Rad Onc Meme Thread

[elementaryschooleconomics]

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[TheWallnerus]

Ken Olivier has put on some weight (like we all have during COVID)

 

[CurbYourExpectations]

 

[evilbooyaa]

You didn't even photoshop a RW or LP face onto the guy, c'mon man!

 

[CurbYourExpectations]

You didn't even photoshop a RW or LP face onto the guy, c'mon man!

after spending 20 minutes trying to photoshop Simul's face onto a 4 second Katniss everdeen video and failing I have learned my limits

 

[Ray D. Ayshun]

I am my target audience...

 

[TheWallnerus]

I am my target audience...
View attachment 347923

as an aside for those who've never seen the movie, Google 'Trainspotting' and 'worst toilet in Scotland'

 

[elementaryschooleconomics]

I am my target audience...
View attachment 347923

Radbio writtens: "The volatile organic compounds dimethyldisulfide, 2-butanone, 2, 3-butanedione, 6-Methyl-5-hep-ten-2-one, indole, and 4-Methylphenol are known components of human feces. Which volatile organic compounds are more commonly associated with CDiff?"

OLA: "Is this a picture of a toilet or the moon?"

 

[TheWallnerus]

@elementaryschooleconomics

 

[Palex80]

A dear colleague of mine has been arguing that GBMs subclinically invade the brainstem and ultimately many patients die because of that.

Extensive brainstem infiltration, not mass effect, is a common feature of end-stage cerebral glioblastomas - PubMed

With improving care, severe mass effect appears to be less common in GBM patients today, whereas dissemination, including life-threatening brainstem invasion, is now more pronounced. This has major implications regarding preclinical GBM models, as well as the design of clinical trials aimed at...

pubmed.ncbi.nlm.nih.gov

We should be targetting the brainstem! He made this nice meme for me.

 

[Ray D. Ayshun]

@elementaryschooleconomics

If I remember this patient correctly, perineural invasion was noted on path, so he also received STADT.

 

[elementaryschooleconomics]

If I remember this patient correctly, perineural invasion was noted on path, so he also received STADT.

This joke triggers me deeply...

Well played.

 

[TheWallnerus]

View attachment 348691

A dear colleague of mine has been arguing that GBMs subclinically invade the brainstem and ultimately many patients die because of that.

Extensive brainstem infiltration, not mass effect, is a common feature of end-stage cerebral glioblastomas - PubMed

With improving care, severe mass effect appears to be less common in GBM patients today, whereas dissemination, including life-threatening brainstem invasion, is now more pronounced. This has major implications regarding preclinical GBM models, as well as the design of clinical trials aimed at...

pubmed.ncbi.nlm.nih.gov

We should be targetting the brainstem! He made this nice meme for me.

This would work if radiation worked for GBM

 

[Ray D. Ayshun]

This would work if radiation worked for GBM

Irradiating the brainstem extensively has the bonus of making a GBM patient so nauseous they'd rather be dead, which is helpful for those who need the push to make an advance directive.

 

[Neuronix]

This would work if radiation worked for GBM

Radiation improves overall survival in GBM.

It is not curative intent. But, the overall survival benefit with radiation therapy alone is on the order of 4 months, similar to temozolomide, Optune, and many other blockbuster drugs elsewhere in the body.

Let's not sell radiation any shorter than it's already sold.

 

[TheWallnerus]

Radiation improves overall survival in GBM.

It is not curative intent. But, the overall survival benefit with radiation therapy alone is on the order of 4 months, similar to temozolomide, Optune, and many other blockbuster drugs elsewhere in the body.

Let's not sell radiation any shorter than it's already sold.

Didn't mean to trigger! I'm irradiating GBMs obviously. Radiation works; a bit depn on age and MGMT status. Although I'm sure you have seen GBMs laugh in the face of RT more so than almost any other tumor. But I can't stand upsetting you. A more appropriate statement would be:

This would work if (elective) radiation worked for (subclinical) GBM

 

[Neuronix]

But I can't stand upsetting you.

 

[Palex80]

 

[elementaryschooleconomics]

How I know @Palex80 didn't train in America:

 

[CurbYourExpectations]

 

[CurbYourExpectations]

 

[CurbYourExpectations]

 

[CurbYourExpectations]

 

[RickyScott]

Radonc applicants 2022

 

[medgator]

Radonc applicants 2022
View attachment 349257

Was thinking more along the lines of

 

[medgator]

Maybe it belongs in the Twitter thread also?

 

[tjquinn]

 

[deleted941485]

It’s important that we suffer…for the good of the patient ofcourse.

 

[TheWallnerus]

View attachment 349761

I mean, there is data for 48 fractions…

 

[Mandelin Rain]

Been that kind of day.

 

[TheWallnerus]

View attachment 349872
Been that kind of day.

I would definitely fail hard if I tried to change your mind on this.

 

[medgator]

View attachment 349872
Been that kind of day.

Just finished my last IMRT medical necessity note of the day.... Very gratifying

 

[OTN]

View attachment 349872
Been that kind of day.

I'm not going to try to change your mind about radonc, but I also don't think it's an outlier in this aspect when it comes to medical specialties.

 

[TheWallnerus]

Just finished my last IMRT medical necessity note of the day.... Very gratifying

Weekly OTV: needs no medical necessity note (is it really medically necessary?)

Weekly physics: needs no medical necessity note (is it really medically necessary?)

Doing a basic dose calc on every beam: needs no medical necessity note (is it really medically necessary?)

Doing IMRT: needs a medical necessity note (most of the time inherently medically necessary and this is backed by literature, disease site, "industry standards," the plan itself, etc.)

Doing a second IMRT plan: needs medical necessity note (the 2nd CT can appear wildly different than the 1st... but still, you need to dictate a note and not just rely on the medical record which literally shows the CTs being different)

MY POINT IS... "they" could take medical necessity notes wayyyy farther than what we require now & thank god they don't.

 

[Gfunk6]

 

[deleted941485]

View attachment 349920

We’re gonna run an experiment.

The predetermined conclusion it will save money because well we are going to pay you less.

Oh and also you have to be in it if you’re picked.

I don’t understand why people get so hung up on “at least I don’t have to document anymore”. Yeah my center loses millions and my job is on the chopping block “BUT THE DOCUMENTATION BURDEN IS SOO MUCH LESS”. As usual the point is lost on so many.

 

[TheWallnerus]

We’re gonna run an experiment.

The predetermined conclusion it will save money because well we are going to pay you less.

Oh and also you have to be in it if you’re picked.

I don’t understand why people get so hung up on “at least I don’t have to document anymore”. Yeah my center loses millions and my job is on the chopping block “BUT THE DOCUMENTATION BURDEN IS SOO MUCH LESS”. As usual the point is lost on so many.

Falling out of an airplane without a parachute... "This brisk wind is really clearing my sinuses"

 

[deleted941485]

Falling out of an airplane without a parachute... "This brisk wind is really clearing my sinuses"

Clearly a benefit but we will need a subgroup analysis to really tease out who benefits.

Not the total depletion of epinephrine and norepinephrine as certain death comes

 

[OTN]

 

[temujim]

View attachment 350154

MR Guided traditional fractionation with adaptive. Squeeze while the squeezing is good.

 

[medgator]

MR Guided traditional fractionation with adaptive. Squeeze while the squeezing is good.

Plus spaceOAR just in case. What's another $4k between friends

 

[seper]

Is there a patient getting 45 fractions of prostate RT on an MR-linac? I bet there is

 

[Ray D. Ayshun]

This meme just came upon me. which is only a slight modification of what was actually said

 

[deleted1111261]

This meme just came upon me. which is only a slight modification of what was actually saidView attachment 350385

😂

 

[evilbooyaa]

Is there a patient getting 45 fractions of prostate RT on an MR-linac? I bet there is

*45 fx prostate RT with daily adaptation on MR-linac with submission of a fresh 77301 each time

 

[thecarbonionangle]

*45 fx prostate RT with daily adaptation on MR-linac with submission of a fresh 77301 each time

Is this actuay being paid out as such? Just because it is “billed” dont mean you get paid!

 

[jondunn]

Is there a patient getting 45 fractions of prostate RT on an MR-linac? I bet there is

Spratt said there’s a reason private groups are buying mri Linacs

He said it - but I’m not aware of many (or any?) yet

 

[RickyScott]

Spratt said there’s a reason private groups are buying mri Linacs

He said it - but I’m not aware of many (or any?) yet

Genesis is buying some.

 

[deleted941485]

Genesis is buying some.

Wonder how they’ll bill for it.

 

[elementaryschooleconomics]

Genesis is buying some.

I could be thinking of a different group but - by "some", didn't they buy like, 12? I'm told they bought so many they essentially got a "bulk discount".