Rebecca Allen-Tapp reveals the role cannabis has played in helping her heal, after being diagnosed with a rare cancer at the age of 30.
“I’ll try and give you the summarised version,” says Rebecca Allen-Tapp, whose life changed forever, when doctors found a golf ball size tumour in her lung in 2018.
Her health had become progressively worse following the birth of her son the year before, but her story starts much earlier, in her teenage years.
Rebecca, who was living in her home state of Washington in the US at the time, had been plagued by depressive episodes and anxiety since she hit puberty. The symptoms would be so extreme that she would be forced to take time off school and later – when they continued into her 20s – weeks at a time off work.
Doctors ran tests but never found anything wrong, so “chalked it up to hormones”. Even a therapist struggled to identify the cause of her sadness, diagnosing her with bipolar disorder, despite the fact she showed no signs of the manic highs associated with the condition.
“Doctors were dismissive, because they couldn’t figure out what was wrong,” she says. “As a woman I was not listened to, it was just downplayed, which led to a lot of distress afterwards.”
During her pregnancy though, Rebecca felt the best she had in years.
“I felt comfortable and well-rounded for the first time in my life,” she says. “I’m probably one of the few women who enjoyed being pregnant.”
But just a week after her son was born, things began to deteriorate. She started experiencing ocular migraines where she would lose her vision, her blood pressure went through the roof, and the suicidal thoughts returned.
“I started doing my own research and took all this information to my doctor,” she explains.
“I said ‘I think I have what’s called PMDD [premenstrual dysphoric disorder]. They agreed to assess me and I actually had 10 of the 11 classic symptoms of PMDD.”
This diagnosis brought Rebecca some clarity, but in the background she was still struggling with her physical health. In July 2018, she developed pneumonia which she couldn’t seem to shake.
“The pneumonia never went away,” she continues. “I started having X-Rays and they could see signs of it in the lung but they said it just needed time to repair…fast forward to October and it was hurting to breathe during a normal day of work or yoga, it wasn’t normal.”
Despite this, she put off having a CAT scan, planning to go back in the New Year after the busy Christmas period. She was only 30 after all, she didn’t think it was urgent.
But Rebecca’s symptoms worsened and two weeks after Christmas she found herself calling an ambulance, unable to move her arm.
“My lung lining was so inflamed that it was actually hurting my shoulder, it’s called pleurisy and it’s actually quite a common phenomenon,” she says.
That’s when they found the tumour.
She adds: “My doctor wasn’t incredibly worried at first, because cancer just wasn’t on their radar and I thought ‘it doesn’t just happen like that, right?’”
A rare and “misunderstood” cancer
Neuroendocrine cancer is an extremely rare and – in Rebecca’s words – “misunderstood” cancer, caused by tumours growing in the neuroendocrine cells, which have similar traits to those of nerve cells and hormone-producing cells. Only around 20 per cent of neuroendocrine cancer patients have a tumour in the lung.
Luckily, Rebecca’s tumour had a very low malignancy, but doctors believe it had been growing for 10-15 years before it was discovered.
Neuroendocrine tumours tend not to respond to traditional treatments such as radiation and chemotherapy, so the best route was surgery. In February 2019, despite her surgeon’s best efforts, they ended up taking out her whole left lung.
“I’ll never forget the moment where I woke up and turned to my husband and said ‘how much did they take? And just the look on his face when he had to say they took the whole thing,” she says.
“I tried not to let it get to me, and I still don’t today, because it was the best course of action.”
Rebecca made progress quickly and remarkably was home the next day, where cannabis became a big part of her recovery.
“I leaned on cannabis heavily during my recovery,” she says.
“I used tinctures to help with the pain but I thought I’d probably have to couple the cannabis with other painkillers, but I didn’t. That’s really where I started to really understand the way cannabis could be used as a medicine.”
Discovering cannabis as a medicine
As well as her physical recovery, cannabis has played – and continues to play – a big part in maintaining Rebecca’s mental equilibrium too.
Survivors of neuroendocrine cancer have to live with the knowledge that it can return at any time, to any part of the body.
“For the rest of my life, the reality is that I have to get scanned and it could be anywhere at any time, I might not even know that it’s present,” she explains.
“There’s Rebecca before the diagnosis, and Rebecca after the diagnosis, it’s almost like everything goes into slow motion, you start to realise that time is fleeting and that crazy things can happen to you.
“You start to battle that paranoia, because you fear that you are going to get struck by lightning twice.”
She adds: “At the time that they found it, I didn’t have any metastasis, so I didn’t have any other tumour locations, and usually by that point, it would have had some other activity somewhere else. But is that to say that there’s not one somewhere else that I don’t know about?”
Cannabis has helped Rebecca find a sense of normalcy again, reducing her anxiety levels and helping her focus on what’s important so she can take care of herself properly.
“They’ve tried to prescribe heart medication, muscle relaxers, painkillers and anti-anxiety medicines, but I don’t want them. I use one plant for it all and it does the trick. It’s so versatile, I don’t know where I would be without it,” she says.
Her physical symptoms, which include tachycardia, raynaud’s, shortness of breath, severe heartburn and fatigue are all compounded by stress, so maintaining a good work-life balance and keeping her anxiety levels down is vital.
“Stress is one of the biggest drivers, we’re all desensitised to stress but the impact is real,” says Rebecca.
“If I’m not making time for myself and I’m putting too much into my day and constantly chewing on things mentally, I see that taking its toll on my body.”
She continues: “My mind is like a browser with 15 tabs open. I feel like cannabis is what closes those tabs down. It helps me prioritise what’s most important. I always joke that I feel like I have the ‘Good Wolf’ and the ‘Bad Wolf’ in my brain and never know which one to feed. Cannabis helps me feed the Good Wolf.”
The root cause?
At first glance, it might seem like Rebecca’s tumour and the PMDD that has afflicted her for much of her life are unrelated. But a self-confessed “science nerd” she has been studying herself for long enough to have reason to believe her symptoms are connected by a root cause; hormone dysregulation.
“My body responds negatively to hormone dysregulation and it’s something that I’m still battling to this day, there are times that I can’t get out of bed for days on end,” she says.
“I started tracking my cycle and recording notes on anything that bothers me and I started to notice patterns about when it was happening based on the time of the month.
“I don’t know the correlation and it’s really hard to pinpoint, but I definitely notice what time of the month it is.”
She adds: “I think the tumour was more of a byproduct of the larger root cause, which is hormone dysregulation and inflammation. I think this created the opportunity to develop a tumour microenvironment.
“I’m in a lot of neuroendocrine support groups and so many of those with tumours in their lungs are women.”
Eat, sleep and breathe cannabis
Rebecca has made a career out of cannabis, first the states working in sales and marketing, before moving into the post-extraction side and co-owning a processing lab. Having recently moved to the UK with her family, she’s keen to bring her expertise to this side of the pond – as both a patient and a professional.
She is working as business development manager for Asahi Glassplant UK and recently joined the PLEA (Patient-Led Engagement for Access) advisory board.
“I eat, sleep and breathe cannabis,” she says.
“It’s a very different market, but I feel what spans the borders is the stigma facing patients. There are people who could really benefit from using cannabis that aren’t using it and need someone to champion that way for them.”
She adds: “It might not be the answer for them, but for others it will be life-changing.”
Mental health, addiction and medical cannabis – an expert’s insight
We sit down with the recently-appointed medical director of The Medical Cannabis Clinics, Dr Luisa Searle.
The recently-appointed medical director of The Medical Cannabis Clinics, Dr Luisa Searle, shares how her background in psychiatry and addiction is feeding into her new role.
Dr Luisa Searle has been treating patients with addiction disorders for the last six years, seeing patients struggling with substance misuse and establishing outreach services for young people and the homeless across London.
Now, she is helping people legally access cannabis, a substance that has historically been demonised as a ‘gateway drug’.
Feeling burnt out and craving a fresh new challenge, Dr Searle was looking for a change in her career when she crossed paths with The Medical Cannabis Clinics, joining the team as medical director in April this year.
“It frustrates me, this division that there seems to be in mental health, whereby if you’ve got a substance misuse issue, you’re not worthy of mental health treatment,” Dr Searle told Cannabis Health.
“But actually, your mental health is often being self-medicated by substances and whether you agree with that or not, that’s how some people cope.”
Prior to joining TMCC, Dr Searle was unaware that medical cannabis was beginning to be prescribed more widely.
She was coming into the industry with a fresh perspective, and despite her background in addiction medicine, she said she had very little prejudice against cannabis.
“It didn’t make sense to me to not explore it,” Dr Searle said.
Dr Luisa Searle, medical director at The Medical Cannabis Clinics
A balanced approach
“I’m not here to say it’s a wonder drug. I’m not here to say it doesn’t have its risks or side effects. It’s by no means suitable for everybody, but this idea that it’s a substance of abuse and not even [worth] researching as a potential medicine I think is, unfortunately, based in historical racism and hysteria, which has no place in science as far as I’m concerned.”
But while she was intrigued by this new and emerging field of medicine, due to her past experience, she was determined to take a “balanced approach” to prescribing.
For Dr Searle, it is imperative that cannabis is seen for what it is. While it has immense potential for managing hard-to-treat conditions and a possible alternative to physically addictive opioids, it is still a substance that can cause dependence.
“Any substance, legal or illegal, with some psychoactive effect has the potential for abuse, but that’s where I come in as the doctor,” Dr Searle said.
“If I felt that you needed diazepam, that prescription is entirely under my control. It is down to me to work with patients to try to prevent [dependency] from happening and to advise and educate them, so that they can make informed decisions about their care.”
Dr Searle is only three months into her role at TMCC but she is already seeing the positive impact that medical cannabis is having on patients.
People with difficult-to-treat conditions like insomnia and anxiety are seeing improvements in their lives after trying numerous conventional treatments that failed to help.
Meanwhile, patients who have previously relied on pharmaceuticals like antidepressants and SSRIs – which can come with severe side effects – were able to “feel themselves” again after reducing their dose of traditional medication in favour of medical cannabis.
“What’s really been nice is seeing success with people who have tried lots of different conventional treatments and haven’t really gotten anywhere,” Dr Searle said.
“I was talking to a gentleman who had a traumatic brain injury and was getting migraines on a regular basis. He had really struggled with his work and his life. With a small amount of medicinal cannabis flower, he feels much more himself.
“That’s the really nice thing [about] working in this clinic; just seeing that turnaround in people who’ve been quite stuck.”
Having worked for the NHS for 15 years, Dr Searle is a firm believer in everyone having access to the healthcare they need.
Right now, this does not apply to the medical cannabis space. Very few people have been able to access an NHS prescription while private prescriptions can cost hundreds per month.
“It is a little bit challenging for me that I have to be in a private clinic in order to provide medical cannabis treatment,” Dr Searle said.
“While TMCC has extremely reasonable prices in comparison to other types of private health care, it is still a cost and if you’re on a low income it might as well be a million pounds.”
Dr Searle wants to see medical cannabis being more widely prescribed, but it has to be “sensible” with regulations around who can prescribe and how.
She continued: “Why shouldn’t it be available on the NHS in the right circumstances? What I don’t want to see is what can potentially happen with opioids – with people becoming dependent on them.
“It’s not a medication for all. There are concerns, particularly among younger people. We’re still not 100 per cent clear as to the risks around potentially life-changing mental health issues and specifically psychosis.”
Importance of eduction
Dr Searle has not encountered huge numbers of cases where recreational users have later developed psychosis, but she has seen enough for it to be a concern.
“It’s not something that I could just dismiss,” she said.
“When we have young people coming to us, it’s all about education. It’s just like any medication, if you start on antidepressants, you don’t start with a high dose, you start on a low dose and build it up. You check the tolerance and you review the patient regularly to see if there have been any improvements or side effects.”
Dr Searle also points out that studies into psychosis and cannabis use have examined street cannabis rather than medical-grade products prescribed by clinics like TMCC.
“Street cannabis potentially has incredibly high levels of THC and very low levels of CBD,” she said
The benefits for some patients speak for themselves, but Dr Searle stresses the fact that a medical cannabis prescription is not right for everyone.
“Whilst I think [medical cannabis] is great and we get lots of positive feedback, we do have some adverse reactions to it where it’s not suitable,” she said.
“People shouldn’t be lulled into a false sense of security that just because your doctor prescribed it and it’s legal for medicinal use it’s not without its risks.”
Dr Searle sees a lot of potential in cannabis as an alternative drug for chronic mental health disorders and pain, even as a possible method for weaning patients off opioids. But she warns that people who are prone to addiction may end up transferring their dependency from one substance to another.
“If you break your leg, opioids are fantastic for that, but what they’re not so good for is chronic pain,” she said.
“The withdrawal process from them can be horrendous and there could be a place for cannabis to alleviate some of those withdrawal symptoms.”
But, she added: “I think I would be much more cautious about that, simply because until you’ve dealt with and understood your addiction and those behaviours and those are resolved and you’ve engaged with other ways to cope with your emotional stresses, you may just be switching one addiction for another.”
Medical cannabis and pregnancy – what you need to know
Canadian cannabis patients use less opioids and alcohol – study
Just under half of patients say they have reduced their use of other controlled substances.
Just under half of Canadian medical cannabis patients say the treatment has enabled them to reduce their use of other controlled substances.
According to new data, nearly one in two Canadian patients authorised to use medical cannabis say they have been able to reduce – or cease entirely – their consumption of other controlled substances, particularly opioids and alcohol.
A team of researchers from Canada and the United States surveyed almost 3,000 Canadian patients enrolled in the nation’s federal medical marijuana programme, which began over two decades ago.
Medical cannabis has been legal in Canada since 2001, the country legalised the possession and retail sale of adult-use cannabis in 2018.
In the research, which was published in the Journal of Cannabis Research, investigators reported that 47 per cent of respondents acknowledged substituting cannabis for other controlled substances.
Of those who said that they used cannabis in place of prescription medications, half acknowledged doing so for opioids – a finding that is consistent with other studies.
Many respondents also reported using cannabis to reduce their alcohol intake.
However, the study highlighted the need for more open communication between patients and their doctors.
Around one-third of respondents did not inform their primary care providers (PCP) that they were engaging in drug substitution.
Authors concluded: “This study examined patient-provider communication patterns concerning cannabis use and substitution in Canada.
“Results suggest that patients often substitute cannabis for other medications without PCP guidance. The lack of integration between mainstream healthcare and medical cannabis could likely be improved through increased physician education and clinical experience.
“Future studies should investigate strategies for effectively involving PCPs in patient care around medical cannabis with specific focus on substitution and harm reduction practices.”
Commenting on the findings, NORML’s deputy director Paul Armentano, said: “Cannabis has established efficacy in the treatment of multiple conditions, including chronic pain, and it possesses a safety profile that is either comparable or superior to other controlled substances.
“It is no wonder that those with legal access to it are substituting cannabis in lieu of other, potentially less effective and more harmful substances. As legal access continues to expand, one would expect the cannabis substitution effect to grow even more pronounced in the future.”
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