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Palliative Care

Mark is a 68-year-old man referred by his Oncology team to discuss whether cannabinoids can help alleviate progressive and distressing pain, nausea, weakness and fatigue.

Mark was diagnosed with pancreatic cancer 2 years ago and despite interventions including Whipple’s procedure and chemotherapy his cancer has metastasised extensively to liver and his function is now deteriorating. Coeliac plexus block was somewhat beneficial 4 months ago but the interventional team is reluctant to attempt repeat due to nodal masses and his frailty.

Mark is experiencing a constant dull pain over his right upper abdomen that is unrelated to movement and has no radiation. Dexamethasone has not improved this pain. He gets severe spasms of sharp sternal / epigastric pain. His appetite is very poor and he has constant low-grade nausea with worsening at the sight / smell of food. He sleeps a lot during the day but struggles to sleep at night. His mood is variable and he describes increasing fatigue and weakness. Both Mark and his wife Joy have engaged with the local palliative care team.

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Suboptimal symptom control in a man with terminal illness despite optimisation of supportive care

Consideration of medicinal cannabis is indicated

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