RadOncMD

Life is short. Don't make it shorter. Live in the present moment.

[RadOncMD @ejvfrag]

@NiuSanford Excellent lecture!👏🏽👏🏽👏🏽

[Adam Bruggeman, MD @DrBruggeman]

I translated this into English for everyone to read. This is written by an orthopedic surgeon colleague in Spain, but I know my American colleagues will appreciate the text an similarities to challenges we face here

1/
The Asymmetry in Medicine in Spain: Responsibility Without Authority (I)

Opinion

Francisco J. Guitián Lema

The Asymmetry in Medicine in Spain: Responsibility Without Authority (I)

“There is irrefutable empirical proof of this asymmetry: the doctor can replace anyone; no one can replace the doctor,” states Francisco J. Guitián Lema, a Vigo-based traumatologist specializing in orthopedic surgery

There is a truth so elementary that it feels uncomfortable to state it: a hospital exists solely and exclusively to cure the sick. It is not there to provide jobs or to justify organizational charts. Nor to feed bureaucracies or to experiment with organizational theories. It exists so that a sick human being leaves it less sick or, at the very least, having received the best possible treatment.

From this premise follows a logical consequence that the Spanish healthcare system seems determined to ignore: in that healing process, there are only two absolutely indispensable figures. The patient, who is the reason for the entire structure’s existence, and the doctor, who possesses the knowledge to guide that process. Everything else — and this is not disdain, but taxonomy — is support structure. Necessary, valuable, often heroic, but auxiliary.

The doctor is the only professional capable of performing the core act that justifies the hospital’s existence: diagnosing the disease and establishing the treatment. Without a diagnosis, there is no possible direction. Without a therapeutic indication, there is no meaningful action. An orderly transports the patient, but it is the doctor who determines where and why. A nurse administers medication, but it is the doctor who decides which, how much, and when. A technician performs a test, but it is the doctor who orders it and interprets its result.

This functional hierarchy is not a social convention or an inherited privilege: it is a direct consequence of training. Six years of medical school plus four or five years of MIR specialization produce a professional capable of integrating knowledge of anatomy, physiology, pathology, pharmacology, and a thousand other disciplines into a diagnostic synthesis that no other healthcare professional is trained to perform.

There is irrefutable empirical proof of this asymmetry: interchangeability. A doctor can, in case of need, perform the functions of any other hospital professional. They can push a stretcher, insert an IV line, draw blood, take vital signs — in Germany, doctors routinely perform these functions. The reverse is not true. An orderly cannot diagnose pneumonia. A nurse cannot order a surgical intervention. The doctor can replace anyone; no one can replace the doctor.

Recognizing this reality does not imply disdain toward anyone. Nursing care is essential. The orderly’s work ensures that hospital flow does not stop. Everyone deserves respect and fair compensation.
But respect for personal dignity cannot be confused with functional equivalence. In an operating room, the surgeon is not worth more as a human being than the assistant; but their function is irreplaceable in a way that the assistant’s is not.

This distinction, obvious in any other field, has become taboo in Spanish healthcare. The prevailing egalitarianism has managed to make an evident functional truth be perceived as a moral offense.

[Sam E @Sm137023]

The 2 dogs in Bondi Beach have been neutralised

[RadOncMD @ejvfrag]

@MMDA Why not put them in QC memorial circle and Luneta?

[RadOncMD @ejvfrag]

@GabrielleVanRam @mskcc @ESSOnews @OncoAlert Hi Gabrielle! May I have the abstract of this OPRA trial. Thank you!

[RadOncMD @ejvfrag]

@goodkidbikecity Art. XV Section 4. The family has the duty to care for its elderly members but the State may also do so through just programs of social security…It is a duty not a responsibility. Why not strengthen the second statement.

[RadOncMD @ejvfrag]

@tmprowell This is mine. From a child.

[Drew Moghanaki @DrewMoghanaki]

The cult leader is rarely curious. 🐺

[RadOncMD @ejvfrag]

@NiuSanford This is an excellent review to all practicing Rad Oncs as well. Thank you for this! 👏🏽👏🏽

[RadOncMD @ejvfrag]

@awgaffney Agree to this especially for underdeveloped countries like ours.

[RadOncMD @ejvfrag]

@NiuSanford Happy birthday! Thank you for imparting your knowledge and wisdom in the field of radiation oncology.

[p🕒d💿k @pdokprodo]

Prof. Cielo Magno lumabs na sa kalsada para kondenahin ang panggagahasa ng gobyerno sa budget ng bansa.

Salamat prof.Magno👊🇵🇭

[Gustavo @gusviani]

🎙EUROPA Trial: ☢️ shows ⬆️ HRQOL and ⬇️⬇️ side effects vs. endocrine therapy in women 70+ with early-stage breast cancer❗️ @OncoAlert
🎯 Objective:
•☢️✖️ET as single-modality treatments for women aged ≥70 w/ luminal A-like breast cancer
🧪 Methods:
•Design: Non-inferiority, Ph 3, randomized trial
•👥: ≥70y w/ stage I, luminal A-like breast cancer, post breast-conserving surgery, ECOG 0–1
☢️ (whole/partial breast, 5–15 fractions) or ET (aromatase inhibitors/tamoxifen for 5–10 years).
🥇Endpoints:
• Change in HRQOL (GHS scale) at 24 m, 5-year IBTR (not reported here).
•Interim analysis: At least 152 👥 completed the 24-m HRQOL
📊 Results:
•👥: 207 in interim analysis (☢️: 104, ET: 103)
•HRQOL at 24 Months:
•☢️group: Mean change –3.40 (95% CI –7.82 to 1.03; p=0.13)
•ET group: Mean change –9.79 (–14.45 to –5.13; p<0.0001)
•Adjusted mean difference: 6.39 (0.14 to 12.65; p=0.045) favoring RT 🏆
•Adverse Events (AEs):
•☢️group: 65 (67%) ✖️ ET group: 76 (85%) 👌
•Common G3–4 AEs in ET group: Arthralgia (7%), pelvic organ prolapse (3%), fatigue, hot flashes, myalgia, bone pain, fractures (2%)😯
•Serious AEs: Similar between groups (15% RT, 15% ET)✅
•☠️: No treatment-related deaths🆗

https://t.co/g0Ig7csYIo
S1470-2045(24)00661-2

[𝚐𝚊𝚗𝚍akoh 🇵🇭🇸🇦 @Akoganda12]

The Problem of the Philippines.

Credit to the rightful owner of the video.

[Gustavo @gusviani]

🧵 SBRT in Oligometastatic Breast Cancer: What does the evidence show? A summary of key studies and their impact on survival. Let’s dive in! 👇

1/ What is Oligometastatic Breast Cancer (OMBC)?
OMBC is an intermediate state between localized and widespread metastatic disease, characterized by limited metastases (typically ≤5). It’s a promising target for local therapies like SBRT (Stereotactic Body Radiotherapy).

[RadOncMD @ejvfrag]

@NiuSanford 
"A rose by any other name would smell as sweet"

[NonsparseOncologist @5_utr]

Their own data is consistent with 8.6% and up to a whopping 16.7% worse grade 2+ GU toxicity at 5 years with SBRT

👎

[Agapito Bagumbayan @Braggadocio2022]

ANO ITO RECTO???

[Rappler @rapplerdotcom]

Kabataan party-list faces media after filing CONA

WATCH: Talking to reporters after filing its certificate of nomination and acceptance, party-list group Kabataan says it will endorse an impeachment complaint against VP Sara Duterte. 1st nominee Renee Co says the youth seeks accountability from the Vice President on the spending of her public funds. #PHVote #AmbagNatin #BeTheChange

Get live updates: https://t.co/wpmvslntVQ

[raffy magno @raffymagno]

“In its special congress today, Akbayan Partylist votes Chel Diokno as its number 1 nominee for the 2025 partylist elections.”

#AkbayanSiChel
#AkbayanTayo2025