Diaza Ariyanto

MD in 🇮🇩 | Cancer Survivor | Cancer Biology Graduate @ImperialSandC | Part of @Lharaorg at @ImperialPhysics

[Diaza Ariyanto @DiazaOA]

Dalam rangka Hari Kartini 21 April kemarin dan Hari Buruh ini, Saya menulis suatu esai singkat mengenai gap dari pelayanan kanker kita, khususnya dalam konteks hak-hak mengenai pengobatan kanker pada perempuan yang patut diperjuangkan.
https://t.co/vQBsTrG0pY

[Diaza Ariyanto @DiazaOA]

The manly urge to play Farming Simulator and Euro Truck Simulator

[Diaza Ariyanto @DiazaOA]

@alah_gadang Ketawa dulu si paling "I'm back" (back home maksudnya)

[Diaza Ariyanto @DiazaOA]

@allisonoconn This can't be true. Unless there's data to back it up?

[Diaza Ariyanto @DiazaOA]

@DongNguyeb And I agree. That it is highly structured and very academic. I am more convinced now than ever.

I'm writing this for agreeing purposes, so others can see how much I adore it.

[Diaza Ariyanto @DiazaOA]

Hey no need to keep selling me the greatness of FT. Don't you see all the love emojis I used???

[Dong Nguyen @DongNguyeb]

2/ And about there are currently no completed phase 3 RCTs directly comparing FT with RP or RT, this point needs clarification,

There are many ongoing phase 3 trials with direct comparison FT vs RP or RT but not complete, mostly are using a non-inferiority design.
This means the primary goal is not to prove that FT is superior to any radical treatment in cancer control, but rather to demonstrate that FT is not unacceptably worse in terms of oncologic outcomes, while offering significantly better functional preservation and QoL.

In fact, before entering phase 3, FT has already been used for a considerable period of time in phase 1/2 studies, registries, and clinical practice, with substantial accumulated data on safety and short to medium term efficacy.
Phase 3 here mainly serves as a form of confirmation at the highest level of evidence.

Therefore, an Urologist offer FT as a “selective option” to carefully selected patients is entirely reasonable, if he provided to selected patients that a thorough, balanced discussion is held regarding the trade-off between better QoL preservation and cancer control and Patients receive close follow-up.

[Diaza Ariyanto @DiazaOA]

It must be nice to be able to market or recommend a "selective option", a therapy that has never had any phase III RCT or head to head trial 😍
Imagine the confidence, backed by all those single arm studies, and the cost+time we save!? I should strive to be more like it 😍❤️

[Dong Nguyen @DongNguyeb]

1/ I think we need to know proper context to avoid the misinformation created by @jryckman3 , a RadioOnco.

FT has never been reasonably marketed as a strategy to spare patients from hormone therapy (ADT).
The proper marketing for FT is to avoid or defer whole-gland treatments such as RP or RT, not ADT. That’s the key message.

When counseling, patients should be told that FT is a selective option, not an alternative to RP or RT, that involves a trade-off between functional preservation and lower than oncologic control in comparison with RT or RP.
Whether that trade-off is acceptable is ultimately a patient-centered decision.
That’s the way, we, Urologist, service our patients.

[Diaza Ariyanto @DiazaOA]

Amazing seeing so many stupid techbros' opinion on Twitter after that Midjourney scanner video

[Nicholas Zaorsky, MD MS @NicholasZaorsky]

Some doctors publish level 3-4 evidence, and the other doctors in their specialty celebrate it.

Radiation oncologists publish level 1-2 evidence, and other radiation oncologists criticize it.

[Diaza Ariyanto @DiazaOA]

One of my worst performances ever 🥀

[Diaza Ariyanto @DiazaOA]

And nobody wanted him!! Everybody doubted him! Looking at you all so called commentators, analysts, etc.

[Deion | SeeReax @SeeReax]

START BUILDING THE STATUE NOW NIGGA BECAUSE WHAT THE FUCK LMAOOOO

[Diaza Ariyanto @DiazaOA]

@EricTopol @EvidenceOpen @UpToDate @VincentRK what do you think of this sir? I assume, in certain specific/niche clinical scenarios, UpToDate will still perform better?

[Diaza Ariyanto @DiazaOA]

Sekiranya, meskipun sebuah cerita telah dianonimkan, apa tidak mungkin ada orang lain yang punya cerita serupa?
Manusia mana sih yang mau dihakimi karena kondisinya?

Profesor, sub, spesialis, DU, koass, S3, S2, S1, semua punya risiko bias yang riil.
Let's strive to be better🙏

[Diaza Ariyanto @DiazaOA]

This is a valid critique.
Saat kita share kasus/kejadian, tidak bisa hanya berlindung di balik anonimitas (sudah merahasiakan identitas). Parabahasa tekstual itu bisa dinilai dan dirasakan oleh masyarakat. Dari situ lah terkadang bias kita bisa bocor dan tampak.

[Uly Siregar @sheknowshoney]

This.

Dokter Indonesia doyan banget share cerita ttg pasien di medsos, caper dan haus engagement. Biar ga sebut nama tetap ga etis. Belum lagi yg dengan bangganya bersikap prejudice, diskriminatif, dan jadi polisi moral.

WTF is wrong with you. Dididik gimana di kampus?

[Diaza Ariyanto @DiazaOA]

Ribet? Iya. But that's the price of our noble profession yang semestinya lebih diperhatikan dan dijaga.
You might not want to be regarded as noble, but you have entered a long-standing entity (as old as mankind itself), where the heritage demands you to be virtuous.

[Diaza Ariyanto @DiazaOA]

Ketika dokter yang disebut profesi mulia ini sudah secara terbuka diskriminatif terhadap kelompok rentan, maka habislah ruang aman terakhir untuk mereka di bumi.

This is such a powerful message from you, OP.
Something that I'll always remember and promise to not be.

[del/mart @timoshenkaur]

rekan sejawat dokter loh yang bilang ini semua; kalo dokternya aja diskriminatif maka bener2 habis ruang aman buat individu queer

[Diaza Ariyanto @DiazaOA]

@PinKIYSensei This layers of quote tweets frying me

[Diaza Ariyanto @DiazaOA]

is this AI? Seems like AI, I hope it isn't.

AI use for visual learning in medicine never sits right with me.

[dr. Adam Prabata @AdamPrabata]

Izin menjelaskan mengenai bekam!

Terapi bekam adalah teknik pengobatan komplementer yang menggunakan cangkir khusus untuk menciptakan tekanan negatif pada kulit, sehingga menarik jaringan kulit, lemak, dan otot ke dalam cangkir. Teknik ini telah digunakan secara tradisional di berbagai budaya, termasuk di Indonesia.

Mekanisme yang terjadi pada tubuh saat dilakukan bekam antara lain:

-Peningkatan aliran darah lokal dan pelebaran pembuluh darah kapiler
-Penurunan kekakuan dan meningkatkan mobilitas jaringan

Manfaat kesehatan bekam bagi tubuh antara lain:
-Menurunkan nyeri punggung dan leher, terutama yang kronis
-Membantu relaksasi otot
-Mendukung pengaturan inflamasi

Namun perlu dicatat bahwa, kualitasi bukti ilmiah bekam hingga saat ini masih terhitung rendah-sedang, dan sifatnya adalah pengobatan tambahan, bukan pengobatan utama apalagi tunggal. Masih perlu penelitian lebih lanjut untuk memastikan manfaat jangka panjang bekam.

Semoga bermanfaat!

Sumber:
-The effectiveness of cupping therapy on low back pain: A systematic review and meta-analysis of randomized control trials
-Cupping Therapy. Statpearls.

[Stewpid Cheese Cat @bihdiswrong]

My mayor MUSLIM
My bagels JEWISH
My Christian DIOR
KNICKS IN FOUR

[Diaza Ariyanto @DiazaOA]

@StasLazarev And I'm afraid this would be a controversial opinion for some cheerleaders, presenters, and authors (unfortunately...)

[Diaza Ariyanto @DiazaOA]

@jryckman3 @SprakerMDPhD @allisonoconn When someone is so vested in the success of a specific sphere of medicine (e.g. drug development by pharma) strongly due to financial interest, it's just hard to not feel repulsed by it.