Rad Onc Twitter

  • Thread starter Thread starter deleted1002574
  • Start date Start date
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
NotMattSpraker said:
View attachment 366177


I hate how I work hard to try to reduce misinformation about radiation in my local environment, teaching patients and referrings... and then we have these idiots calling from inside the house.

This is pathetic.
Click to expand...
To be honest, I think the National Association of Proton Therapy is Underestimating cardiac sparing. Usually I find that our left-sided proton plans are reducing LAD and mean heart dose by 90 to 95%, or more.
 
ChatGPT: "make me a picture of a cereal box called protons"

I'm sorry, as an AI language model, I don't have the capability to create visual images. However, I can describe what a cereal box called "Protons" might look like!

The front of the "Protons" cereal box would likely have a bold, eye-catching design with a science theme. It might feature images of protons or atoms, along with bright colors and graphics. The brand name "Protons" would be prominently displayed, along with a catchy slogan or tagline.

On the back of the box, there might be educational information about protons and atoms, as well as fun science facts and trivia. The ingredients and nutrition information would also be listed, along with serving suggestions and possible recipe ideas.

The cereal itself might be shaped like little balls or spheres, to mimic the shape of atoms. The flavor and color of the cereal could be fruity or sweet, with a playful nod to the science theme. Overall, "Protons" cereal would be a fun and educational way to start the day!

DAL-E sucks too:

(Guess my job is safe for now)
 

Attachments

  • protons DAL-E sucks.png
    protons DAL-E sucks.png
    1.7 MB · Views: 72
IonsAreOurFuture said:
To be honest, I think the National Association of Proton Therapy is Underestimating cardiac sparing. Usually I find that our left-sided proton plans are reducing LAD and mean heart dose by 90 to 95%, or more.
Click to expand...
Not if you put in a heart block, which you should in the majority of cases. (For most upper outer tumors I expand the lad by 1.5 to 2 cm and don’t contour any ptv over this oar for an imrt plan) Also, the small amount of proton xrt that hits the lad should be in the spread out Bragg peak where it is giving a lot more damage than the nominal dose conveys due to higher let/bed. If protons are fracturing ribs, I hate to think what they do to the lad.
 
Last edited:
IonsAreOurFuture said:
To be honest, I think the National Association of Proton Therapy is Underestimating cardiac sparing. Usually I find that our left-sided proton plans are reducing LAD and mean heart dose by 90 to 95%, or more.
Click to expand...
That vast majority of breast cancer patients present at stage 0/1 when partial breast should be the treatment. Whole breast RT for almost all stage 0/1 is horrible overkill; partial breast XRT spares heart and LAD much better than whole breast proton even. The amount of whole breast proton treatment of DCIS and Stage 1 disease, even in the age 60 plus crowd, is insane, shameful, or both.
 
TheWallnerus said:
That vast majority of breast cancer patients present at stage 0/1 when partial breast should be the treatment. Whole breast RT for almost all stage 0/1 is horrible overkill; partial breast XRT spares heart and LAD much better than whole breast proton even. The amount of whole breast proton treatment of DCIS and Stage 1 disease, even in the age 60 plus crowd, is insane, shameful, or both.
Click to expand...
proton centers claim the “need” for whole breast all the time in stage I/dcis so they can justify the protons with comparison plans
 
RickyScott said:
proton centers claim the “need” for whole breast all the time in stage I/dcis so they can justify the protons with comparison plans
Click to expand...
Comparison plans don't help much if a payor clearly states protons are not covered in breast Ca
 
seper said:
Comparison plans don't help much if a payor clearly states protons are not covered in breast Ca
Click to expand...
Usually, yes… but most payors have an exception clause to cover protons for any diagnosis if comparison plans are subjectively compelling enough to the medical director’s eyes. And Medicare just covers everything. And all Medicare Advantage patients have to do is appeal.
 
fiji128 said:
Seems strange that OptumCare would actually own and run a oncology center themselves as there is no indication that they even do this type of stuff on their own main website.

Description
Optum Care is seeking for a Board-CertifiedRadiation Oncologist to join our OptumCare Cancer Care Team in Las Vegas NV. This is an outstanding opportunity for a physician who wants to remain clinically active while helping shape the future of cancer care in Southern Nevada. The Cancer Center combines expertise, compassion and understanding. We offer patient-centered care in a professional and compassionate setting. Our goal is to provide every patient and their family with top-quality care, while treating them with the respect and compassion they deserve. The ideal candidate will carry exceptional inter-personal skills with a goal of sharing a vision of unparalleled delivery of care through teamwork, collaboration, innovations, and persistence for excellence.

Position Profile:
-The Radiation Oncologist team consists of 4 Physicians
-Well established referral process with 10 Medical Oncologist as part of the group
-On average 8 to 10 new consults per week
-Pore Linear Accelerator machines
-We offer Brachy Therapy services
-Varian machines and software
-Excellent staff, nurses, and MA’s
-This is a F/T employed opportunity with benefits, 401k with match, UHG Employee Stock Purchase Plan, PTO, CME, and more.
Click to expand...
F/U on this:

Physicians, Hospitals Meet Their New Competitor: Insurer-Owned Clinics Physicians, Hospitals Meet Their New Competitor: Insurer-Owned Clinics
 
Last edited:
medgator said:
F/U on this:

Physicians, Hospitals Meet Their New Competitor: Insurer-Owned Clinics Physicians, Hospitals Meet Their New Competitor: Insurer-Owned Clinics
Click to expand...
Sounds kinda like Kaiser Permanente. They are an HMO but also have a huge number of physicians working for them and own many locations nationwide.

I don't know if it's changed, but at one point I think that all Kaiser patients had to go to a Kaiser facility for their radiation therapy, even if it was several hours away. Kind of like the VA used to be, before it liberalized community care as a choice for veterans.
 
IonsAreOurFuture said:
Sounds kinda like Kaiser Permanente. They are an HMO but also have a huge number of physicians working for them and own many locations nationwide.

I don't know if it's changed, but at one point I think that all Kaiser patients had to go to a Kaiser facility for their radiation therapy, even if it was several hours away. Kind of like the VA used to be, before it liberalized community care as a choice for veterans.
Click to expand...
That's correct although they do contract out similar to what the VA when they can't offer a similar service in their designated area.

I believe that was happening in northern California until recently when they built their own and had been advertising positions
 
Last edited:
IonsAreOurFuture said:
Sounds kinda like Kaiser Permanente. They are an HMO but also have a huge number of physicians working for them and own many locations nationwide.

I don't know if it's changed, but at one point I think that all Kaiser patients had to go to a Kaiser facility for their radiation therapy, even if it was several hours away. Kind of like the VA used to be, before it liberalized community care as a choice for veterans.
Click to expand...
In general Kaiser provides excellent care.
 
RadOncDoc21 said:
Why care about the benefits and risks of protons when people will use them anyway? Science and data are at a critical state in today’s society.
Click to expand...
can we as a field not take a second to unify and make fun of lymphoma med oncs for this before we initiate the circular firing squad routine?
 
temujim said:
can we as a field not take a second to unify and make fun of lymphoma med oncs for this before we initiate the circular firing squad routine?
Click to expand...
I mean look at the advertising… I spend at least 30 minutes explaining to every patient with cancer why they don’t need protons before I can even get started with the consult.

Reminds me of the Cancer Treatment Centers of America playbook!

mdproton.com

Advances in Proton Therapy in the Treatment of Cancer - Maryland Proton Treatment Center

The number of people diagnosed with cancer continues to rise each year. According to the American Cancer Society, 1.9 million new cancer diagnoses were expected in 2022, an increase of 6% from 2020 projections and 10.5% over 2018 figures. While cancer rates continue to climb, advances in...
mdproton.com mdproton.com

www.mdanderson.org

Two-time cancer survivor grateful for a second opinion and MD Anderson

When Bill Middelthon was diagnosed with cancer of the oral tongue, he came to MD Anderson for a second opinion that changed the course of his treatment. A few months later, he became the first patient to receive the NOVA fiducial marker technique for his second cancer diagnosis of prostate cancer.
www.mdanderson.org www.mdanderson.org

protomag.com

A Time for Protons

Proton therapy has been a cutting-edge cancer therapy for decades. Can researchers at last zero in on its best applications?
protomag.com protomag.com
 
Last edited:
CTCA went from a multi-billion dollar darling to... a cratered shell at 390m.

The pathetic nature of the radoncs that worked at CTCA were... amazing. And the shill and fringe nonsense that CTCA pushed was incredible. The founder (who was, by news reports, staunchly conservative) went thru a nasty divorce and got smoked. Double putz.

All in all, good riddance. Hopefully Hope will clean the mess up... maybe they bought an empty shell at pennies on the dollar..
 
sirspamalot said:
CTCA went from a multi-billion dollar darling to... a cratered shell at 390m.

The pathetic nature of the radoncs that worked at CTCA were... amazing. And the shill and fringe nonsense that CTCA pushed was incredible. The founder (who was, by news reports, staunchly conservative) went thru a nasty divorce and got smoked. Double putz.

All in all, good riddance. Hopefully Hope will clean the mess up... maybe they bought an empty shell at pennies on the dollar..
Click to expand...

I remember back in 97 when they were advertising on television and thinking wow that’s cool….****ing crooks
 
Fpg1245 said:
I remember back in 97 when they were advertising on television and thinking wow that’s cool….****ing crooks
Click to expand...
'97? I remember seeing their ads within the past 2 or 3 years. they seem to target ... low-information demos
(you might ask what i was doing watching fox news late at night, and the answer is elderly parents)
 
pikachu said:
they seem to target ... low-information demos
Click to expand...
I never worked there, but there used to be a regional CTCOA and I shared some patients.

Their model was standard of care with lots of superficial, service type extras or fluffy stuff. (Booking plane tickets, transpo from airport, snacks, smiles, Disney model of excellent service, excellent telephone availability, massage, yoga, etc.). Of course, positive wallet biopsy required (right insurance or cash). Radoncs that I spoke to from CTCOA were not ridiculous or anything.

Never had them provide meaningful experimental therapy for a patient or enroll patient on clinical trial to my knowledge.

Many patients love this stuff BTW. Admins will be on docs tail regarding PG scores, but often, when you get granular, it's your front office staff or a terrible telephone service that's bringing scores down. (Not that PG very meaningful).
 
sirspamalot said:
Free coffee, quality snacks and a pleasant front desk person goes a VERY LONG WAY and yet.. how many places do this despite making MILLIONS in profit every year?

Can we get coffee service?

"Can't do it bro, COVID"
Click to expand...
We do the same for staff... Cases of coke zero, coke, Frito lays, cookies etc
 
We have zero competition in the area, and I'm at (checks notes) about 20 people on treatment (highest: 24, lowest: 2) and we're busy. I am flat paid so it makes no difference financially to me but.... Staff get zinged out or shuffled elsewhere when volumes are low and its unfortunate, but they have no recourse as they either accept or move away. Feels bad man. Hospital is gonna Hospital. They stay, so it is what it is.

Patients are happy to not drive 100 miles to the next center. So, I guess no coffee and donuts it is..
 
communitydoc13 said:
Many patients love this stuff BTW. Admins will be on docs tail regarding PG scores, but often, when you get granular, it's your front office staff or a terrible telephone service that's bringing scores down. (Not that PG very meaningful).
Click to expand...
This is so true and so many places ignore it.

CTCA charged cash for all the fluffy stuff (massage, aromatherapy, etc.), correct?
 
Some CTCA docs have migrated to Genesis. One particularly egregious one I can think of.. a total clown show. Uncertain training history. Bizarre personality issues. Pure crazy (I know the entire story), also.. saw it up close, not. good. Maybe Hope booted him, dunno. Genesis will take anyone who complies.

There are some true weirdo's in our field.
 
sirspamalot said:
There are some true weirdo's in our field.
Click to expand...

This cannot be understated enough, in all generations of our field (although I think it's slowly improving)

I always found it strange that we are dealing with a vulnerable patient population yet seemingly >75% of our doctors cannot even have a normal human conversation in or out of medicine
 
I believe you meant overstated. I'm here to help.

It is -particularly- awful in academic radiation oncology. Raging narcissists who couldn't last a day in the surgical environment. Abusers having been abused, carrying on the tradition. Total psychopaths some of them. The stories..

Beware the 'small shop' looking for a replacement radonc in a smaller area "you can run the place as you see fit, I'm stepping away." Etc. All that matters is who owns what, and who really has control. If you can't get the bad apple out, the apple sauce will always be bad. The fun variant: the existing alpha looking for his biyatch. AVOID. Unless you know, you're into that sorta thing, which is fine. Everybody's fine..nothing wrong with that (ducks)..
 
radiaterMike said:
feisty conversation going down on Twitter

Click to expand...

I'm as far out of the loop as can be. No connection to MSKCC whatsoever.

However, I'm going to go out on a limb, based on this work and some cryptic remarks about their phase II prophylactic bone met trial, and infer that they are going to publish soon some dose finding immunomodulatory work that tells us that somewhere in the 7-10 Gy/fraction is ideal for stimulating an immunologic response. (Throw in their CURB trial oligoprogressive breast and lung paper for good measure).

MSKCC doing good work on the RT in metastatic disease front.
 
You must log in or register to reply here.

Similar threads

uchihastan
Rad Onc vs. Heme/Onc
Replies
18
Views
2K
medgator
M
B
Rad Onc Procedures and RVUs
Replies
35
Views
5K
CurbYourExpectations
CurbYourExpectations
D
Saving Rad Onc
2
Replies
60
Views
7K
RickyScott
R
TheWallnerus
Rad Onc is in a dark place
Replies
13
Views
3K
RickyScott
R
M
Rad Onc Oral Boards: To quote or not quote studies?
Replies
3
Views
427
evilbooyaa
evilbooyaa
Top