Rad Onc Twitter

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medgator said:


Pretty sure John Suh wasn't tweeting about MS4s a few years ago.
Click to expand...

Oh look, another one... Guarantee every US MD/DO rotating through CCF rad onc is getting a chairman tweet shout-out. Might even start happening to FMGs rotating through next year if they don't match well

 


#innovationinradonc

We truly are ruined…
The nominees for this years ESTRO poster prize are:

1. Sonething that‘s usually done in a few places in the country or the continent, if one‘s lucky.
2. Surgical outcomes? Hello? This is a radonc conference
3. Spacy stuff that may work but noone uses?
4. Mouth germs
5. Race to the bottom in fractions.
 
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Palex80 said:


#innovationinradonc

We truly are ruined…
The nominees for this years ESTRO poster prize are:

1. Sonething that‘s usually done in a few places in the country or the continent, if one‘s lucky.
2. Surgical outcomes? Hello? This is a radonc conference
3. Spacy stuff that may work but noone uses?
4. Mouth germs
5. Race to the bottom in fractions.
Click to expand...

Are we making you more pessimistic?!
 
Palex80 said:


#innovationinradonc

We truly are ruined…
The nominees for this years ESTRO poster prize are:

1. Sonething that‘s usually done in a few places in the country or the continent, if one‘s lucky.
2. Surgical outcomes? Hello? This is a radonc conference
3. Spacy stuff that may work but noone uses?
4. Mouth germs
5. Race to the bottom in fractions.
Click to expand...

What the heck, you're really not exaggerating:

1630175297503.png
 
I think he’s saying you don’t need an ITV bc his MRI linac tracks the GTV? I don’t know.

Im not completely sure I buy that a well done gated (or breath hold ) treatment would be causing more clinically significant lung damage.

and the case in Percy Lees slide looked to me like the once-in-a-year (?career?) peritoneal SBRT case.

I bet if you do a ton of pancreas SBRT that mri linac is awesome….but I’m skeptical it moves the needle in lung or prostate for all but a few centers with massive patient volumes.
 
medgator said:


Veterans definitely getting good care by ignoring ITV. If nothing, it's definitely quicker and makes sure the team is out at 429pm sharp
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Start walking out at around 415, go take a piss, slow walk towards the front and at around 429 step into the parkinglot. Been to a VA? You get it. Nothing good ever happens at a VA. The government is here to help!
 
BobbyHeenan said:
I think he’s saying you don’t need an ITV bc his MRI linac tracks the GTV? I don’t know.

Im not completely sure I buy that a well done gated (or breath hold ) treatment would be causing more clinically significant lung damage.

and the case in Percy Lees slide looked to me like the once-in-a-year (?career?) peritoneal SBRT case.

I bet if you do a ton of pancreas SBRT that mri linac is awesome….but I’m skeptical it moves the needle in lung or prostate for all but a few centers with massive patient volumes.
Click to expand...
Peritoneal disease is often oligometastatic
 
medgator said:
Pretty much the basis for why GynOncs go nuts on advanced ovarian cases surgically
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Bill Hoskins is from my hometown in TN (pop 297)... and his brother was my HS principal and math teacher (I guess I just dox'd myself)... and he (Bill, not his bro... his bro lost an eye from a Viet Cong sniper) was the OG on "going nuts" in ovarian. We had a lot of discussions about it.

Amazon product ASIN 0781746892
 
TheWallnerus said:
We really need to look at that single drop of Tc99m to the nipple at time of surgery idea. I think it will be non-inferior to PBI. Could be so many things non-inferior to PBI: observation, prayer, yoga, TARGIT…
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If they are getting Tc99m sentinel node mapping, they have already gotten their radiotherapy.
 
TheWallnerus said:
We really need to look at that single drop of Tc99m to the nipple at time of surgery idea. I think it will be non-inferior to PBI. Could be so many things non-inferior to PBI: observation, prayer, yoga, TARGIT…
Click to expand...
Noninferiority trials are the easiest of all to do and the ones most likely to meet their goal. They show noninferiority approximately 80% of the time. Interesting that the RTOG breast noninferiority trial was negative.
 
thecarbonionangle said:
Start walking out at around 415, go take a piss, slow walk towards the front and at around 429 step into the parkinglot. Been to a VA? You get it. Nothing good ever happens at a VA. The government is here to help!
Click to expand...
Inefficiency aside, the VA actually does a uniquely good job for a large chunk of its patients. Namely the psychiatrically co morbid who don’t interact well with the medical system. Show me a pcp who will send you letters to get you to appointments, arrange your transport, have a social worker reach out to you to facilitate the above, get you in same day or next day to a psychiatric treatment team (with psychiatrist, psychopharmacist, and therapist) and I’ll eat my hat. Those patients fall through the cracks in the real world. In the VA, if humanly possible, they get good care.
It takes a lot of suboptimal xrt/surgery/specialty care to counteract that.
 
I think it is VA dependent. In medschool, I found that VA I rotated through delivered excellent care. Regarding Drew’s va- the west la va in particular has a very good rep- although he may be looking to change that.
 
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RickyScott said:
I think it is VA dependent. In medschool, I found that VA I rotated through delivered excellent care. Regarding Drew’s va- the west la va in particular has a very good rep- although he may be looking to change that.
Click to expand...
Maybe he wants to bring the Atlanta VA’s reputation to West LA.
 
I've treated 9 separate lung metastases (metachronously, naturally) in a colon cancer patient, and I did use an ITV, and he's still doing just fine. I have treated many, many patients with SBRT to 4+ lung lesions, with an ITV, and they do just fine.

Having said that, I do like to defend the VA, as quality studies continuously show they do pretty well, actually:

www.va.gov

VA.gov | Veterans Affairs

Apply for and manage the VA benefits and services you’ve earned as a Veteran, Servicemember, or family member—like health care, disability, education, and more.
www.va.gov www.va.gov
 
RadOncDoc21 said:
I feel like they are speaking another language. Is this how academia attacks each other? I’m not sure if they are giving each other compliments or fighting or is everything extra passive aggressive?
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You don't need to defend everything publicly. She's implying to talk to her directly, not over twitter.


Story goes there was an ASTRO president at one point who was open to making some major billing changes but was worried he would literally be killed if he made major effort in that direction.
 
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Hmm. I think they are truly joking and are friends making an odd joke that I don’t completely understand ?
 
StIGMA said:
extra passive aggressive there with Sue. You don't need to defend everything publicly. She's implying to talk to her directly, not over twitter.


Story goes there was an ASTRO president at one point who was open to making some major billing changes but was worried he would literally be killed if he made major effort in that direction.
Click to expand...
And instead the major billing changes got foisted on us from the outside.
 
medgator said:
Kinda like supervision regulations. I sense a pattern here....
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RO is weak and dying. Least amount of muscle to fight it so that’s why we are first. You have no control over this. It isn’t even worth continuing to think about.
 
RadsWFA1900 said:
RO is weak and dying. Least amount of muscle to fight it so that’s why we are first. You have no control over this. It isn’t even worth continuing to think about.
Click to expand...
If only we didn't spend so much time mentally masturbating over who can remember the pCR rates from the most trials.

"I know the pCR rates from 46 breast trials!"

"Pfft, only 46? I know the rates from 89!"

You could be the smartest RadOnc alive, but it doesn't matter if you can't find a job to deploy that knowledge.
 
elementaryschooleconomics said:
If only we didn't spend so much time mentally masturbating over who can remember the pCR rates from the most trials.

"I know the pCR rates from 46 breast trials!"

"Pfft, only 46? I know the rates from 89!"

You could be the smartest RadOnc alive, but it doesn't matter if you can't find a job to deploy that knowledge.
Click to expand...
This is the only way to justify your existence if you are a self designated “breast expert”, …or run a radiation elimination/omission trial.
 
so ... someone let me know that I'm apparently becoming a "topic of conversation" here, sigh
I am not sure if this is a good idea or not, because I really wonder whether explaining all of this is just going to backfire but to clear up the record for those who don't know me, i email/text/talk to Kavanagh (and Spratt) fairly frequently and yes we do joke around a lot and there is a lot of interpersonal interaction that is not on Twitter
I guess sarcasm or poking/joking on Twitter can definitely be misinterpreted so maybe i'll unfortunately have to restrain myself, I really didn't want so-called "visible leadership" to change my relationships or personality style but i am starting to see it very unfortunately and inevitably does because people judge things a lot and somewhat harshly based on parsing of specific words - I really don't like the silent forbidding "chairperson" style but i am sadly starting to see why people retreat to that because it is "safer"
i would caution everyone that Twitter is not a good reflection of reality - it's decent for rapid dissemination of information but not much else IMHO - the short character limit is something I struggle with and the back and forth 'gotcha' vibe over there are a problem for me
I would also say that the aspects of SDN that I genuinely appreciate are the in depth discussions and insights which in some cases are truly remarkable, but the personality/word by word parsing out of hypothesized disputes and relationships often sounds sort of far fetched -- all of you I am sure are aware that human relationships are complex
just my two cents here - I realize that by virtue of my "positions" many of you will never trust or respect me and I accept that because i consider myself incredibly fortunate just to get to spend time on things I really believe in, it is the only real reward of academia for me and I have walked into a lot of stuff sheerly out of dumb luck as well as objectively harsh self sacrifice in the trenches for most of the best years of my adult life, so... i accept all of this as the price of the service I believe in - it is sort of unfortunate tho because i hoped to highlight and focus on the positives from this forum (and other social media), which I truly believe do exist despite many peers' feelings to the contrary and the many apparent negatives
Well, continue on! Hope to chat again soon, maybe about more substantive things other than my supposed passive aggressive personality LOL (I am actually somewhat well known for being more forthright than most - at least that's what I've been told, somewhat negatively at times in my personnel evaluations)
🙂 best, Sue
 
sueyom said:
so ... someone let me know that I'm apparently becoming a "topic of conversation" here, sigh
I am not sure if this is a good idea or not, because I really wonder whether explaining all of this is just going to backfire but to clear up the record for those who don't know me, i email/text/talk to Kavanagh (and Spratt) fairly frequently and yes we do joke around a lot and there is a lot of interpersonal interaction that is not on Twitter
I guess sarcasm or poking/joking on Twitter can definitely be misinterpreted so maybe i'll unfortunately have to restrain myself, I really didn't want so-called "visible leadership" to change my relationships or personality style but i am starting to see it very unfortunately and inevitably does because people judge things a lot and somewhat harshly based on parsing of specific words - I really don't like the silent forbidding "chairperson" style but i am sadly starting to see why people retreat to that because it is "safer"
i would caution everyone that Twitter is not a good reflection of reality - it's decent for rapid dissemination of information but not much else IMHO - the short character limit is something I struggle with and the back and forth 'gotcha' vibe over there are a problem for me
I would also say that the aspects of SDN that I genuinely appreciate are the in depth discussions and insights which in some cases are truly remarkable, but the personality/word by word parsing out of hypothesized disputes and relationships often sounds sort of far fetched -- all of you I am sure are aware that human relationships are complex
just my two cents here - I realize that by virtue of my "positions" many of you will never trust or respect me and I accept that because i consider myself incredibly fortunate just to get to spend time on things I really believe in, it is the only real reward of academia for me and I have walked into a lot of stuff sheerly out of dumb luck as well as objectively harsh self sacrifice in the trenches for most of the best years of my adult life, so... i accept all of this as the price of the service I believe in - it is sort of unfortunate tho because i hoped to highlight and focus on the positives from this forum (and other social media), which I truly believe do exist despite many peers' feelings to the contrary and the many apparent negatives
Well, continue on! Hope to chat again soon, maybe about more substantive things other than my supposed passive aggressive personality LOL (I am actually somewhat well known for being more forthright than most - at least that's what I've been told, somewhat negatively at times in my personnel evaluations)
🙂 best, Sue
Click to expand...
Ha. For me and my part, I think your vibe/approach is vastly preferable to other prominent personalities in rad onc. Even when I don't quite understand what you're getting at, I still pay loose attention. Keep it weird (as you'd like). Keep it funny (you seem to be). Keep it perspicacious (you are). Respect.
 
TheWallnerus said:
Ha. For me and my part, I think your vibe/approach is vastly preferable to other prominent personalities in rad onc. Even when I don't quite understand what you're getting at, I still pay loose attention. Keep it weird (as you'd like). Keep it funny (you seem to be). Keep it perspicacious (you are). Respect.
Click to expand...
ha ha, that is funny. keep it weird. how did you know - one of my favorite slogans. likewise.
sorry to interrupt btw. you can go back to slinging at evicore.
 
RadOncDoc21 said:
I feel like they are speaking another language. Is this how academia attacks each other? I’m not sure if they are giving each other compliments or fighting or is everything extra passive aggressive?
Click to expand...

I also have no idea what that comment means. I would simply have scrolled past and not really give it another thought. I definitely gave more consideration to when Sue Yom (in what appeared to be quite seriously) asked if it was appropriate to send a Gif of a murderer like a joker to a colleague.

But alas, this comment was posted here, and it's like the bat signal that Sue Yom shows up to defend herself against literally *one* person who called it passive aggressive, and another like 4-5 folks who were just like

1631558284876.png



So idk, mang, why can't we all just get along?
 
sueyom said:
so ... someone let me know that I'm apparently becoming a "topic of conversation" here, sigh
I am not sure if this is a good idea or not, because I really wonder whether explaining all of this is just going to backfire but to clear up the record for those who don't know me, i email/text/talk to Kavanagh (and Spratt) fairly frequently and yes we do joke around a lot and there is a lot of interpersonal interaction that is not on Twitter
I guess sarcasm or poking/joking on Twitter can definitely be misinterpreted so maybe i'll unfortunately have to restrain myself, I really didn't want so-called "visible leadership" to change my relationships or personality style but i am starting to see it very unfortunately and inevitably does because people judge things a lot and somewhat harshly based on parsing of specific words - I really don't like the silent forbidding "chairperson" style but i am sadly starting to see why people retreat to that because it is "safer"
i would caution everyone that Twitter is not a good reflection of reality - it's decent for rapid dissemination of information but not much else IMHO - the short character limit is something I struggle with and the back and forth 'gotcha' vibe over there are a problem for me
I would also say that the aspects of SDN that I genuinely appreciate are the in depth discussions and insights which in some cases are truly remarkable, but the personality/word by word parsing out of hypothesized disputes and relationships often sounds sort of far fetched -- all of you I am sure are aware that human relationships are complex
just my two cents here - I realize that by virtue of my "positions" many of you will never trust or respect me and I accept that because i consider myself incredibly fortunate just to get to spend time on things I really believe in, it is the only real reward of academia for me and I have walked into a lot of stuff sheerly out of dumb luck as well as objectively harsh self sacrifice in the trenches for most of the best years of my adult life, so... i accept all of this as the price of the service I believe in - it is sort of unfortunate tho because i hoped to highlight and focus on the positives from this forum (and other social media), which I truly believe do exist despite many peers' feelings to the contrary and the many apparent negatives
Well, continue on! Hope to chat again soon, maybe about more substantive things other than my supposed passive aggressive personality LOL (I am actually somewhat well known for being more forthright than most - at least that's what I've been told, somewhat negatively at times in my personnel evaluations)
🙂 best, Sue
Click to expand...

Thank you for the kind comments on this non-peer reviewed venue. If only the dreaded Reviewer #2 would be so kind!
 
we are putting some little incentives into the system to try to make the reviewers and associate editors happier (soon to come!), so maybe it will work out better next time - and also installing some additional gentle oversight so that the reviewing is a little bit more regularized and what is needed is more clear - although I think it's pretty good for the most part

again, very sorry to distract - and please do go back to the evicore convo, I was sort of enjoying that - don't know if any of you saw Rahul Tendulkar's thread that led to ideas about dialing patients into peer to peer calls and/or making transcripts available to patients, but there's one example where the crazy back and forth of Twitter actually produced something highly original
 
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sueyom said:
we are putting some little incentives into the system to try to make the reviewers and associate editors happier (soon to come!), so maybe it will work out better next time - and also installing some additional gentle oversight so that the reviewing is a little bit more regularized and what is needed is more clear - although I think it's pretty good for the most part

again, very sorry to distract - and please do go back to the evicore convo, I was sort of enjoying that - don't know if any of you saw Rahul Tendulkar's thread that led to ideas about dialing patients into peer to peer calls and/or making transcripts available to patients, but there's one example where the crazy back and forth of Twitter actually produced something highly original
Click to expand...

Not to **** on Tendulkar, but we discussed that exact premise a few months ago on this forum during a discussion of how to fight EviCore. It's within the private forum, one I would encourage you to PM Neuronix to get access to.

There are a lot of things discussed in radonc twitter that are basically SDN talking points, usually done anywhere between 3 months to 5 years prior, if one can appropriately filter those threads from the remainder of the negativity in regards to SDN.
 
sueyom said:
don't know if any of you saw Rahul Tendulkar's thread that led to ideas about dialing patients into peer to peer calls and/or making transcripts available to patients,
Click to expand...
Make sure if you're still editor and an article on this gets in Red J they give credit to the true originator of this idea.

Wouldn't want him to be the Jocelyn Bell of the "patients on P2Ps" idea...
 
TheWallnerus said:
Make sure if you're still editor and an article on this gets in Red J they give credit to the true originator of this idea.

Wouldn't want him to be the Jocelyn Bell of the "patients on P2Ps" idea...
Click to expand...
thank you for that link, that is a truly interesting story and the joy division connection is wild
you do realize that if you've locked down an idea inside a private forum (or even put it on a public forum) and discussed it using anonymous names, it's pretty hard to attribute? it's kind of like you put an idea on a piece of paper and stuck it inside a balloon or multiple balloons with no signed note - can't exactly call foul if someone becomes interested and tries to move it forward, right?
i don't personally think anything I say or do on social media remains in my control, had to accept that as the precondition of the Internet
 
sueyom said:
you do realize that if you've locked down an idea inside a private forum (or even put it on a public forum) and discussed it using anonymous names,
Click to expand...
Jocelyn Bell should give an ASTRO key note!

(*Was referring to the guy on twitter who came up w/ idea on Tendulkar thread, not in the pvt forum here... but both are the same heh)
 
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