Getting a Medical Card For Fibromyalgia Doesn’t Have To Be a Pain

Understanding Fibromyalgia and Its Potential Link to Cannabis

Fibromyalgia is a complex and often misunderstood chronic condition. It’s characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues. Unlike conditions with clear physical markers, fibromyalgia is believed to involve amplified pain sensations due to how the brain and spinal cord process pain signals. This means that individuals with fibromyalgia may experience pain from stimuli that wouldn’t typically be painful to others.

The common symptoms of fibromyalgia extend beyond just pain. Patients frequently report:

• Widespread Pain: A persistent, dull ache that occurs on both sides of the body, above and below the waist.
• Fatigue: Often described as a persistent, debilitating tiredness that isn’t relieved by rest.
• Sleep Disturbances: Insomnia, restless legs syndrome, and sleep apnea are common, leading to unrefreshing sleep.
• Cognitive Difficulties (“Fibro Fog”): Impaired ability to focus, pay attention, and concentrate on mental tasks, along with memory lapses.
• Other Symptoms: Headaches, irritable bowel syndrome (IBS), anxiety, depression, and temporomandibular joint (TMJ) disorders are also frequently co-occurring conditions.

Recent research has begun to explore the potential role of the body’s endocannabinoid system (ECS) in conditions like fibromyalgia. The ECS is a complex cell-signaling system that plays a crucial role in regulating a wide range of functions and processes, including sleep, mood, appetite, memory, and pain. It consists of endocannabinoids (cannabinoids produced by the body), cannabinoid receptors (including CB1 and CB2), and enzymes that break down endocannabinoids.

Cannabis contains compounds called cannabinoids, primarily tetrahydrocannabinol (THC) and cannabidiol (CBD), which interact with the ECS. THC is the psychoactive component, responsible for the “high,” while CBD is non-psychoactive and is often lauded for its therapeutic potential. The theory is that by interacting with CB1 and CB2 receptors, these cannabinoids might help modulate pain signals, reduce inflammation, and improve other symptoms associated with fibromyalgia. This interaction is what makes medical cannabis a subject of growing interest for managing the multifaceted challenges of this condition.

How Cannabis May Help Fibromyalgia Symptoms

For individuals living with fibromyalgia, the search for effective symptom management is ongoing. Traditional treatments often involve a combination of medications (pain relievers, antidepressants, anti-seizure drugs), physical therapy, and lifestyle adjustments. However, many patients find that these approaches offer only partial relief, leading them to explore alternative therapies like medical cannabis.

The interest in cannabis stems from its potential to address several key fibromyalgia symptoms:

• Pain Relief: Cannabis, particularly strains containing THC, has been studied for its analgesic properties. It may help reduce the intensity of widespread pain by interacting with pain receptors in the brain and spinal cord. Some studies and anecdotal evidence suggest that cannabis can alter how the brain perceives pain, potentially offering relief where other medications have fallen short.
• Improved Sleep: Sleep disturbances are a hallmark of fibromyalgia, exacerbating pain and fatigue. Certain cannabis strains, particularly those high in CBD or specific terpenes, are known for their sedative qualities. They may promote deeper, more restorative sleep, which is crucial for overall well-being and symptom management in fibromyalgia patients.
• Anti-inflammatory Effects: While fibromyalgia is not primarily an inflammatory condition, some patients experience localized inflammation or muscle soreness. CBD, in particular, is recognized for its anti-inflammatory properties, which could contribute to a reduction in discomfort.
• Mood Regulation: Anxiety and depression are common in individuals with chronic pain conditions like fibromyalgia. Cannabis, especially strains with balanced THC/CBD ratios or specific terpene profiles, may have anxiolytic and mood-stabilizing effects, helping to alleviate the psychological burden of the condition.

Current research on cannabis for fibromyalgia is still evolving. A comprehensive review by the National Academies of Sciences, Engineering, and Medicine found substantial evidence that cannabis is an effective treatment for chronic pain in adults. While not specific to fibromyalgia, this finding is highly relevant given pain is the primary symptom.

A study published in PLOS One, for instance, explored the effectiveness of medical cannabis in fibromyalgia patients, with many participants reporting significant improvements in pain and sleep. However, researchers emphasize the need for more large-scale, controlled clinical trials to fully understand the efficacy, optimal dosages, and long-term effects of cannabis for fibromyalgia. Despite the ongoing research, many patients and their healthcare providers are already exploring medical cannabis as a viable option for symptom management.

Can You Get a Medical Card for Fibromyalgia? A Look at State Regulations

The question of whether you can obtain a medical card for fibromyalgia is a critical one, and the answer largely depends on where you live. Medical cannabis laws vary significantly across the United States, with each state establishing its own list of qualifying conditions and regulatory framework.

In many states where medical cannabis is legal, fibromyalgia is explicitly recognized as a qualifying condition. This means that if you have a formal diagnosis of fibromyalgia from a licensed healthcare professional, you may be eligible to apply for a medical marijuana card. States like Florida, for example, list fibromyalgia as a qualifying condition for a medical marijuana recommendation.

However, in other states, fibromyalgia might not be listed explicitly. Instead, it may fall under broader categories such as “chronic pain,” “intractable pain,” or “severe and debilitating conditions.” In these cases, a physician’s discretion plays a crucial role. If your doctor determines that your fibromyalgia symptoms, particularly severe pain, fall within the scope of these broader qualifying conditions, they may still be able to recommend medical cannabis for you.

Each state’s medical marijuana program operates under specific statutes and regulations. These typically define:

• Qualifying Conditions: The specific medical diagnoses that make a patient eligible.
• Physician Requirements: Who can recommend medical cannabis (e.g., licensed physicians, specialists, those with specific certifications).
• Application Process: The steps patients must follow to apply for and receive their medical card.
• Possession Limits: How much cannabis a patient can legally possess.
• Dispensary Access: Where patients can legally purchase medical cannabis.

Staying informed about your state’s specific laws is paramount for legal compliance and successful access to medical cannabis.

How to Check Your State’s Eligibility Requirements

Navigating the landscape of medical cannabis laws can feel daunting, but verifying your state’s eligibility requirements is a straightforward process once you know where to look. We recommend the following steps:

1. Visit Your State’s Department of Health Website: Most states with medical cannabis programs have a dedicated section on their Department of Health or Cannabis Regulatory Agency website. This is the official source for information on qualifying conditions, application procedures, and program rules. Look for terms like “Medical Marijuana Program,” “Medical Cannabis Registry,” or “Office of Medical Marijuana Use.”
2. Review the Qualifying Condition Lists: On the official website, you’ll find a comprehensive list of medical conditions that qualify for a medical cannabis card. Carefully check if “fibromyalgia” is explicitly listed.
3. Understand Broader Categories: If fibromyalgia isn’t listed by name, look for broader categories such as “chronic pain,” “intractable pain,” “neuropathic pain,” “severe pain,” or “debilitating medical condition.” In many states, fibromyalgia symptoms, particularly chronic pain, can qualify under these umbrella terms.
4. Check for Physician Discretion Clauses: Some states grant physicians the discretion to recommend medical cannabis for conditions not explicitly listed, provided the doctor believes the patient would benefit and the condition is comparable to those on the qualifying list. This is often crucial for fibromyalgia patients.
5. Consult with a Qualified Medical Cannabis Doctor: Even after reviewing state resources, the best way to confirm your eligibility is to consult with a physician who is registered and experienced in recommending medical cannabis. These doctors are well-versed in their state’s specific regulations and can assess whether your fibromyalgia diagnosis meets the criteria.

By following these steps, you can ensure you are fully informed about the legal pathways to obtaining a medical card for your fibromyalgia in your specific region.

What if Fibromyalgia Isn’t a Listed Condition?

Even if fibromyalgia isn’t explicitly named on your state’s list of qualifying conditions, there may still be pathways to obtaining a medical cannabis card. The key often lies in the interpretation of broader qualifying categories and the discretion of a recommending physician.

• Physician Discretion and Chronic Pain: Many states include “chronic pain,” “intractable pain,” or “severe and persistent muscle spasms” as qualifying conditions. Since widespread chronic pain is the hallmark symptom of fibromyalgia, a qualified medical cannabis doctor can often certify a patient under this broader category. The doctor will evaluate your specific symptoms, medical history, and how fibromyalgia impacts your daily life to determine if you meet the criteria for chronic pain that warrants medical cannabis treatment. This approach acknowledges that while fibromyalgia itself is complex, its primary symptom aligns with recognized qualifying conditions.
• Petitioning Process: Some states have a formal process that allows patients or medical professionals to petition the Department of Health to add new debilitating medical conditions to the qualifying list. This involves submitting detailed medical evidence and arguments for why a condition, like fibromyalgia, should be included. While this process can be lengthy and complex, it demonstrates a state’s commitment to evolving its medical cannabis program based on patient needs and scientific understanding.
• Alternative Legal Cannabinoids: If obtaining a medical card proves challenging, or while you pursue the application process, you might explore alternative cannabinoids that are legal at the federal level or in your state without a medical card. These include:
  • CBD (Cannabidiol): Widely available in various forms (oils, edibles, topicals), CBD is non-psychoactive and is often used for pain relief, inflammation, and anxiety. It can be a good starting point for those new to cannabis.
  • Delta-8 THC: A cannabinoid derived from hemp, Delta-8 THC is chemically similar to Delta-9 THC (the primary psychoactive component in cannabis) but is typically less potent. It offers some psychoactive effects and potential therapeutic benefits without the intensity of traditional THC. Its legality varies by state, so always check local regulations.

While these alternatives might offer some symptomatic relief, they do not provide the same legal protections or access to regulated dispensary products as a medical cannabis card. Therefore, pursuing a medical card remains the most comprehensive and legally secure option for fibromyalgia patients seeking cannabis-based treatment.

The Step-by-Step Process to Obtain Your Medical Card

Once you’ve confirmed that fibromyalgia, or its associated symptoms, qualifies for medical cannabis in your state, the next step is to steer the application process. While specific requirements vary by state, the general pathway involves a few key stages: obtaining a medical diagnosis, finding a certified physician, undergoing an evaluation, and completing state registration.

The process to Get a fibromyalgia medical card doesn’t have to be overwhelming. Many clinics and telehealth platforms specialize in guiding patients through each step, making it as seamless as possible. We are here to help you understand what to expect.

Step 1: Secure a Formal Diagnosis and Gather Medical Records

Before you can even consider applying for a medical cannabis card, you must have a formal diagnosis of fibromyalgia from a licensed healthcare professional. This is the foundational requirement for demonstrating your medical need.

• Official Diagnosis: Ensure you have received an official diagnosis from a rheumatologist, pain specialist, or your primary care physician. This diagnosis should be documented in your medical records.
• Medical History: Gather all relevant medical records pertaining to your fibromyalgia. This includes diagnostic reports, physician’s notes detailing your symptoms, the severity of your pain, and how the condition impacts your daily life.
• Previous Treatments: Document any previous treatments you’ve undergone for fibromyalgia, including medications (and their effectiveness or side effects), physical therapy, alternative therapies, and lifestyle changes. This demonstrates that you have explored conventional options and that your condition is persistent despite these efforts.
• Pain Journals or Symptom Logs: If you’ve maintained a pain journal or symptom log, these can be incredibly valuable. They provide a detailed, personal account of your daily struggles, pain levels, sleep patterns, and other symptoms, offering concrete evidence of your condition’s impact.
• Specialist Consultation: While your primary care physician might diagnose fibromyalgia, a consultation with a specialist like a rheumatologist can strengthen your case. Their expert opinion and detailed assessment provide comprehensive documentation of your condition.

Having comprehensive and organized medical records will streamline your medical cannabis evaluation and application process, providing the recommending physician with all the necessary information to assess your eligibility accurately.

Step 2: Find a Qualified Recommending Doctor

Finding the right doctor is a crucial step in obtaining your medical cannabis card. Not just any physician can recommend medical cannabis; states require doctors to be specifically registered or certified with their medical marijuana programs.

• State-Certified Physicians: Most states maintain a public registry or list of physicians who are authorized to recommend medical cannabis. You can typically find this list on your state’s Department of Health website. These doctors have completed specific training or requirements mandated by the state to understand the therapeutic uses of cannabis and its legal framework.
• Telehealth Platforms: The rise of telemedicine has made finding a qualified recommending doctor more accessible than ever. Many reputable telehealth platforms specialize in medical cannabis evaluations. These platforms connect you with state-certified physicians who can conduct virtual consultations, review your medical records, and provide a recommendation if you qualify, all from the comfort of your home. This can be particularly beneficial for fibromyalgia patients who may experience mobility issues or severe fatigue. When choosing a telehealth provider, ensure they operate legally in your state and have physicians licensed there. Look for platforms with transparent processes, clear pricing, and positive patient reviews.
• Clinics Specializing in Medical Cannabis Evaluations: In addition to telehealth, many physical clinics focus specifically on medical cannabis evaluations. These clinics often have staff who are experts in the state’s regulations and can guide you through the entire process, from record gathering to application submission.

When selecting a doctor or clinic, we recommend looking for providers who:

• Have experience with fibromyalgia or chronic pain conditions.
• Are knowledgeable about cannabis as medicine, including different strains, cannabinoids, and consumption methods.
• Provide clear communication about the process, costs, and expectations.
• Offer ongoing support and follow-up care.

A qualified and compassionate doctor will not only help you steer the legal requirements but also provide valuable guidance on how to use medical cannabis safely and effectively for your fibromyalgia symptoms.

Step 3: Complete Your Medical Cannabis Evaluation

Once you’ve gathered your medical records and found a qualified recommending doctor, the next essential step is to complete your medical cannabis evaluation. This consultation is a critical part of the process, as it’s where the physician determines your eligibility for a medical cannabis recommendation.

• Consultation Process: The evaluation typically involves a detailed discussion with the physician about your medical history, specifically focusing on your fibromyalgia diagnosis and symptoms. You’ll be asked about the severity and frequency of your pain, fatigue levels, sleep disturbances, cognitive issues, and how these symptoms impact your quality of life. The doctor will also inquire about any previous treatments you’ve tried, their effectiveness, and any side effects you experienced. This is your opportunity to openly discuss your struggles and how fibromyalgia affects you daily.
• Symptom Discussion and Treatment Goals: During the consultation, be prepared to articulate your specific symptoms and what you hope to achieve with medical cannabis. Do you primarily seek pain relief, improved sleep, reduced anxiety, or a combination of benefits? Clearly communicating your treatment goals will help the physician tailor their recommendation and provide guidance on appropriate strains, dosages, and consumption methods.
• Doctor’s Recommendation: If the physician determines that your condition qualifies under state law and that medical cannabis is a clinically appropriate treatment option for your fibromyalgia, they will issue a formal recommendation or certification. This document is crucial for your state application.
• Patient Certification: This certification, often in a digital format, will include the doctor’s details, your information, and confirmation of your qualifying condition. In some states, this certification is automatically submitted to the state’s medical cannabis program, while in others, you may receive a copy to submit yourself as part of your application.

After receiving your physician’s recommendation, the final step is to complete the state registration process. This usually involves submitting an online application to your state’s Department of Health or equivalent agency, along with your physician’s certification, proof of residency, a valid ID, and the required application fee. Once approved, you’ll receive your official medical cannabis card, granting you legal access to dispensaries and medical cannabis products.

Using Medical Cannabis Safely and Effectively

Once you have your medical cannabis card, the journey shifts from obtaining access to using it safely and effectively for your fibromyalgia symptoms. This involves understanding the different components of cannabis, choosing appropriate products, and practicing responsible consumption.

The two primary cannabinoids, THC and CBD, interact with your body’s endocannabinoid system in distinct ways. THC is known for its psychoactive effects and strong pain-relieving properties, while CBD is non-psychoactive and is often sought for its anti-inflammatory, anxiolytic, and pain-modulating benefits. For fibromyalgia, a balanced approach often works best, utilizing both cannabinoids to address the multifaceted symptoms.

Beyond THC and CBD, cannabis strains are broadly categorized into Indica, Sativa, and Hybrid types:

• Indica Strains: Often associated with relaxing, sedative effects, making them potentially beneficial for nighttime pain relief, muscle tension, and improving sleep quality.
• Sativa Strains: Typically known for more uplifting, energizing effects, which might help combat fatigue and improve mood during the day.
• Hybrid Strains: A blend of Indica and Sativa genetics, offering a mix of effects. Many fibromyalgia patients find hybrid strains to be the most versatile, providing a balance of pain relief without excessive sedation or stimulation.

Furthermore, terpenes – aromatic compounds found in cannabis – play a significant role in a strain’s effects. For fibromyalgia, specific terpenes like Linalool (found in lavender, known for calming effects) and Caryophyllene (found in black pepper, with anti-inflammatory properties) may offer additional therapeutic benefits.

When it comes to dosing, the golden rule for medical cannabis, especially for new users, is “start low and go slow.” Begin with a very small dose and gradually increase it until you find the minimum effective dose that provides relief without unwanted side effects. This approach allows your body to adjust and helps you identify what works best for your unique physiology.

Choosing the Right Cannabis Product for Your Symptoms

The market for medical cannabis products is diverse, offering various consumption methods, each with its own onset time, duration of effects, and suitability for different symptoms. Understanding these differences is key to choosing the right product for your fibromyalgia management.

• Edibles: These are cannabis-infused food products (gummies, chocolates, baked goods). They offer a discreet way to consume cannabis.
  • Onset Time: Slow (30 minutes to 2 hours)
  • Duration: Long (4-8 hours or more)
  • Best For: Long-lasting pain relief, overnight sleep aid. Effects can be more intense and prolonged, so precise dosing is crucial.
• Tinctures: Liquid cannabis extracts administered sublingually (under the tongue).
  • Onset Time: Moderate (15-45 minutes)
  • Duration: Moderate (2-4 hours)
  • Best For: Consistent dosing, moderate pain relief, and anxiety management. Offers good control over dosage.
• Topicals: Cannabis-infused balms, creams, and lotions applied directly to the skin.
  • Onset Time: Localized (within minutes)
  • Duration: Varies (1-3 hours)
  • Best For: Localized pain, muscle soreness, or joint stiffness without psychoactive effects.
• Vaping/Inhalation: Inhaling vaporized cannabis flower or concentrates.
  • Onset Time: Fast (minutes)
  • Duration: Short (1-3 hours)
  • Best For: Acute pain flare-ups, immediate relief. Offers quick onset, allowing for rapid titration of dosage.

Here’s a table summarizing the different consumption methods:

We encourage you to discuss these options with your recommending physician or a knowledgeable dispensary consultant. They can help you select products that align with your specific symptoms and lifestyle, ensuring you get the most therapeutic benefit from your medical cannabis.

Potential Risks and Side Effects

While medical cannabis offers promising benefits for fibromyalgia symptoms, be aware of potential risks and side effects. Like any medication, cannabis can cause adverse reactions, and individual responses vary. Understanding these can help you use cannabis responsibly and mitigate potential issues.

Common short-term side effects may include:

• Dizziness or Lightheadedness: Particularly common with higher THC doses or in new users.
• Dry Mouth (“Cottonmouth”): A very common and generally mild side effect.
• Red Eyes: Another frequent, harmless side effect.
• Impaired Memory and Concentration: THC can temporarily affect short-term memory and cognitive function, especially at higher doses.
• Psychoactive Effects: For products containing THC, users may experience euphoria, altered perception, or anxiety. These effects can be undesirable for some, particularly those sensitive to THC. Starting with low doses and high-CBD strains can help manage this.
• Increased Heart Rate: Cannabis can temporarily increase heart rate, which should be noted by individuals with pre-existing heart conditions.

Less common or more severe risks, particularly with high doses or prolonged use, include:

• Paranoia or Anxiety: Some individuals may experience heightened anxiety or paranoia, especially with high THC strains.
• Tolerance and Dependence: Regular use can lead to tolerance, requiring higher doses for the same effect. While physical dependence is less common than with some other substances, psychological dependence can occur.
• Drug Interactions: Cannabis can interact with other medications, potentially altering their effects. Always inform your doctor about all medications and supplements you are taking.
• Respiratory Issues (with Smoking): While vaping is generally considered safer, smoking cannabis can expose the lungs to irritants, similar to tobacco smoke.
• Impairment: Cannabis can impair coordination, reaction time, and judgment. It is crucial to avoid driving or operating heavy machinery under the influence.

We emphasize the importance of responsible use. This includes adhering to your doctor’s recommendations, starting with low doses, understanding your product’s cannabinoid and terpene profile, and being mindful of how cannabis affects you personally. If you experience persistent or severe side effects, discontinue use and consult your healthcare provider immediately.

Frequently Asked Questions about Getting a Medical Card for Fibromyalgia

We understand that you may have further questions about obtaining a medical card for fibromyalgia. Here, we address some of the most common inquiries.

What documents do I need for my medical cannabis evaluation?

To ensure a smooth and efficient medical cannabis evaluation, it’s helpful to come prepared with the necessary documentation. While specific requirements can vary slightly by state and clinic, generally, you will need:

• Government-Issued Photo ID: This is crucial for verifying your identity and age. A driver’s license, state ID card, or passport are typically accepted.
• Proof of Residency: Most states require you to be a permanent or seasonal resident. This can often be proven with a utility bill, bank statement, or voter registration card showing your current address.
• Medical Records: This is perhaps the most important document. It should include your formal diagnosis of fibromyalgia, physician’s notes detailing your symptoms, a history of your condition, and a list of any previous treatments or medications you’ve tried. The more comprehensive your medical records, the easier it is for the recommending physician to assess your eligibility.
• List of Current Medications: A complete list of all prescription and over-the-counter medications, as well as any supplements you are currently taking. This helps the doctor identify potential drug interactions.

It’s always a good idea to confirm the exact requirements with the specific clinic or telehealth provider before your appointment.

How much does it cost to get a medical card for fibromyalgia?

The cost of obtaining a medical card for fibromyalgia typically involves a few components, and these can vary significantly by state and by the provider you choose. Generally, you can expect to pay for:

• Physician Evaluation Fee: This is the fee charged by the qualified medical cannabis doctor for their consultation and recommendation. This fee is usually an out-of-pocket expense, as health insurance typically does not cover medical cannabis evaluations. These fees can range from $100 to $350, depending on the provider and the state.
• State Application Fee: Once you receive your physician’s recommendation, you’ll need to pay a fee to your state’s medical cannabis program to process your application and issue your medical card. This fee varies widely, from as low as $25 to over $100 annually. Some states offer reduced fees for veterans, low-income individuals, or those on government assistance.
• Renewal Costs: Medical cannabis cards are not permanent; they require annual or biennial renewal. This involves another physician evaluation and a state renewal fee, similar to the initial costs.

It’s important to budget for both the initial application and ongoing renewal costs. While it’s an investment, many patients find the benefits of legal access to regulated medical cannabis and potential tax savings (in some recreational states) outweigh the expenses.

Will my health insurance cover the cost of a medical card or cannabis?

Unfortunately, in the United States, health insurance typically does not cover the cost of a medical card evaluation or the cannabis products themselves. This is primarily due to cannabis remaining classified as a Schedule I controlled substance under federal law. Because it’s illegal at the federal level, insurance companies, which are largely regulated by federal laws, cannot reimburse for cannabis-related expenses.

This means that all costs associated with obtaining your medical card – including the physician’s evaluation fee and the state application fee – as well as the cost of purchasing medical cannabis from a dispensary, will be out-of-pocket expenses.

While this can be a financial consideration for patients, some jurisdictions, like Canada, allow medical cannabis to be tax-deductible as a medical expense. However, this is not currently the case in the United States. We recommend discussing the financial aspects with your chosen medical cannabis provider, as some clinics may offer payment plans or discounts for certain patient groups. Despite the lack of insurance coverage, many patients find the symptomatic relief and improved quality of life provided by medical cannabis to be a worthwhile investment in their health.

Conclusion

Living with fibromyalgia presents unique and often debilitating challenges, from widespread pain and chronic fatigue to sleep disturbances and cognitive difficulties. For many, finding effective and sustainable relief remains an ongoing quest. Medical cannabis has emerged as a promising avenue, offering a potential complementary treatment that interacts with the body’s natural systems to alleviate a range of symptoms.

As we’ve explored, obtaining a medical card for fibromyalgia is a tangible and often straightforward process, provided you understand your state’s specific regulations and prepare adequately. From securing a formal diagnosis and gathering your medical records to finding a qualified recommending physician and completing your state application, each step brings you closer to legal access and personalized care.

We emphasize the importance of approaching medical cannabis use with informed decisions, guided by healthcare professionals. Understanding the differences between THC and CBD, choosing appropriate consumption methods, and being aware of potential side effects are crucial for safe and effective management.

The goal is patient empowerment – providing you with the knowledge and resources to make informed choices about your health. By following state laws and consulting with experienced medical cannabis professionals, individuals with fibromyalgia can explore this therapeutic option with confidence, working towards improved symptom management and a better quality of life.

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