Rheumatology   

Would you continue corticosteroid therapy even with a normalized serum IgG4 concentration?

In patients with bone metastases and osteoarthritis, if it is unclear if the pain is from cancer or OA, how do you decide on the radiation dose/fracti...

Cervical cancer FIGO stage IIIC2. Bloodwork shows elevated ESR and CRP. 

In which situations or patient populations do you find this useful? How is it sterilized?

Patient with active rheumatoid arthritis, on escalating dose of Rituxan and Methotrexate, also has antisynthetase syndrome and Hashimoto's thyroiditis...

If so, what dose-fractionation do you utilize? What other factors do you take into consideration?

There was a recall on viscous lidocaine and many of our patients cannot find it. What would you recommend as alternatives?

The patient is on a dose of 22 mg of methotrexate weekly for severe rheumatoid arthritis. If you would discontinue the methotrexate, how long would y...

It's been 5+ years after the first course. If you decide to re-irradiate what dosing schema would you use?

Would you favor the use of any particular biologics over others?

The patient has notable lip lesions from her discoid lupus erythematosus

If you avoid parathyroid hormone-related protein analog drugs in patients with prior external beam radiation, what data is this based on?

How does a diagnosis of active RA inform your treatment approach for patients with breast cancer, if at all? 

Would chemotherapy be preferred over RT? 

Would your answer change for favorable vs unfavorable intermediate risk disease?

Does it depend on the DMARD type (biologic, targeted synthetic, or conventional synthetic)?

Is there a risk of increased radioresistance or secondary malignancy (or conversely, toxicity) for patients on TNF inhibitors...

What non-pharmacological interventions do you recommend? Do you routinely prescribe prophylactic laxatives to patients initiating opioids? How do you ...

If so, do you take any additional precautions with planning?

In a patient with early stage breast cancer that would otherwise require radiation, would you recommend treatment if the patient has active skin lupus...

Acknowledging that there is no time for good trials yet in this setting

Also, how would you handle immune modulators for rheumatoid arthritis during their treatment?

 Is there any literature on the safety of giving radiation to patients with scleroderma in H&N setting?

Would you require the rituxan to be held prior to radiation?  Would this matter if it was in the post-prostatectomy setting?

Is IO related pneumonitis in the radiation field or more diffuse?

Are there any other medications, outside of anticoagulation, that would be considered absolute or relative contraindications?

Do you always stick with a conventional fracionation, or in some cases, are you comfortable hypofractionating? Do you ever use a wait and see approach...

Do you put more weight on specific CVDs such as scleroderma as contraindications for any RT?

Do you have any concern for increased toxicity when you treat a patient with radiation therapy who has an autoimmune disorder? (hypofractiationation v...