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Physician Spotlight

Meet Patrick Miller, MD, of Ironwood Cancer & Research Centers in Glendale, AZ as he shares his thoughts on medical cannabis.
From Print Issue - Summer 2022
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Q: Why do you use medical marijuana to treat your patients?

I use medical marijuana for symptom man­agement. Most of our patients have received or are concurrently receiving chemotherapy, and are experiencing nausea/GI upset, fatigue, poor appetite, difficulty sleeping, and taste changes. Medical marijuana can help to alleviate some of these symptoms.

Q: Are there cons to using medical marijuana with patients?

Some people experience a dysphoric feeling, which I think is related to the THC concentrations of the product they are using. Concentrations in the 10-15% range usually do not cause that. Financial costs can be difficult for many patients.

Q: What forms of medical marijuana do your patients recieve? For example, do patients use edibles, pills, liquids, smoke leaves, or other forms?

My patients almost exclusively use edibles, mostly gummies. I discuss various forms with them but feel that small edibles are the easiest. 

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"I have not had experiences where colleagues told patients they should not use medical marijuana"

Q: Are patients with certain types of cancer more responsive to cannabis than others?

I do not have enough experience to say if particular cancer types respond better to the symptoms management. I do know that when the radiation field involves the GI tract, such as pancreatic cancer, or rectal cancer, and the patient is having concurrent chemotherapy, symptoms are hard to control.

Q: Would you say the oncology community supports, opposes, or is on the fence about medical marijuana? Why?

I think that the average medical or radiation oncologist favors the use of medical marijuana. In fact, I have not had experiences where colleagues told patients they should not use medical marijuana. I think the major reluc­tance still lies in the fact that it is legal in Arizona, but not federally legal. Oncologists get DEA licenses from the federal govern­ment, and there is always a concern of new administrations turning back the clock and wanting to limit use of medical marijuana, or even prosecuting doctors who prescribe it. That makes many physicians somewhat wary to get involved beyond simply telling patients about it.

Q: Are there ongoing studies about medical marijuana for cancer patients? If so, then what do you predict would be the outcomes about efficacy for relieving symptoms of pain, neuropathy, nausea, appetite, etc?

There are starting to be some studies, but this area needs much more research.

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