Ringing a bell couldn't be harmful could it?

[Chartreuse Wombat]

https://www.redjournal.org/article/S0360-3016(19)32042-5/fulltext

Discuss...

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[medgator]

Saw that. One of the docs at one of our satellites has a bell. Never saw the point of it, now I have evidence to poopoo it

 

[BobbyHeenan]

I shut down the bell when it was brought up by nursing/therapists.
How awful would it be to hear that damn bell after you're on course 3 of palliative XRT for your incurable cancer?

 

[Lamount]

I don't get the trial design. Did patients choose their enrollment arm? If so, those in the experimental arm may have chosen to ring the bell to try to raise their spirits.

 

[evilbooyaa]

Yeah we have a bell and certain attendings are considering whether to continue the practice. We've somewhat made it optional. Seems like definitive patients (and/or their families) seem to get very excited about it and palliative patients don't as much - wonder how much of that was driving those results.

 

[deleted1002574]

Hate the bell
It’s at our clinics. Staff seems to be more excited than (most) patients ...

 

[xrthopeful]

Hate the bell
It’s at our clinics. Staff seems to be more excited than (most) patients ...

hundred percent agreed.

The staff are the ones that want to keep it IMO.

 

[OTN]

We use confetti the therapists throw over the patients when they're done. Not as annoying as the bell.

 

[evilbooyaa]

We use confetti the therapists throw over the patients when they're done. Not as annoying as the bell.

What, seriously? Whose job is it to clean up the confetti?

 

[medgator]

We use confetti the therapists throw over the patients when they're done. Not as annoying as the bell.

We use certificates. Much prefer that

 

[OTN]

What, seriously? Whose job is it to clean up the confetti?

Nightly cleaning crew does it. Couldn't have been easy when we had carpet. Hardwood now, fortunately.

 

[Palex80]

We only "celebrate" when kids finish treatment, that's it. Usually it's handing over a book full of stickers (one sticker for each fraction) and some chocolate.

I am not familiar with any clinic using "the bell" in Europe.

 

[medgator]

We only "celebrate" when kids finish treatment, that's it. Usually it's handing over a book full of stickers (one sticker for each fraction) and some chocolate.

I am not familiar with any clinic using "the bell" in Europe.

So you treat peds in general practice there? We usually send peds to specialists in academic or tertiary care centers

 

[deleted1002574]

Well, Medgator, the ABR does test us on it and thus feels we are able to do so (if I could roll my eyes any further...).

ABR- the correct answer for every pediatrics question if we are taking this exam one year out of residency is “I would refer this patient to a high volume pediatric center.” Unless you work at one of those, every other answer should be a failing answer.

 

[OTN]

Well, Medgator, the ABR does test us on it and thus feels we are able to do so (if I could roll my eyes any further...).

ABR- the correct answer for every pediatrics question if we are taking this exam one year out of residency is “I would refer this patient to a high volume pediatric center.” Unless you work at one of those, every other answer should be a failing answer.

My partner tried that. It did not work.

 

[radoncgrad2019]

really is not that hard to know peds for the purposes of oral boards.

 

[medgator]

really is not that hard to know peds for the purposes of oral boards.

Don't the protocols change every other year? At least that's what I recall studying for orals a decade ago

 

[radoncgrad2019]

Protocols do change over time of course but not every other year. But yeah you learn the basic paradigms and current dosing for the main peds cases, be safe about it. I don't think anyone is going to get failed for a Peds case unless they do something colossally stupid. but even then, I think the CNS/Peds team is just checking a box when they ask you the one Peds case on that section

 

[Palex80]

So you treat peds in general practice there? We usually send peds to specialists in academic or tertiary care centers

I work in a small academic center. We treat a few kids per year.
We do send quite a few away for proton treatment but there are several indications where protons are not necessary / beneficial (whole brain for ALL, palliative cases, etc)

 

[Pointless]

https://www.redjournal.org/article/S0360-3016(19)32042-5/fulltext

Discuss...

I don't understand how the field isn't leaping forward with heady research like this.... IN THE RED JOURNAL.

 

[evilbooyaa]

Nightly cleaning crew does it. Couldn't have been easy when we had carpet. Hardwood now, fortunately.

Do you do the confetti in a special room? Or in the hallway? Don't other patients see confetti littered all over the floor? This seems like a very strange practice. Agree with certificates. We add on medals.

 

[thecarbonionangle]

Not surprising that some folks would find even a more low hanging fruit than survey research to put out on red journal, now they have to come for the bell. Screw them and their “research”

 

[xrthopeful]

The bell sucks. We all know it.

 

[OTN]

Do you do the confetti in a special room? Or in the hallway? Don't other patients see confetti littered all over the floor? This seems like a very strange practice. Agree with certificates. We add on medals.

I thought it was a bit strange when I arrived, but I like it now.

We do it as they leave the treatment room. Our waiting room is outside the hallway, so not all patients see it happen. They do see the confetti on the floor, but most either don't think much of it or look forward to their "turn" to have it happen. It's just a small thing, and we only do it for definitive patients.

There's no "bell" sound to annoy the other patients, it's pretty quick and quiet, and from time to time family members join in to throw it on the patient. Patients seem to enjoy it, and we haven't had any complaints.

 

[evilbooyaa]

Hmm, interesting to hear about. Thanks for the details.

 

[Gfunk6]

I think someone needs to publish a Phase III randomized trial in a center that has > 1 vault. One vault has a bell and the other one doesn't. That may be too simple for NRG so I would additionally suggest a 2 x 2 cross-over with cetuximab..

 

[Brim]

I don't even like the bell at Long John Silver and Arby's.

 

[medgator]

I don't even like the bell at Long John Silver and Arby's.

You might like The Bell though.

 

[taserlaser]

And dose escalation. Why stop at one bell? Why not a bell tree? Repeated bell ringings? An air horn? Really, this is an entire subspecialization ripe for research!

 

[deleted1002574]

We actually hired a guy to do this.

 

[RadOncDoc21]

We actually hired a guy to do this.

That’s not a bell he’s “ringing.”

 

[scarbrtj]

The Cancer Bell: Too Much of a Good Thing?

‎ASTRO Journals: The Cancer Bell: Too Much of a Good Thing? on Apple Podcasts

‎Show ASTRO Journals, Ep The Cancer Bell: Too Much of a Good Thing? - Dec 18, 2019

podcasts.apple.com

 

[dieABRdie]

We have a gong.... not kidding.

We don't use it... but very tempted

 

[FrostyHammer]

We have a gong.... not kidding.

We don't use it... but very tempted

"Cancer Be Gong"