Rad Onc Twitter

[RadOncDoc21]

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Let's say the results are real and side effects are less. My issue is what it will do for the cost of healthcare and how are we supposed to give patients the "standard of care" if they can't afford it or can't travel to a proton facility or if insurance just flat out says no? They could just say it's a reasonable alternative for patients but as an option and should not be the preferred treatment.

 

[Gfunk6]

Let's say the results are real and side effects are less. My issue is what it will do for the cost of healthcare and how are we supposed to give patients the "standard of care" if they can't afford it or can't travel to a proton facility or if insurance just flat out says no? They could just say it's a reasonable alternative for patients but as an option and should not be the preferred treatment.

What MDACC and their like will never say, but is undoubtedly true (take a look at the demographics that Palex posted), is that protons are for the rich elite. Either people who are comfortably wealthy with good insurance who can afford to spend a couple of months in Houston or the obscenely rich for whom money is never an object.

 

[TheWallnerus]

Let's say the results are real and side effects are less. My issue is what it will do for the cost of healthcare and how are we supposed to give patients the "standard of care" if they can't afford it or can't travel to a proton facility or if insurance just flat out says no? They could just say it's a reasonable alternative for patients but as an option and should not be the preferred treatment.

Just try and offer the protons. Really hype them. Put the patient on a guilt trip to make a proton trip. And then if all that fails, you did the right thing and the burden of feeling like you have mistreated the patient is removed. Let the insurance thing fall on the academic center. (If it’s Medicare, no problemo.) I’m sure if they can’t get protons approved they will send the patient back to you for IMRT.

 

[RadOncDoc21]

Just try and offer the protons. Really hype them. Put the patient on a guilt trip to make a proton trip. And then if all that fails, you did the right thing and the burden of feeling like you have mistreated the patient is removed. Let the insurance thing fall on the academic center. (If it’s Medicare, no problemo.) I’m sure if they can’t get protons approved they will send the patient back to you for IMRT.

Actually seeing a patient who has a GBM demanding they receive protons. I'm sure we all have had these experiences because they all fed false hopes of a cure with protons and nothing else is acceptable.

 

[RadOncDoc21]

Just try and offer the protons. Really hype them. Put the patient on a guilt trip to make a proton trip. And then if all that fails, you did the right thing and the burden of feeling like you have mistreated the patient is removed. Let the insurance thing fall on the academic center. (If it’s Medicare, no problemo.) I’m sure if they can’t get protons approved they will send the patient back to you for IMRT.

The centers around here will kidnap my patients even if they were to give IMRT. They use protons as a marketing tool to get them through the door. By the time I see them again, they were already told how much better their Trubeam is compared to mine.

 

[OTN]

A large cancer center just told a patient their right breast radiation was better than mine, so it definitely was worth leaving their hometown and getting a hotel for a few weeks to leave their family with young children. Not even the machine. Just the whole kit n' kaboodle. I would prefer to have been surprised by the news. I am not.

 

[RadOncDoc21]

A large cancer center just told a patient their right breast radiation was better than mine, so it definitely was worth leaving their hometown and getting a hotel for a few weeks to leave their family with young children. Not even the machine. Just the whole kit n' kaboodle. I would prefer to have been surprised by the news. I am not.

Oh the centers here always get a new set of imaging studies and work up because their radiologists, pathologists, staff, labs and machines are the best!

 

[winstonfoot5]

Didnt you hear?? "Local doctors can't keep up"!

https://www.wsj.com/health/healthcare/cancer-treatment-personalized-doctors-170f4be6

A large cancer center just told a patient their right breast radiation was better than mine, so it definitely was worth leaving their hometown and getting a hotel for a few weeks to leave their family with young children. Not even the machine. Just the whole kit n' kaboodle. I would prefer to have been surprised by the news. I am not.

 

[MegaVoltagePhoton]

I find the trial to be hard to believe too, but are some of you being intentionally obtuse?

The abstracts says "a new standard of care" treatment, not "the new standard of care" treatment. They're not overselling the results in the abstract.

 

[winstonfoot5]

Def a fair question to ask and want to avoid piling on. Personally, I would have preferred the below, but maybe we are splitting hairs:

Interpretation
IMPT showed non-inferiority to IMRT for progression-free survival and reduced high-grade toxicity relative to IMRT. Treatment-related and post-progression deaths occurred more frequently with IMRT. IMPT is a standard-of-care treatment option for patients with oropharyngeal cancer.

Theirs:
Interpretation
IMPT showed non-inferiority to IMRT for progression-free survival, improvement in overall survival, similar disease control, and reduced high-grade toxicity relative to IMRT. Treatment-related and post-progression deaths occurred more frequently with IMRT. IMPT is a new standard-of-care treatment option for patients with oropharyngeal cancer.

I find the trial to be hard to believe too, but are some of you being intentionally obtuse?

The abstracts says "a new standard of care" treatment, not "the new standard of care" treatment. They're not overselling the results in the abstract.

 

[RadOncDoc21]

I find the trial to be hard to believe too, but are some of you being intentionally obtuse?

The abstracts says "a new standard of care" treatment, not "the new standard of care" treatment. They're not overselling the results in the abstract.

I mean we all know what happens next.

 

[Palex80]

I mean we all know what happens next.

😛 😛 😛