According to the Canadian Rheumatology association guidelines:
1. In general, in rheumatoid arthritis patients with active malignancy, treatment with DMARDs (traditional and biologic) should be withheld while patient is receiving chemotherapy or radiotherapy. The decision should be made on case-by-case basis in conjunction with oncologist.
2. In rheumatoid arthritis patients with history of lymphoma, hydroxychloroguine, sulfasalazine, and rituximab may be used. Use of anti-TNF medications is not recommended. Treatment with traditional and biologic medications should be used with caution.
3. In rheumatoid arthritis patients with a history of nonmelanoma skin cancer and solid malignancy, traditional DMARDs can be used. Biologic medications should be used with caution.