NHL

Could you guide me with the management of mucositis? I know it is a step-up approach and we usually start up with topical solutions such as Maalox Benadryl lidocaine. Then there is role of oral suctioning and oral hygiene. My patient is having gag reflex with all of these. Are there any other topical options we could consider?

GYN | Age 77 | New Dx

Patient with 2cm FIGO Grade 1 endometrioid adenocarcinoma with tumor invading > 50% of myometrial depth. Cervical stromal invasion and extensive (>3 vessel) lymphovascular invasion were seen. Negative margins. pT2Nx FIGO stage II. Molecular markers with pMMR, wild type p53, POLE testing pending, ER 91-100%, PR 71-80%, HER2 0+. Would you consider completion lymphadenectomy or move on to adjuvant EBRT?

Heme | Age 34 | New Dx

34 yo male with lymphocytosis. Flow cytometry at his PCP's hospital showed concerns for LGL, so he was referred to hematology. At our facility we repeated another flow cytometry and our pathologist reported flow to be normal without any concerns for LGL. He is clinically asymptomatic without any symptoms and no symptoms related to any chronic infections. We have been monitoring his counts for over a year, ALC is about the same without any other cytopenias. an you please suggest if I need to do any other work up?

Non-Hodgkin Lymphoma

78 yo male with DLBCL is now s/p 6 Pola CHP with complete response. I did not do baseline MRI or LP before starting Pola C HP. He does not have any other high risk features that predispose him to CNS disease, no testicular involvement no primary cutaneous diffuse large B cell, no kidney or adrenal involvement. However, given I do not know whether he had the MYC Bcl-2 BCL6 rearrangements, and no baseline MRI and LP, would you give CNS intrathecal prophylaxis, or skip it?

Breast Cancer

For patient with osteopenia and frax score less than 20%, or hip fracture risk less than 3% do we need to do bisphosphonates / denosumab in breast cancer patient on aromatase inhibitor?

CNS

I was reading about DOTATATE PET scans for meningiomas and was impressed by the sensitivity of the test. I was wondering how it has impacted your treatment recommendations for grade 1 or 2 meningiomas that are resected?