r/radiationoncology

I had extensive radiation to my tailbone, and the skin broke last July, almost a year ago. It's gone from a pin prick to a lemon-sized wound that exposes necrotic bone.

Every plastic surgeon I've seen--top, top doctors--tell me it will never heal due to the radiation damage, and that I should just live with it because the reconstructive surgery would be so damaging. I have a relatively good quality of life right now, though my cancer is metastatic, so I'm inclined to stay the course and just do wound care, as inconvenient and awful as it is.

I'm wondering: has anyone else had a radiation wound they were told would never heal? How did you approach this?

What is the level of concern here around AI in radiation oncology?

There have been a number of reports that radiation oncology is at a level of saturation, although this may be overblown.

My prediction is that AI may offer some efficiency gains to radiation oncologists. It will take away from the boring tasks - contouring, documentation, and image review. It may also benefit in treatment planning. Given a lot of the work is software heavy in rad onc with a good amount of procolization I'd argue radiation oncology is likely to benefit from efficiency gains more than other specialties.

With more efficiency, I suspect radiation oncologists will earn be able to see more patients and earn more. However, as a single rad onc becomes able to see more patients, we will also likely need fewer radiation oncologists.

Wanted to ask the group - what do you think will happen with AI in this field? Will it be a net positive for radiation oncologists? How will this impact the job market in the field?

I’m about to graduate from radiation therapy school and I’ve been really conflicted on what direction to go next career wise. Right now I’m stuck between pursuing medical dosimetry or medical physics. I already have my bachelor’s degree in Biology, and I want to start applying to programs within the next few months, but I keep going back and forth.

I honestly feel more drawn to dosimetry because I like treatment planning and the day to day role and I hear a lot of great things from dosimetrists enjoying their job and how they have a flexible/great worklife, but what’s holding me back is constantly hearing people say AI is eventually going to take over a lot of the dosimetry field. I’m not sure how true that actually is, especially long term, so it’s been making me second guess things.

On the other hand, medical physics seems very stable and something im interested in, but from what I understand it would add a lot more years of schooling and training before actually being fully established in the field. Sometimes I wonder if it’s worth it or if I’d burn out before getting there.

I know there is a great difference in responsibilities/salary for both careers, but for people already working in either field, what would you realistically recommend right now? How do you see the future of dosimetry with AI? And for physicists, was the extra schooling and residency worth it in the end?

I've had Stage IV breast cancer for more than eleven years so have had more CTs, PETs, and MRIs than I could possibly count. I have extensive/widespread bone mets plus several tumors in the liver. I'm on my fourth of fifth-line treatment, depending on how you count. I know the number of treatments are limited and when they run out...well, I'm done.

It's been my practice to drag my heels on changing treatment, riding each one out as long as possible, even if this involves some risk. I've begged oncologists to let me remain on treatment when the scan reports indicate worsening progression, and this has worked for me, adding anywhere from several months to several years to treatment. And I'm not talking about progression a couple months in...

On more than one occasion I've gotten a report that notes mostly or only areas that are worsening but when my medical oncologist and I look at the images, she'll see areas that are better, which would indicate a mixed response, and a decision to stay the course to see if the treatment is adequately keeping things at bay. In one case, the report noted a new met and the MO asked the RO to double check and, lo and behold, it was actually there previously.

I get the sense that ROs are either pessimistic by nature (!) or are more concerned about portraying a positive result than let's call it a "balanced" or even "optimistic" result.

Is there any truth to this? I think about all the patients whose MOs might rely solely on the RO read/report and so change treatment, robbing them of more *time*. How much do ROs consider the effect on patients' lives of being conservative in the interpretation or are they trained to look mostly for problems?

I see that this is not a very active subreddit, but am still hopeful for any insight someone in the field could provide.