Rad Onc Twitter

[elementaryschooleconomics]

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Jokes aside, hiring Jay was an amazing business move, ESPECIALLY in the Florida private market.

 

[jondunn]

 

[evilbooyaa]

If you think the vitriol is high from radonc towards urology from time to time, wait until they start giving systemic treatment for metastatic prostate cancer like they do in this town. That gives medical oncologists the big mad.

They're already doing Abi/Xtandi relatively poorly and anecdotally making patients CRPC faster than Med Oncs.

 

[BobbyHeenan]

They're already doing Abi/Xtandi relatively poorly and anecdotally making patients CRPC faster than Med Oncs.

Oh yeah.

There have been blow ups in urology vs. med onc when urology sent patient for a taxane consideration then med onc takes over the ADT/xtandi, etc when urology wanted to be the ones doing that. It is especially bad with the huge urology groups that have drug/pharmacy contracts.

 

[Palex80]

If "Fewer treatments = good for society = likely less number of RO needed", then

"likely less number of RO needed" = "good for society"?

 

[TheWallnerus]

If "Fewer treatments = good for society = likely less number of RO needed", then

"likely less number of RO needed" = "good for society"?

Sometimes people just don't think it through the whole way, logically speaking

 

[Lamount]

If "Fewer treatments = good for society = likely less number of RO needed", then

"likely less number of RO needed" = "good for society"?

Not sure '=' is correct from a symbolic logic perspective, '->' would probably be more appropriate (i.e. 'if x, then y').

...but your point is well taken haha

 

[deleted941485]

If "Fewer treatments = good for society = likely less number of RO needed", then

"likely less number of RO needed" = "good for society"?

It’s like they have a thought and it goes directly to Twitter without any hesitation.

 

[jondunn]

 

[deleted1111261]

I vote that with rando posts about rando tweets, must provide some analysis.

 

[medgator]

I vote that with rando posts about rando tweets, must provide some analysis.

@evilbooyaa @Neuronix ?

 

[jondunn]

Medgator do you guys do weekly

 

[Neuronix]

@evilbooyaa @Neuronix ?

I vote meh on this one. We try to be light on the censorship. If someone is being disruptive by posting weird out of context stuff let me know.

 

[medgator]

Medgator do you guys do weekly

Been doing it for months now, ever since abstract hit.... Also do weekly on my hpv+ pts

 

[jondunn]

love weekly! makes a big difference, specifically in nausea/lack of appetite I find

 

[medgator]

I vote meh on this one. We try to be light on the censorship. If someone is being disruptive by posting weird out of context stuff let me know.

How about we keep this thread rad onc focused? We can post about the bad job market in other specialties in their respective forums?

 

[jondunn]

Noted disparities expert Dan Spratt

 

[TheWallnerus]

Noted disparities expert Dan Spratt

I mean he is kind of an expert on the disparities between all the incorrect opinions and his own.

 

[jondunn]

 

[deleted941485]

I mean he is kind of an expert on the disparities between all the incorrect opinions and his own.

Disparities in Muscle mass. Maybe that’s his next talk

 

[maxxor]

Disparities in Muscle mass. Maybe that’s his next talk

His next big paper: body comp / morphometric analysis as a predictor for grade 3 toxicity.

 

[deleted941485]

His next big paper: body comp / morphometric analysis as a predictor for grade 3 toxicity.

ASTRO podium presentation

 

[OTN]

Disparities in condiment use among radiation oncology department chairs and academic productivity: a case-control study

 

[Mandelin Rain]

Disparities in condiment use among radiation oncology department chairs and academic productivity: a case-control study

I save at least 200 hours a year by not applying ketchup/catsup to food.

 

[thecarbonionangle]

“How I was able to bench three plates and help minorities by skipping ketchup” TED talk coming soon is what im hearing.

 

[Ray D. Ayshun]

I save at least 200 hours a year by not applying ketchup/catsup to food.

I'm writing up a study comparing Qalys of no ketchup vs glass bottle ketchup vs squeeze bottle ketchup vs ketchup packet use. No ketchup and packets neck and neck for worst outcomes.

 

[TheWallnerus]

I save at least 200 hours a year by not applying ketchup/catsup to food.

“A six-year study of 48,000 male health professionals, conducted by Harvard Medical School in 1995, found that consuming tomato products more than twice a week, as opposed to never, was associated with a reduced risk of prostate cancer of up to 34 per cent.”

Pretty hypocritical Dan

 

[deleted1111261]

I save at least 200 hours a year by not applying ketchup/catsup to food.

That is such an odd behavioral quirk

 

[thecarbonionangle]

Perhaps one of our ketchup experts can weigh in but is the glass bottle ketchup akin to mexican coca cola, made with sugar cane and not high fructose corn syrup?

 

[Ray D. Ayshun]

“A six-year study of 48,000 male health professionals, conducted by Harvard Medical School in 1995, found that consuming tomato products more than twice a week, as opposed to never, was associated with a reduced risk of prostate cancer of up to 34 per cent.”

Pretty hypocritical Dan

Did they do subgroups? Wondering the role race played.

 

[metallica81788]

Did they do subgroups? Wondering the role race played.

Also brand analysis - Heinz v Hunt's v store brand

 

[TheWallnerus]

Did they do subgroups? Wondering the role race played.

IDK! But I legit had a prostate attending in residency who was Richard Nixon level pro-ketchup with his patients.

 

[Ray D. Ayshun]

IDK! But I legit had a prostate attending in residency who was Richard Nixon level pro-ketchup with his patients.

Po or pr?

 

[Mandelin Rain]

“A six-year study of 48,000 male health professionals, conducted by Harvard Medical School in 1995, found that consuming tomato products more than twice a week, as opposed to never, was associated with a reduced risk of prostate cancer of up to 34 per cent.”

Pretty hypocritical Dan

That's called job security.

 

[jondunn]

Disparities in condiment use among radiation oncology department chairs and academic productivity: a case-control study

'Pass on the Mustard or you won't Pass Muster: The Dan Spratt Experience'

 

[deleted1116990]

I save at least 200 hours a year by not applying ketchup/catsup to food.

Huge meme potential here. Unfortunately I am far too technology inept/lazy.

 

[Ray D. Ayshun]

Huge meme potential here. Unfortunately I am far too technology inept/lazy.

Sticking with simpsons, also think radonc twitter/sdn meme potential here:

 

[thecarbonionangle]

The swamp is overflowing out of the toxic sludge toilet and the boomer “leaders” unable to stop it. Love it!

 

[jondunn]

The swamp is overflowing out of the toxic sludge toilet and the boomer “leaders” unable to stop it. Love it!

Yesterday’s ‘young kid’ is today’s ‘leader’

It’s a new era. Dennis H is nowhere to be heard from.

 

[deleted1116990]

That is such an odd behavioral quirk

In a prior career I worked with an old engineer who literally designed the main product the company sold. He wore the same pair of baggy cargo pants every day.

He drove an old beat up Volkswagen rabbit and would park it at very back of company's parking lot (parking lot was on a hill). At the end of the day he would let the car coast down to the bottom without the engine running, got it up to maybe 20-30 mph, then would throw the clutch out violently starting the thing in a cloud of smoke and nearly running over everybody.

Finally, somebody asked him why the hell he did this and he answered like it was the most obvious thing ever "SAVES GAS THAT WAY"

He was technically correct. I feel like everyone's got this story about this person who was "technically" the smartest person they've ever known in their life.

 

[jondunn]

Simul why would you say something so controversial? A lot of people are very upset!

 

[jondunn]

Low dose bath and malignancy risk is a common argument made by proton enthusiasts/****s

 

[TheWallnerus]

Low dose bath and malignancy risk is a common argument made by proton enthusiasts/****s

The ideas that second malignancy risk is correlated with dose and that secondary malignancy risk is higher because of increased low dose region volume can not mathematically peacefully coexist.

 

[Ray D. Ayshun]

What percentage of childhood cancers occur in children with germline mutations in something that has a role in DNA repair? Not to say the authors are saying this should be extrapolated to justifying protons in prostate, but it's kind of unfair to make an argument that second cancer risk in kids has anything to do with adults. OTOH, the low dose bath in adults is pretty much equivalent to the prescription dose in kids.

 

[Lamount]

The ideas that second malignancy risk is correlated with dose and that secondary malignancy risk is higher because of increased low dose region volume can not mathematically peacefully coexist.

I am gonna push back on this one...

Secondary malignancy risk is likely (roughty) proportional to both dose and the volume of tissues irradiated.

If two plans have the same volume in the high dose region, but one has minimal (if any) dose elsewhere, while the other has a large volume getting 2-5 Gy... the second plan likely has a higher chance of causing a secondary malignancy.

Just because the risk increases with dose, it doesn't mean that low dose is irrelevant, especially if there is a large volume impacted. Otherwise, why would we even bother having the X-ray techs go in another room?

 

[TheWallnerus]

Secondary malignancy risk is likely (roughty) proportional to both dose and the volume of tissues irradiated

Ok thanks for push back 🙂

What is the data for the bolded. Intuitively it makes sense. But sometimes intuition regarding "volume of tissues" (ie number of cells) is not correct:

 

[jondunn]

 

[Lamount]

Ok thanks for push back 🙂

What is the data for the bolded. Intuitively it makes sense. But sometimes intuition regarding "volume of tissues" (ie number of cells) is not correct:

hmmm... I am to find data supporting the notion that tissues that see radiation dose are more likely to get radiation-induced cancers than tissues that don't.

Can I cite stochastic statistics? Or this paper (off the top of my search engine)

 

[radiation]

hmmm... I am to find data supporting the notion that tissues that see radiation dose are more likely to get radiation-induced cancers than tissues that don't.

Can I cite stochastic statistics? Or this paper (off the top of my search engine)

I am gonna push back on this one...

Secondary malignancy risk is likely (roughty) proportional to both dose and the volume of tissues irradiated.

If two plans have the same volume in the high dose region, but one has minimal (if any) dose elsewhere, while the other has a large volume getting 2-5 Gy... the second plan likely has a higher chance of causing a secondary malignancy.

Just because the risk increases with dose, it doesn't mean that low dose is irrelevant, especially if there is a large volume impacted. Otherwise, why would we even bother having the X-ray techs go in another room?

Radiation-induced second cancers: the impact of 3D-CRT and IMRT - PubMed

Information concerning radiation-induced malignancies comes from the A-bomb survivors and from medically exposed individuals, including second cancers in radiation therapy patients. The A-bomb survivors show an excess incidence of carcinomas in tissues such as the gastrointestinal tract, breast...

pubmed.ncbi.nlm.nih.gov

Altogether, IMRT is likely to almost double the incidence of second malignancies compared with conventional radiotherapy from about 1% to 1.75% for patients surviving 10 years. The numbers may be larger for longer survival (or for younger patients), but the ratio should remain the same.

Eric Hall wrote this editorial years ago and was basically debunked. The volume of tissues getting low dose radiation is almost certainly higher in IMRT/VMAT plans than 3D but that increased secondary cancer risk has not borne out in modern data. Probably why every peds site outside of Wilms is mostly still getting IMRT (if not going for protons)

Also with protons, people continue to perpetuate the assumption that the high dose is the always same, when its clearly not. There was a whole era of passively scattered protons where the high dose conformality was terrible. Even with pencil beam and robustness you still have to account for set up error + range uncertainty. If high dose RT is the main cause of secondary malignancy, you could even argue it could be worse with a bad proton plan (passively scattered, large target)

 

[jondunn]