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General Internal Medicine

Radiation Oncology   

Questions discussed in this category

How do you differentiate demoralization from depression during cancer treatment?
2 Answers available
What is the optimal management of pain and loss of function due to pathologic compression fractures?
Assume no epidural/cord compromise. Is kypho/vertebroplasty, radiation therapy, or conservative management (brace, antiresorptive therapy) the superio...
1 Answer available
Which patients, if any, treated according to PROSPECT for an early stage rectal cancer, would you offer surveillance if they achieved cCR after neoadjuvant chemotherapy?
Some patients have declined surgery knowing they achieved cCR. Would you observe or recommend chemoRT?
1 Answer available
Is there any evidence for amyloid/amyloidosis causing a spurious/false PSA reading?
1 Answer available
How would you plan a post-op, distal rectal adenocarcinoma s/p neo-adjuvant chemotherapy and APR with minimal treatment response?
How would your planning be influenced by a possible, single inguinal lymph node metastasis?
3 Answers available
Should I treat a patient who doesn't know she has cancer?
My patient’s family has asked that I don’t tell her that she has metastatic cancer because it will devastate her. I am planning on palliat...
8 Answers available
Would you change treatment approach for rectal cancer with an associated intussusception?
1 Answer available
Has there been an observed interaction between ACE inhibitors and development of angioedema in a block demarcated superficial radiation therapy treatment volume (ex. lip)?
After discontinuing the ACE inhibitor, the angioedema resolves three to four days later and does not recur when radiation is resumed. 
2 Answers available
How do you manage persistent rectal bleeding in the setting of rectal adenocarcinoma in a treatment-naive patient?
1 Answer available
How do you approach rising PSA following radical prostatectomy and early salvage radiation therapy?
What are your action points in terms of PSA thresholds?
1 Answer available
What is the expected timeframe for the development of radiation myelitis and therapies that have helped with neurologic symptoms?
4 Answers available
When treating pancreatic body/tail lesions that result in significant dose spread to the spleen, what is your threshold to offer pneumococcal, hemophilus influenza, and meningococcal vaccines? 
2 Answers available
What is your approach to management of radiation-induced bullous pemphigoid?
1 Answer available
What is your approach to radiographically suspicious lung nodules for which initial biopsy was negative for malignancy?
4 Answers available
How do you prescribe a steroid taper for radiation and checkpoint inhibitor related pneumonitis?
I've seen a handful of fatal radiation pneumonitis associated with rapid steroid tapers by the non-treating physicians. How do you recommend prescribi...
2 Answers available
What is your approach to managing asymptomatic ORN of the mandible?
1 Answer available
What are your preferred strategies to manage mild to moderate rectal ulceration causing tenesmus and discomfort after chemoradiation for rectal adenocarcinoma?
Or, to manage tenesmus and discomfort after any type of pelvic radiation.
1 Answer available
In what situations would you treat a rectal mass as cancer despite negative biopsies?
For example, if mass is ulcerated and cannot be excised with polypectomy? Would you ever consider radiation and chemotherapy?
4 Answers available
Is there a role for nintedanib in the management of patients with radiation-induced pulmonary fibrosis?
1 Answer available
In patients with active IBD and rectal cancer, do you take any precautions before starting TNT?
Would you wait until bowel symptoms are controlled or ever pursue diversion before starting treatment?
2 Answers available
Is there a risk of increased skin toxicity with combined radiation and doxycycline?
1 Answer available
Should methotrexate be stopped prior to radiation therapy if a patient has rheumatoid arthritis?
2 Answers available
Would you start any treatment for radiation pneumonitis if there is a large area of consolidation in the irradiated lung field but the patient is asymptomatic?
Would you consider pentoxifylline and vitamin E to mitigate fibrosis?
2 Answers available
For a patient who has T4 squamous cell esophageal carcinoma on imaging, and who has biopsy-confirmed disease in an involved local lymph node, are EUS or EGD still indicated to complete workup?
1 Answer available
For a pedunculated rectal polyp found to be adenocarcinoma after endoscopic removal, with PNI as the only adverse feature, would you recommend additional treatment such as surgery or chemoradiation?
Consider some stalk invasion, but no deep submucosal extent and negative margins by 9 mm. 
1 Answer available
For a patient with a lung tumor that is radiographically consistent with early-stage NSCLC but pathology with characteristics overlapping with upper GI origin, what additional diagnostic procedures would you consider before treating?
For example, there are no abnormalities on CT or PET in the upper GI and the pathology demonstrates strong CK7 staining and mucinous features with neg...
2 Answers available
How do you counsel cancer patients when they ask if they should avoid sugar?
9 Answers available
How do you manage incidentally identified pituitary lesions on brain imaging?
What workup do you typically recommend?
1 Answer available
How would you manage a patient with radiation pneumonitis who remains symptomatic on steroids?
2 Answers available
How do you time PET/CT surveillance and COVID boosters?
Is anyone advising delaying COVID booster until after PET/CT to avoid false positive?
1 Answer available
For patients undergoing TNT for rectal cancer with planned operative management, what is the optimal sequencing and timing of workup imaging and procedures?
Do you have a preference in ordering MRI, endoscopy, CT scan (chest, abdomen, pelvis), EUS, or other testing before starting any treatment, for re-sta...
1 Answer available
How would you manage patients with exposed bone due to injured gingiva after recent chemoradiation?
Any experience using phenytoin?
1 Answer available
Should patients with co-existing moderate-severe valvular disease (particularly AS and MS) and malignancy requiring radiation therapy undergo more frequent surveillance surface echocardiograms?
1 Answer available
Why do we use dexamethasone for CNS edema and prednisone for pneumonitis?
Is this an artifact of what agent prior clinical trials used or something to do with the mechanism of action (i.e., less mineralocorticoid effect of d...
1 Answer available
In patient s/p definitive chemoRT for vulvar cancer with complete response, how do you manage a non-healing vulvar defect if biopsy is negative for residual disease?
2 Answers available
What is the recommended follow-up/surveillance schedule following organ preservation treatment approach for cT1-2N0 rectal cancer?
Taking into account follow up from NEO, OPERA and other organ preservation trials?
2 Answers available
When is it safe for a rectal biopsy in a patient with prior prostate radiation?
Is the patient permanently at elevated risk for rectourethral fistula with rectal biopsy? Do you have any threshold for the GI to biopsy a rectal lesi...
2 Answers available
How do you define an adequate EBUS when staging NSCLC?
Is there a minimum standard for which stations to sample? Does lymph node size affect your recommendations?
3 Answers available
How would you approach a non-healing wound following lumpectomy for recurrent disease in a patient who underwent breast conservation therapy with radiation 10 years prior?
The patient had lumpectomy with standard radiotherapy to 50 Gy whole breast, followed by 10 Gy boost 11 years ago, and was recently found to have a sm...
1 Answer available
What is your response to the question, "Is this terminal?"
How do you "have the talk" in a way that is straightforward without emotionally crushing the patient?
8 Answers available
Does recent COVID-19 infection result in elevated PSA?
1 Answer available
What is your approach to rectal cancer staging in patients who cannot undergo an MRI?
1 Answer available
How would you manage an adult patient status post subtotal resection of spinal osteoblastoma?
The patient presented with spinal cord compression, had subtotal resection and instrumentation with metallic hardware. Main concern is that post op su...
1 Answer available
How do you balance aspiration risks with encouraging PO intake for HN cancer patients during and after chemoradiation?
Encouraging aggressive PO intake in patients with swallowing dysfunction may place them at risk for aspiration pneumonia, especially risky if undergoi...
1 Answer available
What is your go to steroid regimen for post SRS headache?
If a patient calls you after hours with a headache following SRS and have not been given steroids, what is your preferred regimen? 
1 Answer available
How do you counsel NSCLC patients receiving SBRT on fatigue?
I've noticed that these patients have been having greater than expected fatigue that persists for months after SBRT. This is very different than the f...
2 Answers available
How do you manage an infection that occurs in the treatment field while under treatment?
Do you stop treatment? What if an abscess is also present?
2 Answers available
For a rectal cancer with questionable T3 or questionable N+ by MRI, can short course radiation be given followed by surgery and the pathology still be interpreted to guide adjuvant chemotherapy?
I.E., can a patient with a questionable 5 mm node (MRI T2N1) which is negative on pathology after short course radiation be staged T2N0 and receive no...
3 Answers available
How do you follow up a patient with esophageal adenocarcinoma who is not a surgical candidate after finishing chemoradiation?
2 Answers available
How should you work up calvarium or other osseous lesions when found during the initial staging of a patient with a new diagnosis of NSCLC otherwise non-metastatic?
1 Answer available
When would you consider a workup for C. diff in a patient with diarrhea under-going concurrent chemoradiotherapy for rectal cancer?
If the patient is outpatient and coming into clinic each day, at what point would you initiate a C. diff workup?
1 Answer available
How do you manage osteonecrosis and pelvic insufficiency fractures after pelvic radiotherapy?
3 Answers available
Do you do recommend further mediastinal staging for patients with SCLC or inoperable NSCLC with N1 disease on PET?
If a patient clearly has N1 disease with high SUV on PET, do you routinely recommend EBUS or mediastinoscopy to evaluate for N2 disease?
1 Answer available
How do you manage dyschezia and tenesmus following TNT with short course RT?
1 Answer available
Do you counsel patients with an ileostomy about significant diarrhea when treating the pelvis with radiotherapy? 
Have you noted significant diarrhea until the ileostomy is reversed?
1 Answer available
What is the best treatment for radiation recall skin reaction of the breast?
If a patient develops a new erythematous macular rash in the exact area of the prior radiation portal months following completion of RT without new me...
2 Answers available
How do you manage/treat acute radiation-induced enteritis?
Are there any medications that you can prescribe? Diet changes? Does this typically resolve on its own after time?
5 Answers available
Do you stop treatment for a prostate cancer patient diagnosed with acute radiation proctitis with significant pain?
If the diagnosis was made by an outside physicain, how do you confirm/refute the diagnosis? Would an alternative diagnosis like a thrombosed hemorrhoi...
3 Answers available
Do you routinely order a thoracic or brachial plexus MRI for patients with apical lung cancers?
Would you consider this standard in asymptomatic patients for workup and treatment planning? Or do you reserve MRI for symptomatic patients only?
2 Answers available
How do you approach a thoracic lymph node that is highly suspicious on CT and PET but negative on EBUS in patients with NSCLC?
3 Answers available
Do you recommend patients wait to have a total hip sx after salvage radiation for RP?
If so, what is timing after salvage radiation that you would recommend? 
1 Answer available
When staging prostate cancer, does MRI pelvis/prostate replace CT A/P?
5 Answers available
Do you offer adjuvant therapy for rectal intramucosal carcinoma within a large rectal adenoma?
Would you follow the same guideline recommendations for adenocarcinoma if the adenoma component is invading miscle wall?
1 Answer available
Are there best practices or data regarding the use of open notes among oncology patients?
What is the impact among patients and providers? Has your documentation been adjusted now that patients can readily review?
2 Answers available
What is your treatment paradigm for rectal cancer in the setting of COVID-19?
Are you doing more TNT to prolong time to surgery? If so, do are you starting with CRT or chemotherapy?
4 Answers available
How soon after completion of salvage RT to the prostate bed do you allow urethral dilation?
Eg patient has been catching for years but now developing stenosis towards end of salvage RT course.
2 Answers available
For rectal adenocarcinoma initially staged as T2N0 and treated with upfront surgical resection, but pathologically upstaged to pT3N0 without high risk features, how do you approach adjuvant therapy?
How do you counsel patients on the benefit of adjuvant therapy who thought surgical resection was curative?
1 Answer available
How do you evaluate a suspicious, but negative pleural effusion when working up NSCLC and SCLC?
Are two negative pleurocentesis' adequate to conclude that the patient does not have metastatic disease? Do you routinely recommend VATS and pleural b...
1 Answer available
How would you manage early-stage low rectal cancer in a patient unable or unwilling to undergo surgery?
3 Answers available
Do you recommend that patients undergoing radiation treatment get a COVID vaccine booster?
If so, what patients do you recommend get one and do you have concerns for patients who also may be receiving chemotherapy as the CDC guidelines recom...
1 Answer available
Do you advise patients to hold DMARDs for conditions such as psoriasis or rheumatoid arthritis while actively undergoing radiation treatment?
Does it depend on the DMARD type (biologic, targeted synthetic, or conventional synthetic)?
2 Answers available
For low rectal adenocarcinoma that extends to the anus through the internal sphincter muscle, would you recommend neoadjuvant therapy in a patient who will undergo APR?
Does extension to the anus affect your determination of T classification? Would you consider this a T2 tumor if it does not extend to the external sph...
2 Answers available
How do you manage acute tenesmus related to SpaceOAR?
Do you manage post radiotherapy onset of tensmus differently? 
2 Answers available
Would you use inhaled steroids with or without oral steroids for the treatment of radiation pneumonitis?
Would inhaled steroids help reduce the PO dose and/or significantly accelerate tapering?  If s, for what pneumonitis grade? What specific steroid...
1 Answer available
What is your approach following R1 resection in a patient who has received total neoadjuvant therapy for rectal cancer?
1 Answer available
Given the long half-life of dexamethasone, what is an appropriate dose schedule?
For a patient receiving 16 mg/day, it is frequently prescribed as 4 mg q 6 hrs.  This results in the patient being awoken at night, when sleep di...
3 Answers available
Which patients with rectal cancer who have not received neoadjuvant treatment do you offer adjuvant radiation to?
Is there a subset of patients you would avoid neoadjuvant CRT and operate first?
3 Answers available
How do you interpret and utilize PSA values in patients on dialysis?
How does dialysis affect PSA lab values?
1 Answer available
What are the current official guidelines regarding COVID-19 vaccination for patients with cancer or for hematologic conditions?
2 Answers available
How do you manage intractable hiccups from radiation?
Have you found any of the more common medical treatments (chlorpromazine, baclofen) to be most effective in the setting of throacic radiation or head ...
2 Answers available
How do you counsel patients who are candidates for a clinical trial regarding their options?
Specifically, are there strategies you use to 1) empower patients to participate in decision-making and 2) reassure patients who may be skeptical?
2 Answers available
Can liquid biopsy be substituted for tissue biopsy in a lung mass that is radiologically suspicious for primary lung cancer when CT-guided biopsy cannot be done?
For example, a patient with a large (>3cm), spiculated, FDG-avid lung lesion, who has poor lung function and is refusing a CT-guided biopsy?
2 Answers available
How do you perform geriatric assessment for cancer patients?
Do you use specific tools or take into account certain factors when considering treatment options for older adults?
1 Answer available
How will you counsel patients receiving radiation therapy regarding COVID-19 vaccine administration?
What is the appropriate timing and what factors do you consider when making such a recommendation?
1 Answer available
How do you manage early rectal symptoms such as tenesmus in a patient undergoing pelvic radiation for prostate cancer?
Assume patient has no history of IBD, UC, etc.
1 Answer available
Are stress-dose steroids indicated in patients with adrenal insufficiency receiving radiation therapy?
1 Answer available
What would be the recommended management for patients with rectal adenocarcinoma with rectovaginal fistula at presentation?
Would preop RT still be the treatment option for these kind of patients? Assuming that the rectovaginal fistula was from tumor progression.
2 Answers available
When a patient presents with 2 lung lesions, do you routinely recommend a biopsy of both lung lesions?
Would your practice change if the patient had N2 disease?
1 Answer available
How would you manage gastrointestinal bleeding after radiation therapy for pancreas cancer?
Is it possible or common for patients to have mucosal telangiectasias along the portions of the GI tract in the radiation fields? If present, would yo...
1 Answer available
How do you handle post-op, pre-radiation breast seromas and hematomas?
3 Answers available
In patients with inflammatory bowel disease with low rectal cancer with planned proctocolectomy, would you consider creation of a pouch?
1 Answer available
What is the optimal work-up for patient with repeatedly negative biopsies of a mid-rectal lesion with signs of malignant etiology?
If biopsies consistently show high grade adenoma and there is a locally advanced rectal tumor with MRF involvement on imaging, what is the next step i...
1 Answer available
What surveillance do you recommend for a patient with locally advanced rectal adenocarcinoma who had a complete clinical response to total neoadjuvant therapy and declines to undergo surgery?
MRI? Endoscopy? Physical exam?
1 Answer available
How do you approach the decision of whether and when to initiate therapy in patients who remain COVID-19 positive >2 weeks after infection but are asymptomatic from the virus?
E.g. a patient with progression of their primary cancer but still is testing COVID19+ over a month after infection?
5 Answers available
When sending patients for follow up chest CT's after SBRT or chemoRT, how do you determine whether to send for scans with or without IV contrast?
2 Answers available
How do you talk to patients about clinical trials?
I care deeply about clinical trials but have always struggled on how to approach this topic. I would really appreciate tips from those of you who have...
5 Answers available
Should patients about to start radiation be required to have COVID-19 testing, if resources are available?
Our hospital is currently testing (PCR) for COVID-19 in all inpatients and outpatients undergoing surgical/"aerosolizing" procedures. Since radiation ...
1 Answer available
What are best practices for taking care of lung cancer patients during the COVID-19 pandemic?
4 Answers available
What form of surveillance do you recommend for esophageal adenocarcinoma s/p NACRT and resection at what frequency?
1 Answer available
How has COVID-19 altered your recommendations for invasive mediastinal staging for NSCLC?
Should staging and treatment decisions be made based on imaging alone?
2 Answers available
What are the current official guidelines regarding managing patients during COVID-19?
3 Answers available
How do you manage neurocognitive decline associated with chemotherapy (i.e. chemo brain)?
Is there specific workup you perform? Are there preventive measures? Once established, are there non-pharmacological and pharmacological treatments yo...
3 Answers available
What screening criteria do you use to give patients IV contrast for the CT sim?
Are there kidney issues in which you would omit IV contrast?
6 Answers available
Is it possible to have diffuse, bilateral pulmonary fibrosis as a late side effect of unilateral radiation therapy for breast cancer?
3 Answers available
Do you insist on biopsy confirmation of invasive disease in the setting of in situ pathology findings but otherwise clinical/radiographic evidence of invasive cancer?
1 Answer available
How do you explain progression free survival to patients?
5 Answers available
How would you manage an elderly patient with GE junction adenocarcinoma who is not interested in surgery and who has ulcerative colitis (not currently on medication or symptomatic)?
Would you be concerned about toxicity given that he has ulcerative colitis?
1 Answer available
How long do you continue surveillance imaging for NSCLC after definitive treatment?
NCCN recommends annual CT surveillance indefinitely after year 5, but I’m curious how many physicians continue and for how long?
3 Answers available
How do you approach rectal cancer with a solitary bone metastasis that is biopsy proven?
Do you recommend definitive therapy? Would your approach change if there are more than 1 site of bone metastases, such as 2-3?
1 Answer available
In what situations do you obtain both a pelvic MRI and EUS for rectal cancer staging and treatment planning?
For instance, in borderline cases for neoadjuvant therapy (e.g. T2N1 disease), should both be obtained to increase accuracy?
1 Answer available
What is a safe time interval from completion of hormones and external beam radiation to TURP in patients who develop refractory obstruction?
1 Answer available
How do you manage soft tissue necrosis in a patient who underwent TORS followed by RT?
1 Answer available
What stage is bilateral orbital/conjunctival NHL (limited only to the bilateral orbit/conjunctiva)?
2 Answers available
Should patients with idiopathic pulmonary fibrosis be placed on nintedanib or pirfenidone before starting radiotherapy for lung cancer?
1 Answer available
Do you perform a bone health assessment in men who will be receiving short term androgen deprivation for localized prostate cancer?
If so, does it differ from the assessment you would perform in men receiving long term ADT?
1 Answer available
Do you refer patients to cardiology if they have no history of cardiac disease but will be receiving XRT with high mean doses to the heart?
Is there an established benefit for this? For instance if your patient has cardiac calcifications on imaging but no history of cardiac disease are the...
2 Answers available
How do you approach rectal spacer for the patient with renal failure?
Given that it is cleared from the body by renal filtration, are you concerned about clearance issues?
2 Answers available
How do you manage acute esophagitis that persists > 1-2 months after completing chemoradiation for lung cancer?
Would you recommend empiric diflucan? Would EGD be indicated? At what point would you consider hyperbaric oxygen?
2 Answers available
How would you approach a biopsy proven NSCLC patient with mediastinum negative disease and contralateral suspicious spiculated PET avid nodule without pathologic diagnosis?
No other site of metastatic disease. It is unclear if this situation should be managed as two separate primaries or metastatic disease.
2 Answers available
Would you continue treatment of a rectal metastasis in a patient who is found to have radiographic evidence of contained rectal perforation during the treatment?
Would you continue treating the patient (in spite of the risk of causing a frank perforation, sepsis, and subsequently devastating consequences), or w...
1 Answer available
Are there any treatment related considerations in a patient with HIV who is on antiretroviral therapy and receiving adjuvant radiation for breast cancer treatment?
What if CD4 count was low?
1 Answer available
Is there anything you use for patients with anticipatory nausea who has failed Ativan and Zyprexa?
1 Answer available
If a patient develops intermittent painless hematuria during standard prostate RT do you attribute this to cystitis or would you work it up further?
1 Answer available
How would you manage a patient with a very large adenocarcinoma of the rectum (10 cm) that extends to the anal verge with positive peri-rectal and inguinal lymph nodes, but no distant organ involvement?
Is this patient considered to have metastatic disease? Should definitive surgery be considered?
1 Answer available
How would you manage a patient who presented with synchronous squamous cell carcinoma of the anus (cT2N0) and adenocarcinoma of the rectum (cT3N0) at 7cm from the anal verge?
1 Answer available
How do you manage urgency and frequency of bowel movements secondary to radiation proctitis?
1 Answer available
When would you recommend hyperbaric oxygen treatments for skin ulceration/non-healing wounds in a radiated field?
2 Answers available
How would you manage a patient with distal rectal adenocarcinoma involving the anal canal and a single non-bulky inguinal nodal metastasis?
Is curative intent surgery off the table?  
4 Answers available
How do you handle the situation where a curative-intent patient unexpectedly passes away while under treatment?
Obviously the details matter a lot, but are there guiding tenets one should follow beyond expressing condolences to the family?
1 Answer available
For patients with a history of seizures secondary to brain metastases, what are your criteria for discontinuing antiepileptic medications if the seizures have been controlled since SRS or surgery?
1 Answer available
What is the appropriate follow up after chemoradiotherapy for patients with anal SCC?
Is obtaining serial MRIs or other imaging appropriate?
1 Answer available
How do you follow patients after SBRT for NSCLC?
Which imaging studies do you perform and what is the timing after treatment?
2 Answers available
Do you take patients off anticoagulation for tandem and ovoid or tandem and ring procedures?
1 Answer available
When is it appropriate to recommend a diverting colostomy for treatment of anal cancer or low lying rectal cancer?
Fecal incontinence can be one indication. What are others?
2 Answers available
How do you approach the workup of subcentimeter contralateral nodules in cases of locally advanced NSCLC?
When there is biopsy proven mediastinal disease, do you offer definitive chemoradiation and monitor, or do you try to prove the presence/absence ...
1 Answer available
How do you treat hiccups in cancer patients?
Does your management differ if the hiccups are felt to be related to chemotherapy as opposed to the disease itself?
1 Answer available
How do you manage dental care, oral hygiene, and nutrition in patients with trismus?
2 Answers available
How do you manage a rib fracture caused by SBRT?
What is the average healing time? What medications and/or procedures do you recommend for pain control? Does management differ for those with chest wa...
1 Answer available
For patients with brain tumors without a history of seizure, what is your policy on driving?
1 Answer available
Do you treat pre- or post-operatively for HO prophylaxis?
What is your approach to deciding when to treat these patients? Or is it solely dependent on when surgeons refer them?
1 Answer available
When TPN is a barrier to enrollment in hospice for an eligible cancer patient with an irreversible malignant bowel obstruction, how do you approach the conversation about discontinuation of TPN?
The immediate response by patients in this situation seems almost universally to be, "But I'll starve to death!" Referencing literature about lack of ...
2 Answers available
How do you approach disease monitoring in patients with localized rectal cancer who have received treatment with chemoradiation?
Is MRI being considered the primary mode of imaging in multidisciplinary tumor boards, especially in light of the results of the MERCURY trial (JCO 20...
1 Answer available
What scans do you order for follow-up in locally advanced non-small cell lung cancer patients who have completed definitive radiation with concurrent chemotherapy?
What is the role of PET?
1 Answer available
How do you manage an open wound that is not healing after radiation treatment for an ulcerated SCC of the scalp?
If the patient is a poor surgical candidate and is a symptomatic, can he or she live with this?
1 Answer available
When is it considered inappropriate to omit pathological mediastinal lymph node staging for non-small cell lung cancer?
The NCCN guidelines call for pathological mediastinal lymph node staging for all NSCLC except in solid tumors <1cm and non-solid lesions < ...
3 Answers available
What is the best way to discuss an early palliative care referral with a patient?
We have a great palliative care clinic and I like to refer many patients with metastatic disease, even if I feel that they will live a year or two lon...
1 Answer available
When do you start steroids for radiation pneumonitis?
Following lung RT, I have rarely seen patients present with pneumonia-like symptoms of radiation pneumonitis. I'm more likely to see a patient with wo...
3 Answers available
When does a rising PSA after prostatectomy indicate growth just of normal prostate?
Guidelines dont seem to account for this possibility. Could it just be normal prostate tissue growing back that is leading to PSA, why just assume it ...
1 Answer available
Should early referral to palliative care be standard of care for all patients with metastatic cancer?
I know that some would argue that healthy patients with an excellent performance status may not need an early palliative care referral, but wouldn't i...
3 Answers available
For elderly patients with locally advanced rectal cancer who are not candidates for surgery or chemotherapy, what would be an appropriate palliative regimen?
1 Answer available
How are patients on anticoagulation managed in the context of intracranial SRS?
Is heparin or warfarin routinely held prior to treatment?  
1 Answer available
How do you take tumor seeding into account when staging NSCLC?
In the case where there is a PET avid subpleural nodule in the exact same location as needle biopsy 3 months prior, is this considered a chest wall me...
1 Answer available
Should I decline to treat a patient with a first site of metastasis who refuses a biopsy?
More specificlaly, in a non-emergent situation?
1 Answer available
Should we be more concerned about cardiac toxicity following breast radiotherapy?
In a case-control study by Darby et al in the New England Journal of Medicine, patients treated for breast cancer with radiation were found to have an...
2 Answers available
Has pelvic MRI replaced EUS as the standard of care for rectal cancer staging?
Are there any indications to choose one over the other?
1 Answer available
What is your management strategy for patients with positive lymph nodes after radical prostatectomy?
2 Answers available
What is your institution's active surveillance protocol?
1 Answer available
If a PET/CT scan is positive for mediastinal lymph node involvement, is a mediastinoscopy or EBUS still required for NSCLC staging?
In practice, do you send patients with N2/3 disease for mediastinal staging if not offered upfront?
1 Answer available
What is the difference between involved node and involved site irradiation?
1 Answer available


Papers discussed in this category

Gynecol Oncol, 2019 Aug 16
Advanced communication: A critical component of high quality gynecologic cancer care: A Society of Gynecologic Oncology evidence based review and guide.
JAMA,
The care of the patient.
Eur. Urol., 2009-05-01
Long-term follow-up of patients with prostate cancer and nodal metastases treated by pelvic lymphadenectomy and radical prostatectomy: the positive impact of adjuvant radiotherapy.
The New England journal of medicine, 2012-07-19
Radical prostatectomy versus observation for localized prostate cancer.
BMJ, 2014-01-08
Prostate cancer: summary of updated NICE guidance.
The New England journal of medicine, 2013-03-14
Risk of ischemic heart disease in women after radiotherapy for breast cancer.
International journal of radiation oncology, biology, physics, 2014-07-15
Modern radiation therapy for Hodgkin lymphoma: field and dose guidelines from the international lymphoma radiation oncology group (ILROG).
The New England journal of medicine, 2010-08-19
Early palliative care for patients with metastatic non-small-cell lung cancer.
The New England journal of medicine, 2013-03-28
Generalist plus specialist palliative care--creating a more sustainable model.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2015-05-01
Early Versus Delayed Initiation of Concurrent Palliative Oncology Care: Patient Outcomes in the ENABLE III Randomized Controlled Trial.
J Can Assoc Radiol, 1975-09-01
The 1975 Gordon Richards Memorial Lecture. Is the Miles operation really necessary for the treatment of rectal cancer?
Int. J. Radiat. Oncol. Biol. Phys., 1995-01-15
Adenocarcinoma of the rectum treated by radical external radiation therapy.
Journal of neuro-oncology, 2011-07
Current practices of driving restriction implementation for patients with brain tumors.
European urology, 2011-04
The prognostic significance of capsular incision into tumor during radical prostatectomy.
Urology, 2001-11
Does capsular incision at radical retropubic prostatectomy affect disease-free survival in otherwise organ-confined prostate cancer?
J Thorac Cardiovasc Surg, 2011 Mar
Randomized trial of mediastinal lymph node sampling versus complete lymphadenectomy during pulmonary resection in the patient with N0 or N1 (less than hilar) non-small cell carcinoma: results of the American College of Surgery Oncology Group Z0030 Trial.
Semin Radiat Oncol, 2015 Oct
Predicting Radiotherapy Responses and Treatment Outcomes Through Analysis of Circulating Tumor DNA.
J. Clin. Oncol., 2008-07-20
Lung adjuvant cisplatin evaluation: a pooled analysis by the LACE Collaborative Group.
Chest, 2007 Sep
Invasive mediastinal staging of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition).
Rev Mal Respir, 2007-05-01
[IFCT-0302 trial: randomised study comparing two follow-up schedules in completely resected non-small cell lung cancer].
The Annals of thoracic surgery, 1995-12
Is follow-up of lung cancer patients after resection medically indicated and cost-effective?
The New England journal of medicine, 1971-12-23
Granulated sugar as treatment for hiccups in conscious patients.
N. Engl. J. Med., 1981-12-31
A bitter cure.
J. Intern. Med., 1990-02-01
Termination of intractable hiccups with digital rectal massage.
Can Fam Physician,
Managing hiccups.
Int. J. Radiat. Oncol. Biol. Phys., 1997-08-01
Prevention of heterotopic ossification about the hip: final results of two randomized trials in 410 patients using either preoperative or postoperative radiation therapy.
Urology, 1999-06
Impact of chronic dialysis on serum PSA, free PSA, and free/total PSA ratio: is prostate cancer detection compromised in patients receiving long-term dialysis?
Biomed Res Int, 2014 Feb 06
Tumour markers and kidney function: a systematic review.
The American journal of gastroenterology, 2001-04
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