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.
Members don't see this ad :)
1721145307120.png


Here is the article he cited.

9 weeks of protons vs 5 days of SBRT. The only advantage of protons was that you get paid more.
 
Gfunk6 said:
View attachment 389425

Here is the article he cited.

9 weeks of protons vs 5 days of SBRT. The only advantage of protons was that you get paid more.
Click to expand...
Dear proton prostate believers,

This is selling snake oil. I mean, why not go all the way and sell gold energy rings and colloidal silver CBD compounds in the lobby wig shop to help the cancer? Maybe have a Reiki guy come once a week?

Sincerely,
Your shameless 45 fraction IMRT prostate bad guy.
 
Mandelin Rain said:
What the gist for those of us not on Elon's toy?
Click to expand...

I don't use X either, but you can see most of his posts, seems to be a guy who wears the bright red woke-style eyeglasses but surprisingly has a bone to pick about anti-hospital/ACA, regulatory capture of healthcare, cartel like practice consolidation, pro-physician ownership, price transparency, etc.

I have immediate respect for anyone (especially non-physicians) who rejects the label "provider" regardless of how stupid their eyeglasses are.
 
MidwestRadOnc said:
the bright red woke-style eyeglasses
Click to expand...
I was questioning my most recent choice in eyewear...bright red, curvy (dare say voluptuous) plastic frames...a tad feminine. I thought they might work well for me, but I wasn't sure. Imagine a middle aged bear with Chino's fashion sense...good or no?

But if they can convey wokeness! Damn... I'm all in.
 
communitydoc13 said:
I was questioning my most recent choice in eyewear...bright red, curvy (dare say voluptuous) plastic frames...a tad feminine. I thought they might work well for me, but I wasn't sure. Imagine a middle aged bear with Chino's fashion sense...good or no?

But if they can convey wokeness! Damn... I'm all in.
Click to expand...

Don't forget the rhinestone cloth mask and pink hair highlights!
 
MidwestRadOnc said:
Don't forget the rhinestone cloth mask and pink hair highlights!
Click to expand...
Just so you know who you are dealing with....I'm considering an unironic "Stay Woke" neck tattoo once I retire.

Rhinestones...yes...unfortunately, I'm way too bald for any sort of highlights.

I've decided that gleeful, inclusive, non-conformity is the way to go!
 
Members don't see this ad :)
temujim said:
View attachment 389634

From the abstract:

View attachment 389635
Click to expand...

I want to see Vinay enroll a patient to his proposed trial. “Miss, I know you’re in pain but… hear me out… what if we randomize you to nothing?”

Also, I interpreted the study as CP radiosurgery IS a palliative option. Haha they showed efficacy.

What are Lancet the way they are?
 
I need to clarify that I am a huge fan of VP for his calling out of the pseudo-scientific Covid-mitigation insanity wrt to masks and distancing mandates. But this is stupid. He’s smarter than this and knows better. Walk it back dude.
 
MidwestRadOnc said:
I need to clarify that I am a huge fan of VP for his calling out of the pseudo-scientific Covid-mitigation insanity wrt to masks and distancing mandates. But this is stupid. He’s smarter than this and knows better. Walk it back dude.
Click to expand...
What he is missing is that there are close to o downside from this approach. Did a case today.
 
RickyScott said:
What he is missing is that there are close to o downside from this approach. Did a case today.
Click to expand...
He would absolutely destroy that argument lol. It’s high dose radiation that we don’t know that’s helping, of course has risks, and importantly if patients are choosing this they may not choose something else that has more chance of helping

To be clear I offer this treatment too, just saying it’s something that is fairly easy to criticize if you’re a purist for evidence as VP is.
 
I suspect that sham RT is highly effective. For subjective measures (pain, depression) the placebo effect is real and strong and level of ritual and belief seem to matter as well.

How should we bill for it?

The trial has shown that at the very least the process of going through RT is effective.

Should negative SHAM controlled trials be kept away from the public? So as to preserve the efficacy of the sham intervention.
 
It’s a stupid comment because it is intentionally single arm with a goal of finding how well the treatment works. We know radiation to the pancreas tumor and involved nerves helps pain- we give RT for tumor caused pain all the time (in this disease, pancreatic cancer is involving the nerves). Sham RT here is unethical. You could argue they should have included a dose escalation run in since 25Gy may be unnecessary.

You have to find out the treatment effect to inform design of the randomized trial. what he is proposing is the phase 3 which the authors also propose, although his version of that is not the right arms. I wouldnt take him seriously. This is far from his first idiotic comment regarding trials.
 
Last edited:
RickyScott said:
For extreme pain, the type requireing massive doses of duragesic, I am not sure the placebo effect is real. It is reasonable to compare xrt to celiac block, but not placebo.
Click to expand...

Placebo effect in the management of chronic pain - PMC

www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov

Excellent summary of placebo effect in management of chronic pain. First key point..."It is unethical to knowingly deceive a patient into believing they are receiving an active treatment whilst offering them an inactive one".

I think it is reasonable to actively take advantage of placebo in practice , while administering a presumably active treatment that has not been subject to a sham controlled trial.
 
communitydoc13 said:

Placebo effect in the management of chronic pain - PMC

www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov

Excellent summary of placebo effect in management of chronic pain. First key point..."It is unethical to knowingly deceive a patient into believing they are receiving an active treatment whilst offering them an inactive one".

I think it is reasonable to actively take advantage of placebo in practice , while administering a presumably active treatment that has not been subject to a sham controlled trial.
Click to expand...
You have to know it’s an inactive treatment. Or that the alternative is active.

Nobody is arguing that radiation is a placebo. We believe it works in this circumstance.
 
MidwestRadOnc said:
You have to know it’s an inactive treatment. Or that the alternative is active.

Nobody is arguing that radiation is a placebo. We believe it works in this circumstance.
Click to expand...
Agree...my interpretation of the key point is that SHAM controlled trials are often morally dubious.

edit: It is likely IMO that the intervention works both because it is active and because there is a component of the placebo effect. I personally emphasize that the treatment is likely to work when administering most palliative pain XRT, because I am confident that this provides a benefit to the patient.
 
Last edited:
BobbyHeenan said:
A not so gentle reminder that the people running things at ASTRO are not only out of touch with the vast majority of radiation oncology, they're completely out of touch with a generation of people that understand online humor/memes.
Click to expand...
I have to give kudos to Todd - doing the Lord's work.
 
BobbyHeenan said:
A not so gentle reminder that the people running things at ASTRO are not only out of touch with the vast majority of radiation oncology, they're completely out of touch with a generation of people that understand online humor/memes.
Click to expand...

I cant understand why anyone would be a member. Even if you set aside the hostility, they spend a TON of money on consultants and lawyers for really dumb stuff.

I think your dollars are almost certainly better spent on literally any other society.
 
NotMattSpraker said:
I cant understand why anyone would be a member. Even if you set aside the hostility, they spend a TON of money on consultants and lawyers for really dumb stuff.

I think your dollars are almost certainly better spent on literally any other society.
Click to expand...

...and here's how it goes with *many* situations where weak kneed admins lean heavily on "consultants" *not unique to ASTRO or health care*....

Admin - we should hire a consultant

Admin to Consultant - we have this idea and we *wink wink* think your recs should be this or that. Oh BTW we will pay you a lot to do a consult on this. We may even use you in the future on some other projects that are in the works.

Consultant - results are just as you expected

Admin to everyone when they face any consequences of their decisions - yeah but the consultant said this was the way to go.


===

What exactly are we paying admins for if they turn to consultants ***without skin in the game*** for every hard decision?
 
BobbyHeenan said:
...and here's how it goes with *many* situations where weak kneed admins lean heavily on "consultants" *not unique to ASTRO or health care*....

Admin - we should hire a consultant

Admin to Consultant - we have this idea and we *wink wink* think your recs should be this or that. Oh BTW we will pay you a lot to do a consult on this. We may even use you in the future on some other projects that are in the works.

Consultant - results are just as you expected

Admin to everyone when they face any consequences of their decisions - yeah but the consultant said this was the way to go.


===

What exactly are we paying admins for if they turn to consultants ***without skin in the game*** for every hard decision?
Click to expand...

That consultant move is the biggest bunch of horse****. Seen it 1000 times.
 
BobbyHeenan said:
A not so gentle reminder that the people running things at ASTRO are not only out of touch with the vast majority of radiation oncology, they're completely out of touch with a generation of people that understand online humor/memes.
Click to expand...

I have it under good authority that Ralph Weichselbaum was the one who produced that letter
 
Where is the original parody letter? Now want to see it all the more...
 
Radonc90 said:
Does ASTRO have better things to do?

Click to expand...

Honestly? No.

They are beyond petty and egotistical. It's sad that Todd had to get a lawyer involved - I'm sure the time, stress, and money were significant.
 
Gfunk6 said:
Honestly? No.

They are beyond petty and egotistical. It's sad that Todd had to get a lawyer involved - I'm sure the time, stress, and money were significant.
Click to expand...
A little lost in all this is… the reality of the situation (apart from social media, which is never real).

And that reality is ASTRO wrote a letter to CMS that said in no uncertain terms general supervision should never be allowed in radiation clinics, and that clinics using general now should be forced with the power of federal government to change their behavior to direct supervision. And then, ASTRO made an essentially complete reversal/180 on the matter a few months later—“under the gun” of widespread outrage. But did not write another letter to CMS (as far as one knows) stating they had “changed their mind” on the whole matter.

It’s things like this that are damaging, not jokey tweets.
 
Last edited:
pikachu said:
Post no longer exists lol

Astro’s crack comms team claims another victim?
Click to expand...
That's why you guys have got to SCREENSHOT all Twitter posts. Anything that is posted on this thread is liable to be deleted shortly.
 
Gfunk6 said:
That's why you guys have got to SCREENSHOT all Twitter posts. Anything that is posted on this thread is liable to be deleted shortly.
Click to expand...
Wait guys, have to disagree with Gfunk

Don’t screenshot the fake ASTRO letter

ASTRO will attack you with trademark attorneys and have Congress subpoena you. You and Steve Bannon may then become roommates.

This is exceedingly dangerous information and digital data

You can’t be trusted with it and you can’t even trust yourself having it
 
You must log in or register to reply here.

Similar threads

B
Rad Onc Procedures and RVUs
Replies
22
Views
2K
Doctorer
D
D
Saving Rad Onc
2
Replies
61
Views
5K
anonymuncule
A
D
Future of rad onc job market
2
Replies
58
Views
5K
BobbyHeenan
B
E
Long live independent rad onc....
2
Replies
55
Views
4K
IonsAreOurFuture
I
U
Rad Onc Job Interview “test”
Replies
21
Views
2K
ramsesthenice
R
Top