The Rhuemys usally don't start you out with cytoxan. When I was diagnosed in 2008, the called it limited Wegs because it was in my sinuses only. At that time they just increased my prednisone to 60mg and I staying on my cyclosporine(immunosuppression kidney transplant). I knew I need more immunosuppression meds...it was too late and I developed a lung nodule 6 months later after being diagnosed. At that time I did not have a WG specialist.