or those who had painful menses or those who suffered from sexually transmitted diseases was utterly removed from the American pharmacy by the 1930s, as both Gaudino and Russo explain.
“I think what has happened is that we buried all that information,” Gaudino says. “We created this demonic association with a plant that was sacred. And all these religious texts, somehow it got turned around into something evil, and this idea was fed to the people who needed something to believe in because we were coming out of the Great Depression.”
Ending the struggle for women in pain
In the last few years there has been an explosion of research into the ways in which CBD can positively effect women’s health.
Deep infiltrating endometriosis (DIE) is a gynecological disease that is characterized by chronic pain and rapidly growing benign tumors in the womb, called fibroids. Fibroids can also begin to grow throughout a woman’s body, as her endometrial cells find their way through the bloodstream. In essence, this disease causes uterine tissue to grow everywhere and anywhere, and when the affected woman menstruates, this tissue can break down and bleed in the same way that it does in the uterus, causing intense pain.
At the Asana Group, the leading global cannabinoids research hub in the field of women’s health run by Lumír Hanuš in Tel Aviv, Israel, researchers have found that CBD has exactly the effect that Sir John Russell Reynolds said it did in the 1890s.12 CBD has antifibrotic properties in addition to its ability to ease pain, which means that when women with DIE take this treatment, they are more likely to be released from symptoms and their bodies will stop producing excess uterine tissue.13
In more than 95 percent of cases, patients who suffer from DIE are prone to very severe pain, and therefore they are usually recommended for extreme surgery, including the removal of the uterus and fallopian tubes, which means they are sterile.14 Women who have endometriosis are much less likely to be able to bring a baby to term than those without the disease. Medical management, however, is insufficient as it is associated with high rate of recurrence and only partial relief of symptoms including chronic pain.15
What’s interesting, however, is that Asana Group researchers have found that endometriosis is linked to what Russo has called an endocannabinoid deficiency (ECD). In other words, they’ve discovered that women with endometriosis have lower levels of CB1 receptors in their endometrial tissue, which means that there is a direct relationship between endometriosis and the endocannabinoid system: uterine cells grow freely throughout the body because these patients’ systems simply aren’t picking up their natural stores of internal CBD.
And there are other very common women’s ailments that can be culled through regular CBD use, says Russo. “Migraines are clearly more common in women than men, and this was one of the main uses of cannabis before prohibition,” he says. “Additionally, fibromyalgia is much more common in women than men, and we’re seeing now that cannabis can be remarkably effective for that disease. The National Pain Foundation did a survey several years ago in which they queried over thirteen hundred people with fibromyalgia.16 Patients reported that the three FDA-approved medicines to treat fibromyalgia were extremely ineffective compared to cannabis. The fact is unless a patient feels that a medicine is helping them, they’re not going to use it. That’s what we have to go on: the fact that people are taking this and reporting benefit. It deserves more scrutiny.”
Acknowledging that ECD exists, and that its effects on women’s health and well-being are so devastating, is an important step toward women’s health equity. CBD not only provides a novel approach for developing badly needed new treatments for endometriosis, this research also provides validation of the monthly menstrual pain and emotional anguish that so many women feel, which has been traditionally diminished by health care providers. While Russo does not advocate smoking cannabis, he says that CBD inhalations or supplements may achieve the same goals for pain reduction.
Amina Cordano agrees. “My hope and dream is that every day we can wake up and take a multivitamin that includes a low dose of cannabinoids, as a preventative, like a pill a day will keep the doctor away,” she says. “I can’t wait to see that happen. It’s just the way of the future.”
Cordano knows that, as a woman, she wasn’t taken seriously when making decisions for herself and her own treatment, something that she suspects will change as more people discover CBD as well as the possibility of an endocannabinoid deficiency.
“I felt very harassed and very pushed into treatment here in Sacramento. I felt like I needed to step away and really come up with the treatment plan that I wanted to do for myself, for my own life. And because I was leaning toward cannabis medicine, I was very harassed. I would get threatening phone calls telling me that I would die if I didn’t go to chemotherapy right away. But I listened to myself, and that was the turning point.”
Masterman-Smith says, in summing up her case, that he is amazed at the extent to which she’s emerged free from the pain of cancer as well as the emotional and physical effects of stepping away from a traditional form of treatment. “Amina has recovered from her ovarian cancer and has been cancer-free for two years. She has no evidence of disease.”
It’s her goal to help others with cancer, Cordano says, now that she’s moved to the other side of treatment. “I’m going to teach chair yoga and massage to people who are going through chemo and radiation,” she says. “I just graduated from doing two hundred hours of yoga teacher training and so I’m going to one of the dispensaries to offer this service and to raise awareness about self-care and its role in healing from cancer.”
1. [Interview with Amina and Ray Cordano.]↩
2. [Interview with Michael Masterman-Smith.]↩
3. [Interview with Jennifer Lanksbury interview.]↩
4. [Applebaum, M.A., Henderson, T.O., Lee, S.M., Pinto, N., Volchenboum, S.L., & Cohn, S.L. (2015). Second malignancies in patients with neuroblastoma: the effects of risk-based therapy. Pediatric Blood & Cancer, 62(1), 128–133.]↩
5. [Kamiya, K., Ozasa, K., Akiba, S., Niwa, O., Kodama, K., Takamura, N. , . . . & Wakeford, R. (2015). Long-term effects of radiation exposure on health. The Lancet, 386(9992), 469–478.]↩
6. [Kryukov, G.V., Bielski, C.M., Samocha, K., Fromer, M., Seepo, S., Gentry, C. , . . . & Van, E.A. (2016). Genetic effect of chemotherapy exposure in children of testicular cancer survivors. Clinical Cancer Research, 22(9), 2183–2189.]↩
7. [Dreher, M.C. (1989). Poor and pregnant: perinatal ganja use in rural Jamaica. Advances in Alcohol & Substance Abuse, 8(1), 45–54.]↩
8. [Dreher, M.C., Nugent, K. & Hudgins, R. (1994). Prenatal marijuana exposure and neonatal outcomes in Jamaica: an ethnographic study. Pediatrics, 93(2), 254–260.]↩
9. [Dreher, M.C. (1989); Dreher, M.C., Nugent, K. & Hudgins, R. (1994).]↩
10. [Russo, E. (2002).]↩
11. [Russo, E. (2002).]↩
12. [Bouaziz, J., Bar On, A., Seidman, D.S., & Soriano, D. (2017). The clinical significance of endocannabinoids in endometriosis pain management. Cannabis and Cannabinoid Research, 2(1), 72–80.]↩
13. [Leconte, M., Nicco, C., Ngô, C., Arkwright, S., Chéreau, C., Guibourdenche, J. , . . . & Batteux, F. (2010). Antiproliferative effects of cannabinoid agonists on deep infiltrating endometriosis. The American Journal of Pathology, 177(6), 2963–2970.]↩
14. [Dmitrieva, N., Nagabukuro, H., Resuehr, D., Zhang, G., McAllister, S.L., McGinty, K.A. , . . . & Berkley, K.J. (2010). Endocannabinoid involvement in endometriosis. PAIN, 151(3), 703–710.]↩
15. [Sanchez, A.M., Vigano, P., Mugione, A., Panina-Bordignon, P. & Candiani, M. (2012). The molecular connections between the cannabinoid system and endometriosis. Molecular Human Reproduction, 18(12), 563–571.]↩
16. [Russo, E.B. (2016). Clinical endocannabinoid deficiency reconsidered: current research supports the theory in migraine, fibromyalgia, irritable bowel, and other treatment-resistant syndromes. Cannabis and Cannabinoid Research, 1(1), 154–165.]↩