If adjuvant radiation is offered to an elderly patient with H&N SCC s/p Mohs surgery who is planned for multi-stage reconstruction of the defect with plastic surgery, when should adjuvant radiation be started?  

Tumor control comes first. If the surgical defect is such that reconstruction is required, it is even more imperative to focus on the above principle, as a recurrence would almost certainly risk ruining the entire collective effort. Vascular flaps could be safely performed post-RT in most cases by...

Always a tough case. How elderly is the patient? >90 y/o? 80 to 90 y/o? What is the functional status and comorbidities? What is the social situation? All these factors intervene in my planning. I think it is time to send these patients for a medical oncology consultation before any surgeries. W...