@sheelasinharoy
“We thank Reviewer 1 for providing a surprisingly prescient demonstration of the necessity of this publication, and have in fact included a screen capture of his review as Figure 4 in the latest revision.”
@ccardyDNP
Name and shame. 70% isopropyl alcohol is best disinfectant for viruses, but sunshine is the best disinfectant for malignant programs
@ARRO_org
@acgme
#EssentialTremor
is a disabling condition affection >10 million in the US.
For patients refractory to medication, a
#radiosurgery
thalamotomy can relief tremor by as much as 60-75%. No scalp burning and no shaved head.
Treatment is noninvasive and takes 1-2 hours!
I’m officially on the believer train for low-dose radiation therapy for arthritis.
I treated a gentleman in his 70s for an aggressive, myeloma relapse in his left orbit, causing massive proptosis & vision loss. Treatment was very effective to the orbital mass, however, he had
Fantastic work by one of our head therapists helping one of our pediatric patients go Super Saiyan for his
#radonc
treatment today
@OSUCCC_James
@OSUWexMed
Car broken into last night— laptop, switch, zelda & Witcher iii games, and hospital badge stolen. Guess what they intentionally left behind... 😂
#radbio
@drernestomd
@MarcusBlimi
Weird how your medical school demanded you and everyone around you to have vaccinations when you were going to be around sick people during rotations, huh?
And my little brother is officially the most badass member of the family as he graduates
@USArmy
Ranger School today! Congrats Lt Aaron Thomas! Hooah buddy!
@SenSanders
Physician in residency here. When I finished medical school, I had roughly 200k in student loans. All my federal loans were at 6.8%. Most of these loans were taken out when the interest rates for banks were almost nothing. Very frustrating.
@WCInvestor
You have some ok financial advice sometimes, but sure are oblivious to a helluva lot and nearing boomer level out of touch
How about minorities from low-income families, supporting families thru med school, who just want to go back & serve their communities? Or non-minorities?
Thanks to my newly acquired amazing fiancée, Hayley, for saying yes and making me the happiest guy in the world. Also thanks to Sir Hugo the frenchie for delivering her the ring
Great to be home in
#radonc
.
For first day back, we present 50Gy/1fx to bilateral L2, L3, L4 sensory nerve roots for intractable spasticity on the
@VarianMedSys
sponsored SPASM trial
Thanks to my rad onc & physics colleagues and exceptional team at
@OhioStateRadOnc
for helping
@MomPedBlog
Early on- he personally DM’d me and accused me of being unprofessional for following and like posts from the hilarious parody account…then of course he blocked me
Winding down 4 month Iraq deployment. Was a privilege caring for my fellow service members & coalition forces in support of OIR. Proud of my team for delivering top notch care to our wounded & sick soldiers.
#ArmyMedicine
Can’t wait to get back to
#radonc
though!
Great study out of MDA. Always ask your breast med oncs to hold antibody-drug conjugates when you tx brain mets!
Significant association of ⬆️ sRN w/ concurrent ADC & SRS/fSRS.
Happy to share our work on SRS with concurrent ADCs, now out
@JAMAOnc
! In this study, led by
@EmilyLebow
, we investigated the risk of symptomatic radiation necrosis for pts receiving SRS and brain metastases. ADCs included T-DXd, T-DM1, and SG. (1/n)
Don't forget to check out my two chapters in Dr's Yamada, Fiveash, Chang, and Knisely's hot new
@SpringerNature
book, "Radiotherapy in Managing Brain Metastases." 🔥🔥🔥
It really STINGs when *very* recently discovered pathways not even covered in latest edition textbook are put on minimum competency board exams.
#abr
#radbio
So happy I’m at home spending another 10-15 hours repeating the same mandatory training modules as last year instead of
1. Spending time with family
2. Patient care
3. Working on research
4. Anything else
Boswellia has been one of the most impactful things I’ve integrated into my practice as a CNS oncologist.
An unexpected benefit has the discussion it opens up into the CAM therapies my patients are otherwise using.
Saw under 50yo gentleman for adj RT after RALP for high risk prostate ca w/ ECE & positive margins w/ FOUR PAD PER DAY INCONTINENCE. If he has 30 more years, that’s roughly 43800 pads. Even w/ value packs at Walmart, that’s $32000 in pads. Wonder if anyone consented him for that?
A centromedian nucleus thalamotomy is a noninvasive radiosurgical treatment used for certain types of severe refractory pain. For
#trigeminalneuralgia
that has failed other options, the second/third order neuron synapse of the trigeminothalamic tract can be targeted here.
How many base pairs did YOUR telomeres lose during residency??
According to this research, interns lose 6x more telomere length than the typical person in a year.
#medtwitter
Radiosurgery for Refractory Depression likely saved the lives of patients who participated in this IRB-approved clinical trial. Treatment target = bilateral anterior limb of the internal capsule)
#radonc
Just wanted to say that I had fair, reasonable
#radonc
P2P w/
@evicorehc
today.
1. Peer was a rad onc
2. Peer appropriately questioned IMRT for a palliative ES-SCLC tx .
3. Peer listened to case, requested plan comparison & to see volumes.
4. I provided, peer approved.
1/N
@AnthemBCBS
just denied authorization for
#SRS
for one of my patients with medically refractory OCD.
But I’m sure it’s an honest lack of awareness!
🧠💡 “Breaking the Chains of OCD: The Promise of Stereotactic Radiosurgery” - A thread on a groundbreaking treatment for
Essential tremor is the most common movement disorder, with increasing prevalence with age.
For many people it becomes disabling & impacts ADLs including eating, drinking, & basic household tasks.
First line treatment is propanolol and/or primidone.
(1/4)
Great to see
@ASTRO_org
recognizing the importance (and in this, paradigm-shifting) of non-oncologic applications of RT in
@SBRT_CR
‘s late-breaking abstract on cardiac radiosurgery for refractory malignant ventricular tachycardia.
#radonc
#ASTRO19
Keynote-522, neoadj pembro + chemo vs neoadj chemo for triple negative breast cancer
#TNBC
dropped in
@NEJM
today. ~33% improvement in pCR & prob EFS increase with longer f/u. Seems to mirror I-SPY2 pembro results. Hard to justify not offering now?
#oncology
#breastcancer
@DrCasteelEM
Please let us know which ED’s you’re covering. I’d like to stay away.
If my aorta dissects “atypically”, I’d like an emergency physician to catch it.
Excellent work by the
@MDAndersonNews
team showing animal model of dose-toxicity reduction of RT by fasting. Exciting not just for
#pancreaticcancer
but for any abdominal RT indication. Now if only I could figure out how to get ppl in Alabama to fast 🤔
#radonc
#sbrt
Rewatched
#House
S01E01 & Wilson the
#medonc
apparently started radiation for a *presumed*
#BrainTumor
in 29yo w/ Wernicke’s aphasia w/o any imaging.
I advise against this course of action.
Turns out she had tapeworms. FYI, it takes > 1000 Gy to kill tapeworms.
#radonc
@marklewismd
I got shamed by the publisher of a book I’m editing, who causally dropped that Fauci (who remains senior editor of Harrison’s NEVER turns in chapters late! 😂 what a freaking legend
Best Practice Statement:
Just say NO to HIFU and cryo for definitive prostate cancer treatment. Inferior cancer outcomes and inferior QOL. There is no win for the patient here.
#pcsm
Thank you Dr Song. With all due respect to anyone involved, I also find it concerning that ASTRO is more interested in policing [probably appropriate] opinions rather than addressing the unfortunate behavior of the ABR.
@WCInvestor
Not sure how someone can’t understand how having 6 figures of student debt doesn’t disincentivize people doing primary care in underprivileged medicaid/charity heavy communities...
In modern era does PCI improve OS in Small Cell Lung Cancer?
YES in both limited & extensive stage in this meta-analysis
In subset of trials w/MRI screening pre-PCI, Suggestion OS benefit in limited stage
The
#ACA
was associated with a significant reduction in suicides among 55-64yo cancer patients. The fact that we let financial toxicity kill our patients before their cancer is revolting. Imagine a world where our care doesn’t bankrupt our patients.
#ASTRO19
#Medicare4All
Proud to be activating with fellow docs & providers in the Alabama Army National Guard Medical Detachment to administer
#COVID19
vaccines to underserved regions of my state!
#medtwitter
#USArmyNationalGuard
Sorry
#radonc
world, all the
@UABradonc
PGY’5s are officially off the market.
Good luck & best wishes in
@ClevelandClinic
to my rockstar co-resident who knows more about p53 than I know about anything!!!
Despite massive budget shortfalls from ⬇️ revenue from COVID,
@UABNews
/
@uabmedicine
commitment to residents is such that they are honoring promised 2020–21 scheduled salary increases. Truly a privilege to train here.
Great study out of
@DeptVetAffairs
on effect of palliative care use in adv
#lungcancer
. Use of palliative care 31-365 days after dx -> improved OS & also importantly, drastically reduced likelihood of death in acute care setting.
#lcsm
Help your pts live out their lives better!
Always great to see new agents with CNS activity - just a reminder that intracranial RR to stereotactic radiosurgery is ~100% and permanent LC is >90%!
Open access
@CCR_AACR
is report on intracranial efficacy of the
#RET
inhibitor selpercatinib. In 22 pts on LIBRETTO with measurable intracranial disease, the intracranial RR was 82% (23% CR) with median not reached.
@OncoAlert
#LCSM
1st time I shared a textbook pdf w/ colleagues was MS1 year & I got sent to principal’s (dean) office.
Doing it again today. Ch 9 of Washington’s rad therapy book is “Infxn Control in Rad Onc Facilities” & is great resource
#radonc
#covid19
#jc
Shout out to
@uabmedicine
for such an efficient healthcare worker
#COVID19
#vaccine
rollout. In and out in 20 min, including 15 min of post injection obs
What dose of RT is best at ⬆️ immune responses in tumor microenvironment?
Answer may be diff doses preferentially activate specific immune responses! Heterogeneity matters.
Thanks
@ZachMorrisMDPhD
!
@the_RSS
Time for those saying all RT ⬇️ immune response is past!
“It’s cool guy, the rad oncs can clean up after me after I destroy your continence and sexual function with an inferior, upfront attempt at definitive treatment.”
Excited to be en rte to
#ASTRO2019
with a great crew from
@UABradonc
! But flying w/ no status 😥 also, I’m a man and totally getting manspreaded by the guy next to me. I never knew. Ladies, I’m so sorry for what you deal with.
#womenwhocurie
#stopmanspreading