These puns are getting out of hand.
Side question - are 12 people needed to co-author a 'how to contour' paper?
Is it purposeful that one of the authors was a Dr. Dickstein? I googled, and apparently Dr. Dickstein treats prostate cancers in gay and biseuxla men. What's he doing on a bulboclitoris contouring atlas?
Side question - are 12 people needed to co-author a 'how to contour' paper?
Is it purposeful that one of the authors was a Dr. Dickstein? I googled, and apparently Dr. Dickstein treats prostate cancers in gay and biseuxla men. What's he doing on a bulboclitoris contouring atlas?
Love this guy but isn’t publicly posting ABR questions a way to lose board certification
And that said … I AM JUST REPORTING. Don Lemon style 🙂
And that said … I AM JUST REPORTING. Don Lemon style 🙂
Imagine Dr. Dickstein, Anthony Weiner, Houston Nutt and me in the same room. That might be the greatest day of my life.
Advertisement - Members don't see this ad
There are 12 CT sclices, one for each author.
I chose "increased job satisfaction of billing staff" but got it wrong 🙁
We all know that's the right answer!
Thankfully you’re still 40% above the passing standard
It's official - Twitter is just another way for good Rad Oncs to get themselve mired in drama. I sincerely hope Dr. Sher does not get cancelled by the ABR.
I’m a huge Simul fan but he has given more grace to this author than he has his rad onc colleagues.
It’s ok to call the infographic and study bull****. I don’t think the urologist author is a bad dude, he just put out a ****ty study.
Advertisement - Members don't see this ad
Rad oncs can still be "brittle" and the data can also still be bad
The problematic behavior I saw online (I haven't listened to audio discussion podcast yet) was people calling for article retraction and resignations and that sort of thing. And then, about the most harmful thing you can say to a doctor: you're harming people. All of that was WAY over the top. But it was 90+% Drew M and Clive Peedell iirc. Those guys can take smug sanctimony and pearl-clutching to impressive levels. Now, was Nick Z saying the infographic was "AI slop" over the top? No.
Have we all learned from this episode? I hope! If I ever get another paper published, I will let the paper speak for itself and not "jazz it up" with some extraneous post hoc SoMe graphics.
Have we all learned from this episode? I hope! If I ever get another paper published, I will let the paper speak for itself and not "jazz it up" with some extraneous post hoc SoMe graphics.
Haven't listened to the interview yet but I did read Simul's post on his substack and he does come down very hard on the paper. He's just also trying to add the meta critique about online mobs.
It sounds like what was seen in public was only tip of the iceberg, some nasty DMs as well.
What surprised me in a negative way, that really made me think "that crosses a line," was Drew M tagging Cleveland Clinic leadership and calling them to censure a Cleveland Clinic Urologist who'd had the gall to not join the chorus of condemnation. I think it's since been deleted.
The paper was bad enough on its own that it's easy to criticize in its own right. The gatekeeping and trying to bring in the employers of other physicians who disagree with you is downright embarrassing and harmful imo
Last edited:
Goodness. I had no clue it went that deep. I saw some superficial commentary on Twitter and saw the figure from the paper which was a hot mess.
Terrible study and not a good response, however, I do think there is something about if you put a stupid opinion out there as a personal tweet eh that’s ok, but If you publish it under the guise of science and just say “don’t be upset by these completely biased data” you can’t expect the field to take it laying down. Yes there is overstepping by some on our side but I’m glad they are standing up for the field. It’s a delicate balance.
Ralph W, Drew M… the rad onc Sith of social media?
The reaal
So much cancer...
Stopping the publishing of BS articles will not happen. First, radiation oncology can't control other specialty's journals which are typically reviewed by those other specialties. Second, there are a lot of friend groups these days that just approve each others articles. The goal is to just get the articles into their hands. Third, there are many open access journals now that will publish things that have no merit for a fee. Since so many people need to publish to move forward in their careers, all of these feed publication of dubious data.
In my opinion, if we come on strong with public shaming, it just looks like personal or turf war squabbles. The way to refute is politely, particularly with data and engagement. We likely will not change the authors or the minds of those who are biased against us with this approach, but we will likely win over people on the fence. I think we alienate them otherwise, and that's a losing battle for us because it's usually the surgeons or medical oncologists who refer the patients to us, and they are also much bigger specialties.
Advertisement - Members don't see this ad
I also don't trust our leaders to argue/fight on our behalf when they allow nonsense to be published in our own specialty. I hope that the majority of physicians are more reasonable then I currently believe.
I agree. Like Ben Franklin said: you can catch more flies with honey than vinegar. These days we need all the flies we can get.
I have never understood that phrase. Why would I want to catch flies? Vinegar sounds like a good thing to keep them away.
While we're at it, why would I want to have a cake and not eat it? Isn't eating the cake the reason to have it?
I have now done a 10 minute dive into what all the bruhaha was about on X.... Does anyone have the 'infographic' that was AI generated that has since been deleted?
At face value, seems like This Urologist is just a ****ing ***** and seems to have no idea how statistics or the English language should work.
The infographic was ridiculous and deserved to be called out.
Contacting a department and demanding a specialist be reprimanded for not calling it out is also ridiculous. Lots of terrible behavior all around.
it would not be my approach but I think they just tagged the department on twitter, not like they called their work.
idk, the bigger point here is how terrible it is that it got published, not the reaction to it, full stop.
it's not like we all don't know that there are some fields that are averse to basic understanding of evidence and statistics and the limitations of each..
I can understand frustration or disappointment with me regarding the interview or giving the guy a platform, but I am not sure if those people listened to it and read my post in detail. I also know that I can be wordy (both in writing and in speaking). Listen at 2x. Have AI summarize my post.
If you do get a chance to listen, I have him concede that it was in fact meeting the definition of misinformation, which had not been done online or on his other recent podcast. I also have a detailed critique of paper in my Substack that goes further than the limited discussion online. I have written in the past a post called "Prostate Cancer Treatment: A Data Driven Look At Toxicity". Please take a gander. In my brain and heart, I truly think surgery should be limited to a small subset of patients. I am about as pro-prostate RT as they come.
As someone alluded to, my issue is the lack of kindness and humanity that was displayed. Yes, the paper was disappointing. Yes, the AI infographic was misinformation. Yes, the initial smugness was infuriating. However, in the community, we are dependent on urologists. And, they stopped listening to the science critique when the personal attacks came. If you have time to listen to this very popular podcast (about 100x more popular than Accelerators) that is sponsored by Pfizer, J and J and many other large companies, they rip us apart - not because of the paper, not because of the toxicity, but because of the reactions. "Undignified, disrespectful ... a ****show." At the 36:40 mark, they read Drew's tweet that calls out the CCF surgeon and tags the CEO of CCF. It is embarrassing.
I know I am generally respected and liked here. I can get over people not liking me - even though I am also 'brittle' 😳. But, I am as pro radiation oncology as they come. We won the scientific argument, but lost the overall war here. We can do better.
We gotta keep fighting the larger battles. We are in the midst of the single biggest attack on reimbursement in our history. This should be all most of us are thinking about. We cannot take our eyes off the ball and risk losing referrals or credibility in the eyes of our multi-disciplinary partners. People like them can be nasty at academic medical centers. We need to be kind and deferential, but also assertive and data drive. Amar Kishan, Dan Spratt, Jeff Ryckman (amongst a few others) behaved in a way I was proud of - that's who we should mimic.
Thanks for listening and reading.
If you do get a chance to listen, I have him concede that it was in fact meeting the definition of misinformation, which had not been done online or on his other recent podcast. I also have a detailed critique of paper in my Substack that goes further than the limited discussion online. I have written in the past a post called "Prostate Cancer Treatment: A Data Driven Look At Toxicity". Please take a gander. In my brain and heart, I truly think surgery should be limited to a small subset of patients. I am about as pro-prostate RT as they come.
As someone alluded to, my issue is the lack of kindness and humanity that was displayed. Yes, the paper was disappointing. Yes, the AI infographic was misinformation. Yes, the initial smugness was infuriating. However, in the community, we are dependent on urologists. And, they stopped listening to the science critique when the personal attacks came. If you have time to listen to this very popular podcast (about 100x more popular than Accelerators) that is sponsored by Pfizer, J and J and many other large companies, they rip us apart - not because of the paper, not because of the toxicity, but because of the reactions. "Undignified, disrespectful ... a ****show." At the 36:40 mark, they read Drew's tweet that calls out the CCF surgeon and tags the CEO of CCF. It is embarrassing.
I know I am generally respected and liked here. I can get over people not liking me - even though I am also 'brittle' 😳. But, I am as pro radiation oncology as they come. We won the scientific argument, but lost the overall war here. We can do better.
We gotta keep fighting the larger battles. We are in the midst of the single biggest attack on reimbursement in our history. This should be all most of us are thinking about. We cannot take our eyes off the ball and risk losing referrals or credibility in the eyes of our multi-disciplinary partners. People like them can be nasty at academic medical centers. We need to be kind and deferential, but also assertive and data drive. Amar Kishan, Dan Spratt, Jeff Ryckman (amongst a few others) behaved in a way I was proud of - that's who we should mimic.
Thanks for listening and reading.
Advertisement - Members don't see this ad
I don't get what the big deal is with the Italian paper. Academic medics on every continent have pressure to publish. Sometimes, that pressure results in crap getting published. It's in a second tier journal that I doubt my urologists subscribe to. There are high quality studies looking at radiation v surgery side effects like ProTect. Prostatectomy is just not that palatable of a treatment for many men.
X is mostly US academics with no or minimal production incentive so why does it matter if they treat prostates or not. I personally would not publicly make attacks against him on LinkedIn or other professional social media because it's awkward. If anyone notices, they'd just see an angry person shouting into the void. I also wouldn't lose sleep if the Italian lost his job. None of this is important.
Protons still a loser for prostate. Wild to me that very smart, very personable, USA-based academic rad onc's cry bloody murder at conventional fractionation at freestanding, but silently acquiesce to protons for prostate at PPS exempt centers. Their GU academic rad onc's must be spinning up the next proton prostate clinical trial as we speak so they can keep up the racket.
X is mostly US academics with no or minimal production incentive so why does it matter if they treat prostates or not. I personally would not publicly make attacks against him on LinkedIn or other professional social media because it's awkward. If anyone notices, they'd just see an angry person shouting into the void. I also wouldn't lose sleep if the Italian lost his job. None of this is important.
Protons still a loser for prostate. Wild to me that very smart, very personable, USA-based academic rad onc's cry bloody murder at conventional fractionation at freestanding, but silently acquiesce to protons for prostate at PPS exempt centers. Their GU academic rad onc's must be spinning up the next proton prostate clinical trial as we speak so they can keep up the racket.
Last edited:
I appreciate the Dollars and Sense substack. Good resource for rad onc issues and captures current issues and perspectives for those of us on the edge.
The CCF tweet makes no sense. I appreciate the VALOR trial and hope it will bear fruit but come on. The author is Italian, even if you did want to cancel somebody as an Internet denizen with a pitchfork, I don't get why you'd cancel an unrelated urologist in Ohio. If someone was malicious and hurt my family and I happened to be best buddies with their boss, I can't say I wouldn't say a few words behind closed doors, but this is again, an observational paper in a second tier journal. It is someone's homework assignment. I wouldn't be aware of it without this forum, and even if it did go viral on social media, everyone will forget about it next week.
Last edited:
The speciality really looses credibility when we pimp protons.
I agree with the above!
I think there are a multitude of issues here:
1) The Urologist who wrote the paper is an idiot for thinking his conclusions were supported by the results he identified, with no denominator to give a 'percentage'. The AI-generated infographic he made was extra stupid and demonstrates a significant misunderstanding of statistics. That being said, if THAT guy's career was threatened (not from me, but like in general) because of not just a crap paper he wrote, but then an AI-generated infographic that he misattributed as being from EU, and not just that, but then making it seem like it was purposeful "lol look how viral this is you guise", basically admitting to generating rage bait without a sense of understanding as to WHY it was ragebait, without any sense as to remorse or 'mea culpa' for igniting a **** storm based on some crap paper, only to eventually backtrack and try to cover his tracks on the internet (good luck), then yeah, I would understand the threatening to his career. I do not want THAT guy near any patients with prostate cancer.
2) Europena Urology is partially to blame for not making him defend the conclusion (in the PAPER, not the infographic) when a denominator was not only not known, but not cared about. His 'infographic' was inappropriately credited to EU, which caught a lot of extra 'hate' for it.
3) Drew is an asshat. We keep acting surprised when this happens, when this is who he is. It's like expecting a horse to not **** on the floor because he hasn't done it in exactly 1 day. I don't know how many times I will write on SDN across a multitude of threads 'Drew is an asshat'. Going after a CCF Urologist or whatever who was 'insufficiently outraged' at the paper/infographic is just prime Drew. Drew is the textbook definition of - 'it's provocative, it's what gets the people going on'. Drew's career should probably be the one that would be threatened based on his ongoing interactions on twitter, but it won't, because he's buddies with the right people. The people who support Drew should seriously consider re-evaluating their positions. Many people had a response to that paper that was good - Dan Spratt, Amar Kishan to note. Clive Pedell is like the UK version of Drew-lite but at least not as face-palmingly insane-seeming.
OK ... did you actually tabulate that or is that a nod to The Hitchhikers Guide to the Galaxy ?
If you did indeed tabulate that - then what was the denominator ??
If you did indeed tabulate that - then what was the denominator ??
All this came just a little too late for a 2026 Burns Supper!
O wad some Pow’r the giftie gie us
To see oursels as others see us! (To see rad onc as uro sees us?)
It wad frae monie a blunder free us
An’ foolish notion:
What airs in dress an’ gait wad lea’e us,
And ev’n Devotion!
18th-century Scottish witticisms aside, you are 100% correct that rad oncs should take a minute, maybe a couple minutes, to think about how others see us. especially our referring
PS, It's very surprising to me that no one called out Moghanaki for seeming to single out the woman urologist out of all the other people online commenting on that paper for most of his online rage. Very strange, very telling imo
Last edited:
Just once instead of “We read with interest” I’d love to see “We read with a white hot chafing sensation in our perineum”
Advertisement - Members don't see this ad
Focal therapy for prostate cancer: a new option
Focal therapy is a transformative option for prostate cancer, preserving quality of life by minimizing side effects like erectile dysfunction compared to traditional treatments.
kevinmd.com
We have a solo urologist who has been doing this as definitive therapy for years now. I’m seeing them 2-3 years out after they met out and need “harsh” radiation. Never a dull moment in the urology space.
Analogous to all of the salvage cryo and high cases I getFocal therapy for prostate cancer: a new option
Focal therapy is a transformative option for prostate cancer, preserving quality of life by minimizing side effects like erectile dysfunction compared to traditional treatments.
We have a solo urologist who has been doing this as definitive therapy for years now. I’m seeing them 2-3 years out after they met out and need “harsh” radiation. Never a dull moment in the urology space.
Man... what a world... to stake an entire academic career on 'craniospinal for leptomeningeal disease'...
Guess there could be worse things to stake an entire academic career on.....
Hyperthermia would like a word
I was most interested that Dr. Yang seemed to now acknowledge the existence of VMAT CSI as an option for these patients. This of course assumes he read the paper.
Haha. I don’t think Evan understands malpractice as a legal concept. Let’s hope some other people don’t understand
Last edited:
Advertisement - Members don't see this ad
