Rad Onc Twitter

Started by deleted1002574
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Maybe so. The less I'm on Twitter, the more I realize those people don't really stand up as a proxy for most normies, though. I think the average, not-very-online person does have some respect for what we do and what it took to get here. I think perhaps they'd even be a little shocked at how little some doctors make. I think I learned on this forum how little pediatricians make (I knew low, but not that low!) and it disgusts me. We love our kids doc and I wish they made more than they do.

The guy that built and then added a renovation to my house makes significantly more than me. But, I love my house and I think he runs a great business and works very hard. I don't believe he has a college degree. Lot of haters online, while maybe in real life people want all hard working, highly skilled people to make a good income.
 
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Most people especially outside tier 1 cities don't interact with SV, wall street, or political elites so populist anger at them less tangible. If you live in a smaller city or town and you're struggling and your doctor seems like just another guy or gal, despite the fact they could up and move fairly easily, they are an easy target. People on Twitter aren't going to register SoCal cost of living, or the regulatory and political capture of California healthcare by so-called nonprofit systems and managed care.
 
WildRivers said:
Maybe so. The less I'm on Twitter, the more I realize those people don't really stand up as a proxy for most normies, though. I think the average, not-very-online person does have some respect for what we do and what it took to get here. I think perhaps they'd even be a little shocked at how little some doctors make. I think I learned on this forum how little pediatricians make (I knew low, but not that low!) and it disgusts me. We love our kids doc and I wish they made more than they do.

The guy that built and then added a renovation to my house makes significantly more than me. But, I love my house and I think he runs a great business and works very hard. I don't believe he has a college degree. Lot of haters online, while maybe in real life people want all hard working, highly skilled people to make a good income.
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Sure. I guess I'm arguing that we should support people posting reasonable, factual things on X, however much it might annoy some.
 
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OTN said:
This post is getting excoriated on Twitter by non-physicians who see it as entitled, out-of-touch, etc. Always important to be careful what you post on social media. Although I strongly agree with her, Dr. Lawrence-Reid's post has done more harm than good to her specialty. There are appropriate forums for this kind of discussion, and Twitter ain't it.
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sure. but can only gate keep so much. information is out there. her whole point is empowering physicians.
 
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Fascinating! But…

Why is he treating a patient on a protocol that is not IRB approved and not on clinicaltrials.gov?
 
Palex80 said:
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Fascinating! But…

Why is he treating a patient on a protocol that is not IRB approved and not on clinicaltrials.gov?
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know of radoncs who have treated their relatives with alz. would probably do the same for close family, . Anyway, good for him for advancing the specialty. save the derision for NRG studies of 5 vs 20 fractions for bladder cancer...
 
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Just curious - why should he not tweet it out? Not saying he should, just wondering about argument against it. Seems interesting. One of our local guys who was on the RJ paper with 5 patients - I cover at his clinic occasionally - has a patient who's symptoms halted after treatment. It is worth exploring more, for sure. Nothing else works. Why not?
 
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WildRivers said:
Just curious - why should he not tweet it out? Not saying he should, just wondering about argument against it. Seems interesting. One of our local guys who was on the RJ paper with 5 patients - I cover at his clinic occasionally - has a patient who's symptoms halted after treatment. It is worth exploring more, for sure. Nothing else works. Why not?
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I agree that tweeting about the trial being activated is fine, after protocol was approved.

Besides that, disclosing trial results (as he did) is not GCP-conform. You cannot / should not disclose how participants of a trial are benefiting from the treatment, during a running trial, certainly not at this level and using metrics.
 
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It seemed like it was a tweet about an off study patient that was also advertising the soon to open trial concept.

Theres nothing inherently wrong with it, but a lot of theoretically wrong things that he seems to make pretty abrasive tweets about sometimes.

For example, it seems a little odd to argue that urologists doing steam therapy are criminals but then turn around and share an N=1 maybe success about LDRT for dementia (not an FDA approved indication, by the way).

If I was him, Id really just worry Im harming the attractiveness of my own trial. If he is offering the treatment off trial, why would anyone agree to be on study if the PI is tweeting about the greatness of the therapy, especially if its randomized?

Another example, therapeutic misconception has been documented with radiotherapy. If his trial is sham controlled, tweets like this could improve the outcome of sham treatment.
 
NotMattSpraker said:
It seemed like it was a tweet about an off study patient that was also advertising the soon to open trial concept.

Theres nothing inherently wrong with it, but a lot of theoretically wrong things that he seems to make pretty abrasive tweets about sometimes.

For example, it seems a little odd to argue that urologists doing steam therapy are criminals but then turn around and share an N=1 maybe success about LDRT for dementia (not an FDA approved indication, by the way).

If I was him, Id really just worry Im harming the attractiveness of my own trial. If he is offering the treatment off trial, why would anyone agree to be on study if the PI is tweeting about the greatness of the therapy, especially if its randomized?

Another example, therapeutic misconception has been documented with radiotherapy. If his trial is sham controlled, tweets like this could improve the outcome of sham treatment.
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Moral superiority for me but none for thee.

Drew M is his biggest fan. That these guys’ minds sync up at the mitochondrial level is beautiful.

 
Ray D. Ayshun said:
More importantly, is anyone here doing this? Seems worthwhile. No getting paid for it I suppose.
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In academics you will likely be in the double-edged position of 1. Being required to have these patients on study, 2. Not actually being able to conduct that study.

I love it when people are actually trying to push the envelope in this specialty. If we keep doing what we've always done we're going to fail in the long-term. I think it takes some interesting personalities to do that pushing.
 
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OTN said:
I sent the tweet to my neuro-oncologists. They said that, while the improvement in MOCA score of 4 isn't particularly impressive, it's an interesting concept and they would be open to considering it depending on the data as it's generated.
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What is the improvement in MoCA score with donepazil or memantine? It's usually 0.
 
RickyScott said:
Is any academic center pursuing this? Why is Evan the only one offering it?
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pubmed.ncbi.nlm.nih.gov

Low-Dose Whole Brain Radiation Therapy for Alzheimer's Dementia: Results From a Pilot Trial in Humans - PubMed

Our results from 5 patients with eAD treated with LD-WBRT (10 Gy in 5 fractions) demonstrate a positive safety profile and provide preliminary, hypothesis-generating data to suggest that this treatment stabilizes or improves cognition. These findings will require further evaluation in larger...
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov

5 patients. Published in 2023

The prospective trial was aborted around 2020?
 
communitydoc13 said:
pubmed.ncbi.nlm.nih.gov

Low-Dose Whole Brain Radiation Therapy for Alzheimer's Dementia: Results From a Pilot Trial in Humans - PubMed

Our results from 5 patients with eAD treated with LD-WBRT (10 Gy in 5 fractions) demonstrate a positive safety profile and provide preliminary, hypothesis-generating data to suggest that this treatment stabilizes or improves cognition. These findings will require further evaluation in larger...
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov

5 patients. Published in 2023

The prospective trial was aborted around 2020?
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Seems like dose should be much lower.
 
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****storm in the comments...

I actually do not understand, why ASTRO chose to highlight this. It seems Netanyahu got surgery, not radiotherapy, for his prostate cancer?
 
Palex80 said:
****storm in the comments...

I actually do not understand, why ASTRO chose to highlight this. It seems Netanyahu got surgery, not radiotherapy, for his prostate cancer?
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yes. this is pretty gross from ASTRO to post this. Read the room ASTRO.

this is the same group that made a very one sided post in Fall 2023 so I should not be surprised, but a lot has happened since then and public opinion has widely shifted. ASTRO will ASTRO.
 
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I have to correct myself, he got radiotherapy after all...

And yes, it appears it was after a TUR-P about 2 years ago.

Perhaps it was a pT1a-b back then, and now they saw a PSA rise, ordered an MRI, saw a lesion growing and decided to treat.

Sounds like he underwent normofractionated or moderately hypofractionated treatment, reasonable bearing in mind the TUR-P he had before.
 
Palex80 said:
I have to correct myself, he got radiotherapy after all...

And yes, it appears it was after a TUR-P about 2 years ago.

Perhaps it was a pT1a-b back then, and now they saw a PSA rise, ordered an MRI, saw a lesion growing and decided to treat.

Sounds like he underwent normofractionated or moderately hypofractionated treatment, reasonable bearing in mind the TUR-P he had before.
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Doesn't make a lot of sense to treat prostate cancer definitively while trying to get Armageddon started. Wouldn't be in line with nccn guidelines.
 
Ray D. Ayshun said:
Doesn't make a lot of sense to treat prostate cancer definitively while trying to get Armageddon started. Wouldn't be in line with nccn guidelines.
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Shame on him for defending his people after the October 7th massacre and subsequent attack by hezbollah in the north. The Usa killed 1 million in Afghanistan and iraq following sept 11th. Starting a War sucks: (In the 10 years after world war 2 ended, 2 million nazi civilians were killed during population transfers.)
 
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drowsy12 said:
looks like ASTRO deleted it. I hadn't seen any comments yet when I noted the post on Friday. what did they say?
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Have some backbone ASTRO ffs. The head of state of the US's major ally in the Middle East was treated with radiation with curative intent. Turn off the comments and let the post ride.

I'm not going to comment on the politics of this because there's no need for this thread to devolve into a reddit post.
 
Ray D. Ayshun said:
Doesn't make a lot of sense to treat prostate cancer definitively while trying to get Armageddon started
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Armageddon?
RickyScott said:
The Usa killed 1 million in Afghanistan and iraq following sept 11th.
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Whenever ASTRO thanks CMS or a US politician I never see anyone respond “How can you support any part of our government, a government that had a part in killing hundreds of thousands of civilians the world over.” I guess outrage suffers from entropy… each of us only have so much energy so we have to be choosy as to which countries, or causes, we get outraged against. ASTRO has never spoken out against fully clothed breast RT (imagine how dicey patient setup would be), which is required in some countries. Breastageddon.

EDIT: I would also like to ask … does ASTRO plan on suing any of the commenters dragging them in the replies? Anyone received any legal threats? Just curious!
 
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TheWallnerus said:
ASTRO has never spoken out against fully clothed breast RT (imagine how dicey patient setup would be), which is required in some countries.
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Sources? I have never encountered meaningful limitations regarding breast RT for any population. I've had Muslim women be chill with a male doctor and secular humanists not want one.

Comments are always fine IMO. Except they aren't (a shame), and consequences (at least per my personal experience) have tended to be remarkably punitive regarding certain positions vs others. This has everything to do with power.

Protest should always be welcome, as should moralizing. I would think the anti-wokesters on this thread would certainly support the right to comment/protest without designating it as something that it is not.

ASTRO should get @$*^ from all sides. It's part of their job. In general, institutions/organizations are not terribly reliable moral agents. As ASTRO is an advocacy group largely involved with government payment...they are among the least equipped of us to actually take the high ground.
 
Neuronix said:
Reminder: no personal attacks, no politics. SDN is a professional forum.



Please elucidate in a professional way or report. Otherwise this is encouraging us to veer off into the abyss.
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Best to leave this where it’s at now as not to derail the thread. Allowing people to reveal horrific opinions stands on its own
 
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