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Working harder than necessary, being on call and rounding on the weekends.Hey, MSIII here deciding between radonc and heme/onc, leaning towards the latter. Would appreciate insight into any of these few questions:
- I should do heme/onc rather than rad onc if I like _______________________
- As an attending, how often are you on call? One week out of four?
- What does being on call entail? How often do you come in on the weekends, and for what?
Dramatically.- How does the above differ between academics and private practice?
- What percentage of cases do you treat palliatively, as opposed to for cure?
It shouldn't. It's a legit question. Copd and chf are chronic diseases of malfunctioning organs. Cancer is an acute disease process that can sometimes end up being managed for years after is diagnosed when it recurs/persists etc, but in the early stages and certain locally advanced stages, it can be cured.This question pisses me off. Nobody ever asks the pulmonologist how many of their COPD patients they treat curatively, or the cardiologist how many of their CHF patients they treat curatively. News flash...everybody dies. Some do it sooner than others. As an oncologist, a lot of your patients will die, many of them from cancer. You either figure out how to deal with that or you do rheumatology.
Agree that there can be a spectrum, but upfront, you kinda have an idea of which way you are trying to go. You are going to try and cure those locally-advanced non metastatic patients upfront, and then obviously it becomes palliative if/when they recur or met out.I think the palliative vs. curative is a dismal simplification. No patients walk into the clinic asking for "palliative treatment only, please". Our goal is to help that patient live as long as possible. There are a lot of patients walking around with Stage 4 cancer who are in remission. Conversely, up to two-thirds of the locally advanced adjuvant or definitive cases will recur in a few years, depending on the tumor type. I think that patient outcomes usually depend on an important interaction with their socioeconomic situation, family support, and coping skills.