not onc in radonc.

[QuantumMechanic]

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Doubtful, your job is to treat cancer. If you want to do basic neuroscience research you would probably better served in Neuro or Psych. I've never seen RadOnc physicians performing research which was not directly related to oncology.

don't want to hijack the thread, but how much research (if any) is going on in the field outside of oncology (keloid treatment and such)?

 

[Gfunk6]

don't want to hijack the thread, but how much research (if any) is going on in the field outside of oncology (keloid treatment and such)?

There is definitely some research on benign diseases treated with radiation but not much. It's kind of a niche field.

Example: http://www.ncbi.nlm.nih.gov/entrez/..._uids=16730305&query_hl=1&itool=pubmed_docsum

 

[deleted4401]

That reminds me of a management consultant friend of mine, who is not a physician, but thinks what I do is so obscure, that he thinks it's funny to tell people he is a radiation oncologist when we're out. Then he says he focuses more on the radiation rather than the oncology. He thinks it's a hoot, and the dumb folks he meets just kind of nod their heads ... "Yeah, it's probably best just to specialize in that, oncology can be kind of sad"

Not sure about the relevance, other than the fact that researching benign diseases is kind of focusing on radiation rather than oncology. Sort of like my friend does.

-S

 

[radonc]

That reminds me of a management consultant friend of mine, who is not a physician, but thinks what I do is so obscure, that he thinks it's funny to tell people he is a radiation oncologist when we're out. Then he says he focuses more on the radiation rather than the oncology. He thinks it's a hoot, and the dumb folks he meets just kind of nod their heads ... "Yeah, it's probably best just to specialize in that, oncology can be kind of sad"
-S

im gonna have to try that line sometime!

 

[stephew]

there's quite a bit in CNS with regard to benign disease.

 

[QuantumMechanic]

there's quite a bit in CNS with regard to benign disease.

has radonc defended this turf (that should be worded less militantly) well from neurosurgeons?

 

[stephew]

has radonc defended this turf (that should be worded less militantly) well from neurosurgeons?

hoo boy. complex issue. The short answer is no, a slightly longer answer is there is evidence that this is not just bad for radonc docs (ie a turf war) but has shown to be very bad for patient outocomes, and the longer answer involves an acknwoledgment that this is only the thin end of the wedge as radiosurgery in other areas gets off the ground with more services getting invovled to use radoncs as technicians (but always under the facilitating name of "multidisciplinary")- and radoncs let them do this- and with urorads. And it requires acknowledgement that Alan Licter's excellent presentation on this issue should be viewed by all radoncs in context of the ARRO presentation of a recent resident's poll . This is a highly complex issue. You are in the middle of pivotal time in radonc. the old dictum was always "a doctor first, an oncologist 2nd, and radiation oncologist 3rd". There are forces narrowing the walls in on us so we are confined as technicians first and foremost. and radiation oncologists are absolutely compliant in this practice.

I would encourage all radiation oncologists, private and academically bound, who wish actually practice medicine on top of getting the big bucks and comfortable work hours, to campaign astro to actively deal with this issue. This issue is a live one and the careers of the general populace that attends this board will be shaped or shaped for you depending upon how it plays out in the near and intermediate future..

 

[stephew]

i should add- the issue isnt that the benign produres are going to the neurosurgeons. they increasingly go to the radoncs (An, mengin, pit adenoma). the problem is the neurosurgeons are perceived as controlling radiosurgery. go meander over to the varian web site. see who the primary target group is for their radiosurgery marketing. speaks volumes. campaigning to get radoncs seen as the customers would be a reasonable goal. in conjunction to making that a reality.

 

[Ursus Martimus]

there's quite a bit in CNS with regard to benign disease.

Agreed, I think the next big step in benign disorders will be the use of sterotactic radiosurgery/gamma knife in the treatment of movement disorders - essential tremors, Parkinson, etc. MAybe even eventually compulsive disorders, paraphilias, and who knows maybe even smoking (how is that for pie in the sky).

The caveat is that the functional imaging will need to improve, but I think it only a matter of time.

 

[QuantumMechanic]

You are in the middle of pivotal time in radonc. the old dictum was always "a doctor first, an oncologist 2nd, and radiation oncologist 3rd". There are forces narrowing the walls in on us so we are confined as technicians first and foremost. and radiation oncologists are absolutely compliant in this practice.

Interesting point steph (you are always making great points 👍)!

Do you think that the small size of the field has also been a major contributing factor in causing the rise of the radonc "technician" role?

 

[stephew]

Interesting point steph (you are always making great points 👍)!

Do you think that the small size of the field has also been a major contributing factor in causing the rise of the radonc "technician" role?

that's not obvious to me at least. though i never really gave that thought. id have to mull that over.
I do urge all junior folks to really get invovled in this issue at whatever level you may. Because this will directly effect you if youre going into this career now. Im not the alarmist type- this is a real phenomenon.

 

[stephew]

Agreed, I think the next big step in benign disorders will be the use of sterotactic radiosurgery/gamma knife in the treatment of movement disorders - essential tremors, Parkinson, etc. MAybe even eventually compulsive disorders, paraphilias, and who knows maybe even smoking (how is that for pie in the sky).

The caveat is that the functional imaging will need to improve, but I think it only a matter of time.

there is certainly that potential. My feeling is it will be a long time before that's accepted in the United States. Its done more elsewhere. Trigeminal neuralgia is tx'd here but the results while initially excellent seemed to be only short lived unfortunately.