Pearls from 3/2/21 Medicine LEADS

Friday, March 5, 2021

The March 2, 2021 session of Duke Medicine LEADS featured Sophia Weinmann, MD, presenting "Rheum-Oncology: The Intersection of Rheumatic Disease, Chronic Inflammation and Cancer."

Here are pearls and takeaways from the session:

  1. Rheum-Oncology is a specialty within rheumatology that studies, researches, and provides clinical care to patients with overlapping rheumatic and oncologic disease. This includes:
    • Patients with chronic rheumatic disease and cancer.
    • Patients with paraneoplastic rheumatic disease. 
    • Patients with cancer who develop rheumatic symptoms secondary to oncologic therapy
    • Patients with cancer who develop rheumatic immune-related adverse events (rIRAEs) from immune checkpoint inhibitors.  
  2. Connective Tissues Disease- associated ILD (CTD-ILD) can be found in many rheumatic diseases and is associated with an increased risk of lung cancer. Smoking cessation and screening for lung cancer are important for patients with CTD-ILD.
  3. There is a higher prevalence of HPV in patients with Systemic Lupus Erythematosus (SLE) and subsequently increased risk of cervical cancer and other HPV-associated cancers. Educating patients with SLE about this risk, vaccination against HPV, and age-appropriate cervical cancer screening are important interventions.
  4. Patients with Sjӧgren's Syndrome are at increased risk (~2.7-9.8%) of developing non-Hodgkin lymphoma. To maximize early detection of lymphoma in these patients, providers including PCPs can do thorough head and neck exams, biopsy concerning findings, and encourage patients to report symptoms concerning for lymphadenopathy.
  5. In patients with new onset rheumatologic disease, this may indicate new-onset cancer. Ensure patients with new rheumatic diseases are up to date on age-appropriate cancer screenings and consider screening for disease-specific associated malignancies. 

Watch the recorded session

Duke Medicine Learning, Education, and Discussion Series (LEADS) takes place each Tuesday at 12 p.m. Learn more and see schedule of upcoming sessions.