Rad Onc Twitter

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evilbooyaa said:
We try to minimize but it's like trying to bail out a sinking boat on an expanse ocean riddled by machine gun fire with a teaspoon

So we never catch everything. Use the report function!

Also - SDN Stock. LOL. Good one. I come here for the education. And the power.

Revenge Of The Sith Power GIF by Star Wars
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I dunno...

I think SDN is currently more professional than RO Hub...has the ASTRO President-elect called anyone at their real-life job to complain about RO Hub moderation?

Doubt it.
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GoSpursGo said:
I defer to @Neuronix and @evilbooyaa . If you look at how they have handled this thread over the years you can come to a pretty decent idea of how they operate. Obviously there is some overlap.
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Thank you GSG.

I want to make a public apology to MidwestRadOnc. I thought this was the return of a banned user. Without giving any details of why I thought this, I was incorrect. This led to his ban, but evilbooya pointed out the error. We reinstated his account.

SDN does not as a matter of policy allow mask and vaccine denial discussions. While this is above my head and not my policy, I am fine to enforce it as I do not disagree.

Mild political discussions are tolerated. Please don't go off the rails.

Also, SDN is non-profit. Over the years I've seen no attempt to change that. I get nothing out of SDN professionally or financially--I just believe in the mission of having a free space to discuss medical topics with and run by like minded individuals.
 
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Neuronix said:
Thank you GSG.

I want to make a public apology to MidwestRadOnc. I thought this was the return of a banned user. Without giving any details of why I thought this, I was incorrect. This led to his ban, but evilbooya pointed out the error. We reinstated his account.

SDN does not as a matter of policy allow mask and vaccine denial discussions. While this is above my head and not my policy, I am fine to enforce it as I do not disagree.

Mild political discussions are tolerated. Please don't go off the rails.

Also, SDN is non-profit. Over the years I've seen no attempt to change that. I get nothing out of SDN professionally or financially--I just believe in the mission of having a free space to discuss medical topics with and run by like minded individuals.
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So no way we can bribe you? What kind of business is this??
 
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Neuronix said:
Thank you GSG.

I want to make a public apology to MidwestRadOnc. I thought this was the return of a banned user. Without giving any details of why I thought this, I was incorrect. This led to his ban, but evilbooya pointed out the error. We reinstated his account.

SDN does not as a matter of policy allow mask and vaccine denial discussions. While this is above my head and not my policy, I am fine to enforce it as I do not disagree.

Mild political discussions are tolerated. Please don't go off the rails.

Also, SDN is non-profit. Over the years I've seen no attempt to change that. I get nothing out of SDN professionally or financially--I just believe in the mission of having a free space to discuss medical topics with and run by like minded individuals.
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@MidwestRadOnc Our bad, Dude/Dudette!
 
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A number of posts in this thread regarding COVID and politics (and UNRELATED to RO Twitter) have been moved to their own thread, which has now been locked.

Further discussion of COVID and politics on this thread will be handled with pistol whips and warnings, and bans. MWRO, looking at you. You had your last hurrah which I have left in place for posterity.
 
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When a rad onc is going to Iraq with tension rising in the Middle East, especially in regards to Iran… can’t help but wonder what’s going to happen next.
 
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RadOncDoc21 said:
When a rad onc is going to Iraq with tension rising in the Middle East, especially in regards to Iran… can’t help but wonder what’s going to happen next.
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Uh.

Yeah.

I obviously have a lot of interest in debating things like ROCR and Direct Supervision

But it increasingly feels naively optimistic that these things will even matter 5 years from now.
 
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RickyScott said:
Would guess that he is a reserve officer. Obviously, not there as a radonc?
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Probably not

Although the technology used in the accelerator in a Cyberknife is an offshoot of Army research to develop a linac that could be portable and the size of a backpack and wearable by a soldier (very Ghostbusters)

The reason the Army wanted this is still unknown to me to this day
 
evilbooyaa said:
Fair enough - Wish him the best and safe travels there and back home. 100% agree with an uneventful deployment.
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definitely
I am intrigued by his role, but wish him the best of luck.
Deployments are hard.
 
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I was not even aware that the US had troops in Iraq.
I thought they had all pulled out, especially after that air strike that killed that Revolutionary Guards guy a few years ago.

I looked it up, and it seems there are around 2500 US troops in Iraq currently. Some probably guarding the embassy / consulates and some small contigents for the few bases left. ISIS is still active in Iraq, so I presume intelligence gathering and drone operations are still a thing.
 
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The department chair answering to a meme account.
Clint Eastwood Nod GIF by GritTV
 
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elementaryschooleconomics said:
"10 fraction SBRT"

"Alex, I'll take 'signs this study was not done in America' for $500, please."
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I like the 10 fractions. Might give me numerically better coverage than 5 fraction regimens in cases with a lot of epidural disease plus I can complain about the US healthcare system while I do it. Win win.
 
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Ray D. Ayshun said:
Any thoughts on this? Just noticed it recently in the context of a relevant case.

SS 25: CNS 1 - 2023 ASTRO Annual Meeting - American Society for Radiation Oncology (ASTRO) - American Society for Radiation Oncology (ASTRO)

Radiotherapy for Metastatic Spinal Cord Compression with Increased Doses: Final Results of the RAMSES-01 Trial
www.astro.org www.astro.org
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I'd like to see the full data on this.
My main concern is that this may be a self-fulfilling prophecy.

The endpoint of the trial is local control and we all know that systemic treatment has also made significant advancements in the past decades. This trial tested dose escalation and compared the results of it to those of a historic series of patients.

Rades is cool, but many of the scores he has established are based on patients who were treated 20-30 years ago.
pubmed.ncbi.nlm.nih.gov

Evaluation of five radiation schedules and prognostic factors for metastatic spinal cord compression - PubMed

The five RT schedules provided similar functional outcome. The three more protracted schedules seemed to result in fewer in-field recurrences. To minimize treatment time, the following two schedules are recommended: 1 x 8 Gy for patients with poor predicted survival and 10 x 3 Gy for other...
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov

A patient with multiple myeloma and spinal cord compression presenting in 2005 had a totally different prognosis than one presenting today, and RT may not be crucial component here.
 
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Ray D. Ayshun said:
Any thoughts on this? Just noticed it recently in the context of a relevant case.

SS 25: CNS 1 - 2023 ASTRO Annual Meeting - American Society for Radiation Oncology (ASTRO) - American Society for Radiation Oncology (ASTRO)

Radiotherapy for Metastatic Spinal Cord Compression with Increased Doses: Final Results of the RAMSES-01 Trial
www.astro.org www.astro.org
Click to expand...

A PhII in bone mets w/ 50 patients is cool and I appreciate Dr. Rades and his input to metastatic disease management, but as Palex noted, comparison to historical controls in terms of both LC and OS are not super relevant in the contemporary era. We have much better evidence for dose escalation (primarily with SBRT, but maybe even '10Fx SBRT' as per Guckenberger paper noted above)
 
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Jordan clowning on ronD
 

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The evicore dbag doesn’t care and will tell you there is conflicting data because of RTOG 0631. Not only tell you, but give you a lecture. Anyone else gotten that lecture?
 
MidwestRadOnc said:
The evicore dbag doesn’t care and will tell you there is conflicting data because of RTOG 0631. Not only tell you, but give you a lecture. Anyone else gotten that lecture?
Click to expand...

I can’t wait to run across an academic doing evicore on the side
 
medgator said:
Very odd behavior from RD though... Retweeting his own posts constantly while being a heavy ion/proton shill etc.
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Looking at Ron's behavior in a vacuum, independent of Jordan:

Jesus Christ I've never seen anyone violently run back and forth so quickly between positions and ideas that are clearly meant to help him make the most amount of money.

For those who don't know, and I'm not exaggerating slightly with this - Ron has found a way to be the main character of basically everything controversial in RadOnc for the last 20 years. He's made a significantly larger amount of money than any actual Radiation Oncologist in doing so.

Ron, Wallner, Dosoretz, Mantz.

The Four Horsemen of the Radioactive Apocalypse.
 
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This is about medicine in general rather than rad onc specifically, but we all see it in our tiny little niche of the medical world too obviously. Corporate takeover of medicine is the root of 99.9% of what we complain about, to my eye. Longer thread of tweets that I didn't bring all of it over, you can go read further if interested.




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the youngest boomer is 60 (ends in 1964). there are def some chairs that are still boomers (oldest one is Ralph who is probably bordering on the greatest generation rather than boomer) but I think a lot of chairs these days are Gen X
 
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Neuronix said:
How dare you! Even suggesting this is anti-trust!
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Controlling 100% of supply and keeping track of salary data, completely kosher. Mentioning oversupply at a workforce meeting, highly illegal.

Confused Season 3 GIF by The Simpsons
 
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Whew it's a good thing they put this on page 2 of the SCAROP/ASTRO salary survey:

"These data, contained in the report, may not be used to limit competition, restrain trade, or reduce or stabilize salary or benefit levels. Such improper use is prohibited by federal antitrust laws."

They were totally innocent all along. Sorry about that SCAROP and ASTRO overlords.

90f.gif


PS: For anyone reading this, if you didn't already know what I'm making fun of--it's that SCAROP and ASTRO have a salary survey among academic rad onc programs that is only released to chairs of rad onc programs. Despite it being an ASTRO supported survey, you are not allowed access to the data as an ASTRO member by paying for it or otherwise.

ASTRO's defense for not even discussing limiting residency expansion is that it would be "anti-trust". Yet, creating a confidential survey only given to department chairs with everyone's salaries is totally not anti-trust according to these same people.

200w.gif
 
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Neuronix said:
Whew it's a good thing they put this on page 2 of the SCAROP/ASTRO salary survey:

"These data, contained in the report, may not be used to limit competition, restrain trade, or reduce or stabilize salary or benefit levels. Such improper use is prohibited by federal antitrust laws."

They were totally innocent all along. Sorry about that SCAROP and ASTRO overlords.

View attachment 385695

PS: For anyone reading this, if you didn't already know what I'm making fun of--it's that SCAROP and ASTRO have a salary survey among academic rad onc programs that is only released to chairs of rad onc programs. Despite it being an ASTRO supported survey, you are not allowed access to the data as an ASTRO member by paying for it or otherwise.

ASTRO's defense for not even discussing limiting residency expansion is that it would be "anti-trust". Yet, creating a confidential survey only given to department chairs with everyone's salaries is totally not anti-trust according to these same people.

View attachment 385696
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Look.

You didn't hear it from me.

But the SCAROP report is, in fact, the most obvious case of antitrust that I've seen in medicine.

Submit a Healthcare Competition Complaint

www.justice.gov www.justice.gov

The government loves to hear about these things.

(from multiple people)
 
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To be even more clear, this is "whistleblowing", yes, but not like what happens in the Medicare "fraud" cases you hear about.

There is no monetary reward here, and it's all handled internally with the DOJ/FTC.

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Complaints can be submitted anonymously, if you'd like.
 
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