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Palex80 said:
Although he already has bone metastases.

So, treating the primary based on Stampede Arm H would be 4 weeks of daily treatments (20 x 2.75 Gy) or 6 fractions, 1x/week (6 x 6 Gy).
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lol, prior auth no longer applies when you are the former POTUS
 
thesauce said:
Is Penn still treating prostate with protons?
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When Biden was told “sir you have mets” he was like “I know he’s my doctor.”

IMG_3458.jpeg
 
pubmed.ncbi.nlm.nih.gov

The Cancer Bell: Too Much of a Good Thing? - PubMed

Counter to our hypothesis, ringing the bell on the final day of RT worsens patients' evaluation of overall distress from cancer treatment, and this distress persists and even worsens in the months after treatment. Emotional arousal created by ringing the bell may magnify the distress from cancer...
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov
 
TheWallnerus said:
I thought randomized data showed bell ringing was harmful to patients. Don’t they practice EBM at Penn.

I guess if you get prostate photon RT you wear sweats. Proton RT you wear suit and tie.
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I doubt it's terribly inconvenient to show up in a suit for low dose whole brain...
 
I guess we’re not afraid to denigrate one president.

Congrats to him finishing. I wouldn’t take the bell ringing study too seriously. It’s probably good for some people and most departments don’t make it reflexive.
 
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communitydoc13 said:
I guess we’re not afraid to denigrate one president.

Congrats to him finishing. I wouldn’t take the bell ringing study too seriously. It’s probably good for some people and most departments don’t make it reflexive.
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Yeah we opened up a new centre and changed the bell to a giant gong in the courtyard. The area is somewhat private and separated so at least someone’s private choice doesn’t affect other patients who don’t have a choice to hear, especially if they’ve relapsed since original curative intent treatment.
 
taserlaser said:
Yeah we opened up a new centre and changed the bell to a giant gong in the courtyard. The area is somewhat private and separated so at least someone’s private choice doesn’t affect other patients who don’t have a choice to hear, especially if they’ve relapsed since original curative intent treatment.
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Is it just me or is it weird that we even offer up the gong or the bell or whatever. After I had my screening colonoscopy I didn’t get to ring a bell on the way out. I suppose none of us even ask or present as an option bell/gong for the single fraction bone met or cranial radiosurgery or heterotopic ossification patients!
 
communitydoc13 said:
I guess we’re not afraid to denigrate one president.

Congrats to him finishing. I wouldn’t take the bell ringing study too seriously. It’s probably good for some people and most departments don’t make it reflexive.
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I agree with you. Giving a man with M1 prostate cancer 28 proton fractions is denigrating, on multiple levels. I could write a PhD thesis on how the ACA made that kind of denigration more likely.
 
communitydoc13 said:
I guess we’re not afraid to denigrate one president.

Congrats to him finishing. I wouldn’t take the bell ringing study too seriously. It’s probably good for some people and most departments don’t make it reflexive.
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Yes, we owe him a lot. Basically everything that's happening now.
 
TheWallnerus said:
I agree with you. Giving a man with M1 prostate cancer 28 proton fractions is denigrating, on multiple levels. I could write a PhD thesis on how the ACA made that kind of denigration more likely.
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Do we know that he got protons? I presume he did…but I don’t know. Denigrating is the wrong word. If anything, protons and overtreatment of the wealthy are status symbols. (The wealthy don’t always choose wisely).

Agree, data purists going to go with 55/20 for limited Mets. But, we know very little about his particular case. I’m sure many here who have given 28 fractions to a patient with 1-3 osseous mets or equivocal Mets.

I’d call the ACA a win overall, a win for my children (one born with a heart defect) and a win for my hospital.

Biden expanded subsidies to alleviate the hurt caused to the not affluent but not poor in the ACA marketplace. I’d call that a win as well. Peak insured at end of Biden era.

Sure, someone should look at the impact of percentile caps on insurance profits.

Public option anyone?
 
communitydoc13 said:
I’m sure many here who have given 28 fractions to a patient with 1-3 osseous mets or equivocal Mets.
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Haha I like to envision that if someone confronted Neha about giving 28 fractions of proton therapy to an 82 year old man with M1 prostate cancer, her response might be that the misanthropes on SDN do it too 🤣
 
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