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Medical cannabis poised to ‘flourish’ within new cannabis era

HealthPartners Cancer Cannabis clinic offers cancer patients personalized education and support over the use of medicinal cannabis.

ST. LOUIS PARK, Minn. — On a warm summer afternoon, Tracy Teyssier sits in her usual refuge: a beautifully manicured yard where squirrels and chipmunks approach her with familiarity. 

“I love sitting here and feeding the animals, watching them,” she said, as a chipmunk scampers near her feet. “I’m part of the furniture now.”

Here – amid both flora and fauna – Teyssier has found her peace. And that peace is precious, the 55-year-old former middle school teacher says, given her current health journey.

“I was diagnosed with colorectal cancer in 2018 and went through kind of the usual chemotherapy and surgery,” Teyssier shared, before adding that her challenges have grown, in terms of both the disease and the treatment.

“We thought that the cancer was gone. And then a couple of years later, it came back and had spread to my liver. And more recently seems to have spread to my lungs a little bit,” she said, noting that the progression – her cancer is now considered stage four – required a new approach to chemotherapy that, “Was making me very, very nauseous.”

And so – after several people suggested “you should try cannabis” – Teyssier, who is also a wife, mother of three daughters and grandmother of six grandchildren under the age of six – did.

“It was such a relief to not feel sick for a little while,” she noted, adding that the medication not only addressed her nausea, but also reduced her anxiety and allowed her to sleep.

“As you can imagine, you know, knowing you have cancer, all kinds of thoughts are going through your head, 24/7. It’s constant worrying about, you know, what your life is going to be, worrying about your children, your grandchildren, and what everybody’s going to do around you,” she said.

“It’s a wonderful tool to give you back a little bit of hope, independence. And you feel like you’re doing something for yourself. There’s something very healthy about that when you have cancer,” she noted.

And with her decision to add medical cannabis to her toolbox of treatments, Teyssier joined the tens of thousands of Minnesotans finding comfort in an ancient medication now seeing a resurgence; a resurgence that’s only expected to grow as recreational marijuana use becomes legal in Minnesota.

‘Just going to flourish’ 

As the research manager in the Office of Medical Cannabis, David Rak has overseen “a huge growth” in the medical cannabis program since it first opened to patients in 2015.

“In that first year, we had less than a thousand patients, but today we have about 40,000 patients,” he noted.

Rak observed some of that growth is directly related to adding more qualifying conditions; the state program started with nine conditions and is now up to 19 (chronic pain, which was added in 2020, accounts for nearly 60 percent of the medical cannabis program participants). Rak also noted a bump in participation in early 2021, when the state introduced cannabis flower as a product that could be sold in Minnesota.

“So that means it’s smokable for patients and a lot of patients prefer that method. And it tends to be cheaper than some of the other products that are available as well,” he said.

Looking forward, Rak notes how some states that previously legalized recreational use saw an immediate and slight dip in participation in their medical program. But he believes the Minnesota medical cannabis program will not only persist, it will grow, as patients realize the distinct benefits of the medical program. And that’s also despite the fact, Rak and other experts say, cannabis remains a Schedule 1 drug at the federal level. In other words, federal health officials have yet to classify the drug as having medicinal value.

According to the Minnesota Department of Health, by the time the two cannabis programs are fully operational in Minnesota – and it will take years for all aspects of the medical cannabis program to roll out – medical cannabis participants will still see benefits unique to the medical program (you can find a full list of those benefits, according to MDH, at the end of this article).

And on that point – the benefits of even more rigorous research on medical cannabis use – one local oncologist couldn’t agree more.

‘They want hope’ 

As the medical director of the HealthPartners Cancer Research Center, Dr. Dylan Zylla long ago recognized cannabis as a possible alternative to opioid use amid the “opioid epidemic” and as a possible tool to alleviate the “suffering” of his cancer patients.

“I see the devastation that cancer brings to patients. Obviously, it’s oftentimes a terminal diagnosis, and it’s devastating in that way. But then to see some of the suffering in the symptoms that patients have to endure and not necessarily always having the greatest options to help them,” the longtime oncologist observed.

And so, Zylla officially began his cannabis research not long after arriving at HealthPartners in 2012. 

“We actually ran one of the first national phase 3 randomized clinical trials with a cannabis-type product,” Zylla recalled, adding that the research “piqued my interest in cannabis and the potential benefit that it could have even before Minnesota’s law passed.”

Of the nearly 40,000 patients currently enrolled in the medical cannabis program, about 5 percent (1,834 people), cite cancer as their condition for participating. Recognizing the research opportunity among this group of patients, Zylla created a work group in 2016, “pulling in” leaders from the health department, University of Minnesota and even the cannabis industry. Zylla says the group began by tackling one fundamental question: “How do we study this? How do we get research studies out there for our patients using the Minnesota model?”

The answer? Conducting a couple of key studies, including one in 2017, that involved analyzing the data of about 1,100 Minnesota patients who had made cannabis purchases for a cancer-related condition.

“They reported multiple benefits in pain, nausea, insomnia, anxiety scores and also reported very few side effects with that,” Zylla said.

Zylla’s research also included a review of existing cannabis research and a controlled comparison of early versus later cannabis intervention. Today, Zylla is still pursuing several cannabis-related research topics from whether cannabis may itself fight cancer (too early to say, he suggests, though allowing a person to remain on chemotherapy – given milder symptoms – may have that additional benefit); to the possible drug-on-drug interaction of cannabis on cancer medications (especially immunotherapy); to even a new study, conducted with colleagues at the University of Minnesota, that considers the benefit of CBD creams on relieving side effects (joint and bone pains and joint stiffness) related to breast cancer treatments.

“We’re kind of trying to become pioneers, and how do we best study this product, knowing that it’s here and it’s here to stay,” Zylla said, noting that cancer patients still need to navigate the cost barrier of about $200 a month for their cannabis products. 

For Zylla, the research always needs to serve directly – and as immediately as possible – the patient. This is why he also launched the HealthPartners Cannabis in Cancer Research and Education (CanCaRE) Clinic.

CanCaRE Clinic 

Since creating the CanCaRE Clinic in 2021, Zylla and his team of nurse practitioners have seen about 300 cancer patients about their medical cannabis use.

The clinic’s specific purpose, according to Zylla, is, “To provide one-on-one personalized education and treatment-dosing guidelines about how to safely and effectively use medical cannabis.”

What’s more, Zylla says, his team has access to a patient’s health records and current treatment plan that needs to work alongside any potential cannabis use.

“They spend usually about 45 minutes kind of going over their cancer history, their treatments, their symptoms and really learning from the patients, what do they want to get out of cannabis,” Zylla said, adding that the consultations are designed to provide comfort and clarity for patients considering this option.

“Surveys and studies show that patients, probably 70 percent of patients with cancer, are interested in at least learning about cannabis, and most of them want that education and that information to come from their cancer team,” he said.

And that interest – along with the favorable reviews from both patients and other healthcare providers – is why Zylla is actively considering where and how to expand this outreach.

“I will say I think there’s a lot of room for growth there. We are happy to see patients from other organizations. I think we have capacity to do that and interest certainly to do that,” he said.

For Zylla, the mission is clear.

“Cannabis, as I mentioned, is something that just seemed to have a lot of potential to treat so many different symptoms all at once. And so it really was to try to give my patients hope, right?” Zylla noted, adding, “I mean, our patients who have a cancer diagnosis, they want hope.”

From ‘hopeless’ to ‘hope’ 

And hope is exactly what Tracy Teyssier says she’s reclaimed through her medical use of cannabis.

“You feel so hopeless when you feel that bad,” Teyssier said, while also acknowledging the role of the CanCaRE staff in supporting her growth toward a healthy cannabis protocol – critical, she says, given she hadn’t used cannabis before being diagnosed with cancer.

“That was the biggest help – when you don’t have much experience yourself. And I can call them anytime,” she said.

Teyssier’s hope even extends to those patients who may not have previously considered medical cannabis use but may do so now, she said, given the new cannabis era.

“And I hope that it has, you know, kind of less of a stigma to it,” she said, adding, “I hope that making it legal makes it also more comfortable.” 

“I really hope that hospitals recognize that people are going to do it anyway once they get more comfortable with it. Let’s hopefully get them some help and certainly do it safely and get the most benefit out of it,” she observed. 

And of course, Teyssier hopes for a “new therapy” that defeats her stage four cancer. Until then, the grandmother finds comfort in her natural treatments, outside oasis and growing family.

“I need to keep doing [chemotherapy] to stay alive, so all those tools that can help with nausea are really, really important to me,” she said, before returning again to her family. “It’s absolutely saved me, you know, just keeping your mind on these little cuties… It’s everything, you know. When you’re in my position, family is the most important thing.”

To learn more about the CanCaRE Clinic and how you can make an appointment, just email: cancercannabis@healthpartners.com.

Patient benefits of Minnesota's medicinal cannabis program

Source: Minnesota Department of Health

  • Elimination of the $200 annual medical cannabis registration fee.
  • Personal relationship with a clinician and pharmacist who has the patient’s interest at heart and can help evaluate medical cannabis needs on an ongoing basis.
  • Another benefit of having a pharmacist-direct product recommendations is that they are trained to look for drug-drug interactions. So, a person’s other medication usage will be considered.
  • Medical cannabis is available to people of all ages, including children. Recreational cannabis is available only to those 21+.
  • Medical cannabis products are completely tax free. It’s not just no gross receipts tax, there is no sales (or other) tax on these products.
  • Through the recent legislation, the Office of Medical Cannabis has been directed to create an application process for veterans using the VA health care system. The U.S. VA does not allow its health care practitioners to refer or sign paperwork/forms to enroll a patient into a state-sanctioned medical cannabis program. This means that some veterans wanting to try medical cannabis to relieve symptoms have a barrier to entry. Through a special application process, after a veteran provides documentation they receive their health care through the VA, they can enroll in our medical program starting January 1, 2024.


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