Still baller though. Any case where you are offering emergent XRT is a Hail Mary type of case. But, to get it done immediately and very quickly, without utilizing a lot of resources (and a bit creatively) lets the team move on to the other options or breach the hospice discussion earlier.
On the other end of the spectrum you havent really lived until you get paid to randomly fill out a survey about which third line fake believe immunotherapy would be best.
I will never forget. Residency around 2002. I had just read about a randomized trial where palliative RT for lung cancer was given in a 17 Gy/2 fx schedule. It wowed me. We had a lady on vent knocking on deaths door and were consulted for palliative RT for huge lung mass. I begged attendings to try the dangerous, horrifying, risky 8.5 Gy per fraction treatment. The lady was almost dead so I guess that’s why they relented. Treatment delivered without difficulty.
Used to feel great, doing commando heroic inpt RT on ICU patients.
Now that I'm in a freestanding, can't treat anyone with more than a nasal cannula and honestly i think that's probably for the better based on what I've seen with those really sick pts getting RT, end of life
My hospital hates treating impatiens and I have had endless meetings over the yrs abt this. Once I gave 8.5 gy x 2 to a homeless additct on a vent and he left the hospital 2 weeks later. Guy would have been on a vent for at least 2 months before he died w/out xrt (no distant disease). I made a real effort to calculate savings, but they don’t really care. They just look at the bill and think they would have recovered it as an outpt.
What am I missing here? The SF arm isn't even using SF for early glottic cancer.
Yep, AF arm is roughly what most of us have been doing for years anyway for early stage glottic CA. (This goes back at least 12-15 years.)
The inexorable trend to eliminate as much radiation oncology as possible. Even if it is just one fraction at at time.
There's a whole branch of 'research' being done in this space from WashU.... didn't know it was even necessary to document the times I've done this lol
www.astro.org
CHART improved survival in NSCLC, the only RT dose trial in Stage III ever proven to do so
Cancer cells do not undergo mitosis during the weekend. I tell that to all my patients.
If they don't consume any sugar over the weekend, sure.
They need to get that publication out ASAPWas always skeptical of abscopal and partial metastatic ablation, particularly in unselected, asymptomatic patients.
Identifying and treating high risk, asymptomatic bone metastases is still promising.
Radiation therapy for high-risk, asymptomatic bone metastases may prevent pain and prolong life - American Society for Radiation Oncology (ASTRO) - American Society for Radiation Oncology (ASTRO)
Phase II trial suggests radiation could ward off complications of bone lesions and extend overall survival for patients with advanced cancers
Does alcohol count?
Just the "sugars" on the nutritional readout. Cancer runs on fructose and nothing else is my understanding.
Nothing some vitamin C infusions can't address
Can we please not have the enemies of 95%+ of Rad Onc (people who shill protons for all diagnoses regardless of appropriateness) leading the organization, please?
I think some of the people from upenn and maryland would disagree that “he is the nicest guy” he is driven.
I have trouble trusting those who button their entire white coat.
i don't know if i trust or really care about what UPENN or Marylands folks think
WASHU circa just before 2000 has entered the chat.. And kicked all your asses.. Everyone is crying and the black female resident has been manhandled by a small racist man from Kentucky..
Stanley order at Hopkins
