Radiation Oncology

[vyparik1]

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I understand that this is a four year residency. How hard is it to match? What is the lifestyle like (hrs/wk)? Compensation? How does this differ from Medical Oncology? What are the pros and cons in becoming Radiation Oncologist?

Thanks

V

 

[AnnK]

This is one of the specialties I am thinking of. Its a 4 year residency after a transitional/ preliminary medicine year. It seems pretty interesting - lots of physics and interesting technology. Compensation is good -
250 and up. I can't remember what else you asked. It has become really hard to get a residency spot in.

 

[vyparik1]

Hey AnnK. I was also wondering how Radiation Oncology differs from Medical Oncology? What are the pros and cons of each (i.e., lifestyle)?

Thanks

V

 

[Goofy]

Originally posted by vyparik1:
•Hey AnnK. I was also wondering how Radiation Oncology differs from Medical Oncology? What are the pros and cons of each (i.e., lifestyle)?

Thanks

V•••


Rad/Onc is an especially difficult discipline to enter. Perhaps the most difficult of all. This happened in just 3 short years. There is an exceedingly small number of slots for rad onc, yet wild popularity. Compensation and lifestyle are very good. Med students are finally catching on with the predictable explosion in interest.

One caveat though. The field is a bit of a gamble in my opinion, although there are certainly those that would debate this. As newer methods of treatement are developed, this entire discipline could be outmoded to some degree.

 

[vyparik1]

Klebsiella, wow, I cannot believe that Radiation Onc. could one day become obsolete. Then what would the current Rad Onc. do? Find another line of work?


V

 

[navs]

I agree that Rads. Onc. is a Great field in terms of lifestyle, but also agree with the last post about the future of the field.

Who knows where it will be in the future:

1. With Chemo. advances
2. Eventually u figure the gov. will figure out that their Medicare pts. are being overcharged.
3. How many rad. onc. does a hospital need?? All u do is make sure everything is okay and there is a plan and the techs. do all the work. Very easy to run an entire rad. onc. unit with few MDs and just a whole bunch of rad. techs. Surely cheaper for the hospital and gov.!!

Just my 2 cents. Please correct me if someone has a different opinion.

 

[Voxel]

I believe the idea of radiation oncology becoming absolete in my life time is hard to believe. I would like to live long enough to see the day when metastatic disease is at least controlled and becomes a "chronic disease" and to live even longer to see the day when metastatic disease is cured. I think that there will be advances in cancer diagnosis and treatment but when will this come? In 1975, they said that gene therapy will revolutionize medicine soon, has it really done that or will it take another 25-30 years?

Right now many metastatic diseases are treated with radiation. So besides the nice hours and nice pay, you have to be able to deal with end of life issues. Many patients go to the rad onc doctor to receive palliative care. Sure you can treat cord compression (one of the few emergencies in rad onc), breast and prostate cancer, but a significant number will die no matter what you do and you will have to deal with these patients day in and day out. If you have end of life issues think long and hard about going into rad onc or heme/onc.

 

[vyparik1]

Can anyone tell me the difference between a Medical Oncologist and a Radiation Oncologist? Is the difference that a Med. Onc. cannot use Radiation as a treatment option and must refer the patient to a radiation onc.? I also know you must do an IM residency to be a medic. onc. But, what other differences, if any, are there?

thanks

V

 

[AnnK]

Differences between med onc and rad onc

1. Training. med onc doctors are internal medicine trained with a hem onc fellowship while rad onc doctors are specifically trained in treating cancer with radiation.

3. Practice. Med oncologists are more likely to see the cancer patients earlier in their treatment. They may diagnose, and will treat with chemotherapy. They may then consult with a rad oncologist and surgical oncologist. The radiation oncologist will get the patient as a consult from the medical or surgical oncologist and is specifically responsible for deciding if radiation is appropriate, designing and administering the radiation treatment and following up with the patient. Like another person commented, radiation is often used palliatively so rad oncologist are likely to be involved in end of life care. Anyone, please correct me if my impressions are incorrect.


So, I hope that answers your question.

Also, I think that the subject of whether radiation is going to become obsolete is an interesting one. I really think that eventually cancer treatments are going to progress so that cancer is a chronic disease that is managed with drugs and radiation in a very cancer-specific manner. Also, it seems likely to me that imaging will be used to screen eventually and other screening tests will improve so that cancer is generally caught earlier and has better outcomes because of this. Of course no one really knows and its possible that a new treatment will be devised that makes radiation unnecessary, which would be really wonderful and probably worth the trade off from my perspective of having to do another residency. Personally I dont think thats too likely in our lifetime.

Ann

 

[Academic Radiation Oncologist]

I am an academic radiaiton oncologist. I agree and disagree with what was mentioned. I agree that we are treating a lot of metastatic cases but on the other hand, we cure a significant proportion of patients with RT. Examples like prostate cancer, breast cancer, brain tumors, lymphomas, head and neck cancer, gynecologic malignancies, testicular cancer, sarcomas, GI cancers, bladder cancer, pediatric cancers and much more. I find it to be a really fascinating field. The amount of training in oncology is extremely extensive. The board examination is among one of the toughest. Overall, only about 50-60% of the first time takers get thru' the written and oral boards (70-80% of first time takers passed the writtens and the same percentage passed the orals the first time). The amount of information you need to register in your brain is phenomenal. You need to know about every single clinical trial that is regarded as important. When I was preparing for my boards, I had 16 boxes of articles. We always base our treatment recommendation on data from the literature. This is a specialty that truely qualifies as evidence-based medicine. Technically, we need to have an excellent grasp of radiology, physics and radiobiology. Radiation oncologists are not just pressing buttons as what other physicians think.

I don't believe RT will become obselete in our lifetime. But I think RT could be enhanced by incorporating systemic therapy in the treatment. I am also trained in medical oncology, so I know both sides of the story. I find radiation oncology more stimulating, so I decided to do rad onc instead of med onc. Radiation oncologists are like surgeons. We need to know the anatomy of the body very well in order to give good radiation therapy. We also do procedures like radiosurgery and brachytherapy. If you are thinking about doing rad onc, check it out by doing a rotation. You'll like it.

 

[Academic Radiation Oncologist]

Check out the following sites:

<a href="http://www.radiotherapy.com" target="_blank">www.radiotherapy.com</a>
<a href="http://www.astro.org" target="_blank">www.astro.org</a>
<a href="http://www.abr.org" target="_blank">www.abr.org</a>
<a href="http://www.acro.org" target="_blank">www.acro.org</a>

Good luck! 🙂

 

[Voxel]

Can you quantify what you mean by "significant portion", what percentage of tumors at the most frequently found stage do you cure for each of the cancers you mentioned. People need to know the facts. What percentage of metastatic cancers does radiation therapy cure (5-10yr disease free survival)? Give people a realistic perspective. Yes, you do cure people and that is wonderful. However there are a significant amount of people who are not cured and will die. This is probably one of the hardest aspects of Rad Onc.

 

[vyparik1]

Hello Academic Radiation Oncologist..Wow, this specialty sounds like what I am looking for if what you have said is accurate. You get to do some procedures, interact with patients, have a good lifestyle and comp. Furthermore, I like the fact that you can see and treat a variety of cancers from different parts of the body and It requires extensive knowledge of physics and anatomy (subjects I really like!).

Also, can someone tell me how rigorous the residency training is?

Finally, Can you expand on what systemic therapy is in addition to using radiation therapy? Is it where we manipulate the patient's own immune system and make antibodies against the cancer cells? (i.e., somehow program a patients B-Cells to produce antibodies specific for the malignant cells in a certain tissue).

Thanks to everyone who replied

V

 

[Academic Radiation Oncologist]

The training is very intensive intellectually. You need to know a lot of hard facts and apply what you know in clinical practice. In the oral board exam, you have to quote evidence from papers and data in the literature for every single answer you give. Currently, the systemic therapy that has been proven to improve survival is chemotherapy. The latter sensitizes RT. I agree that we have to deal with end-of-life issues, so if one is not comfortable with dealing with dying patients, oncology might not be a good choice for the person. But we treat a lot of benign diseases as well e.g. AVM's, trigeminal neuralgia, keloids, heterotopic bone formation, Graves' ophthalmopathy, meningiomas, acoustic neuromas, coronary artery disease, pituitary adenomas, pterygium, ...etc. For malignant diseases, we cure &gt;90% of early stage seminomas, 80-90% of early stage Hodgkin's disease, 80% of early stage cervical cancer, 80-90% of endometrial cancer, ...etc. For metastatic disease, most of the cases are palliative with a few exceptions. But palliative XRT can relieve very distressful symptoms. Do a rotation in radiation oncology and find out whether you like it or not. If you decide to do it, it's important to buff up your CV gearing towards rad onc. The match rate was among one of the lowest last year and it seems that the competition is even more vigorous this year. Doing some research projects in radiation oncology might help. 🙄