The Accelerators Podcast

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TAP is back with another live podcast for ASTRO 2025! Well, sort of. 

The Accelerators (Drs. Matt Spraker and Simul Parikh) didn't make it to the meeting this year and we were missing our time with our friends! 

We invited Drs. Laura Dover, Jamie Pawlowski, and Jeff Ryckman to hang out and discuss some of the new data from this year's meeting. 

Here are the studies we discussed:

1. RADCOMP
2. NRG BN001
3. NOM-ERA
4. PACE C / GU005
5. NRG GU006
6. LUNAR
7. EXTEND 

The Accelerators Podcast is a Photon Media production. For more from Matt, visit his website. For more from Simul, visit his blog, Radiation Medicine: Dollars and Sense.

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The Accelerators co-host Dr. Matt Spraker is joined by two experts in brachytherapy for brain tumors, Radiation Onocologist and CMO of GT Medical Technologies Dr. Michael Garcia, MD, MS and Neurosurgeon Dr. Simon Hanft, MD, FAANS.

We first review the origin story of GammaTile, an evolution of the practice of brachytherapy for brain tumors. 

Simon then shares how he has deployed GammaTile in his practice. We dive in to patient selection, how the design facilitates a shallow technical learning curve, and the process of prescribing and placing the implant.

Discussion then shifts to research. We review some of the published studies (see links below) that support use of GammaTile for both brain metastases and recurrent primary brain tumors, such as GBM and meningioma. We also discuss some recently completed and soon-to-open trials, including Mike's creative idea - time intensification! -  to move the needle on outcomes for glioblastoma. 

Here are some of the studies we discussed and other useful links:

• The ROADS Study 
• The GESTALT Study
• Ekhator et al., Review of GammaTile Studies 
• Prasad et al., Radiation Protection Considerations for GammaTile
• Griffin et al., Fast Neutron Therapy for GBM
• Beckham et al., GammaTile for Salvage of Recurrent Brain Mets and a nice industry summary of findings in context (BioSpace)
• Dr. Simon Hanft, Building a Successful GammaTile Program (YouTube)
• A nice Insta patient video by a Dr. Bohnen, a neurosurgeon at Matt's center

Editor's Note: TAP were compensated for this episode and GT Medical Technologies participated in planning the content. The discussions in this episode are the opinions of the participants and are not clinical advice.

Please see our website for complete information on our past and current sponsors.

The Accelerators Podcast is a Photon Media production. 

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Welcome to Season 4! 

The Accelerators (Dr. Matt Spraker and Cameron Tharp, MPH, RT(T)) kick it off with a sequel to our prior podcast on the Advanced Practice Radiation Therapist (APRT) role. 

We host friends-of-the-show Drs. Join Luh and Marsha Haley, Radiation Oncologists who bring important past experiences and unique expertise to the discussion. 

We kick off by examining some articles from the Spring 2025 issue of ASRT's Radiation Therapist:

• Caldwell and Lee, Defining Advanced Practice Radiation Therapy at MDACC
• Burch et al., Advanced Practice Role in IGSRT for Nonmelanoma Skin Cancer Treatment
• Beckert, Implementation of an APRT in Online Adaptive Radiation Therapy

We then explore "scope creep", a phrase used to describe mid-level healthcare provider encroachment on traditional physician roles. One example is the UPenn study comparing the interpretations of Radiology Assistants with physician residents. Don't miss the excellent YouTube review of this study by Physicians for Patient Protection. Join shares his experience with another example, California Assembly Bill (AB) 890.

Later, Join shares some discussion about the APRT among ASRT and CARROS members at the ACR 2025 meeting.

This leads to an open discussion of what APRTs should do -- versus could do -- in a radiation oncology clinic. As evidenced by Table 1 in Caldwell and Lee, the tasks are wide ranging, may replicate existing roles of US radiation therapists, and might make more sense in international markets than in the United States.

We close by reviewing Marsha's letter to the IJROBP editor in response to an APRT role scoping review. 

Here are some other things we discussed in the episode.

• Physicians for Patient Protection Website
• AMA successfully fights scope of practice expansions (2024)
• Patients at Risk Audio and Video Podcast
• Council of Affiliated Regional Radiation Oncology Societies (CARROS)
• Beckert et al., Impact of APRT for on-table adaptive radiotherapy
• Shah et al., Radiation Oncology Workforce Analysis Review
• Book recommendation: Lower Ed by Tressie McMillan Cottom
• Patients at Risk Video - Deficiencies in NP Education

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The Accelerators (Drs. Matt Spraker and Simul Parikh) host the 2025 ACRO candidates for Vice President/President-Elect in the first ever radiation oncology election debate! 

Well, it's more like a friendly discussion, but Simul asked them their opinions on 4 great topics. 

1. What differentiates ACRO from other radiation oncology societies? 
2. Can you explain ACRO's position on physician supervision of radiation oncology services over the years? 
3. Why link accreditation to payment in ROCR?
4. Should proton therapy be included in ROCR, and what is your position on the PPS exemption program? 

The Accelerators Podcast is a Photon Media production. For more from Matt, visit his website. For more from Simul, visit his blog, Radiation Medicine: Dollars and Sense.

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Accelerators co-host Dr. Matt Spraker is joined by radiation oncologists Drs. Bobby Koneru and Mudit Chowdhary for an update on low dose radiotherapy for osteoarthritis! 

Dr. Koneru is a radiation oncologist in Freeport, IL and prolific social media educator on benign indications. Dr. Chowdhary is a radiation oncologist at Northside Hospital in Atlanta, Georgia, and a friend of TAP (see his prior episodes).

We start by discussing their ASTRO 2024 panel on benign indications for radiotherapy; it sounds like there was a lot of knowledge sharing among those getting started with these treatments.

Bobby and Mudit share how they built a referral network for their successful practices.

We close by discussing some practical tips and recommended educational resources. 

Here are some other things we discussed in the show, or links that may be helpful in building your benign radiotherapy practice: 

• Matt's LDRT & Benign Resource List
• Radiotherapy Academy for Benign Diseases (RT-ABC)
• Makarova et al., RCT showing LDRT reduces disability risk in OA
• English Translation of the DEGRO-AG “Radiotherapy of Benign Diseases”
• TAP reviews LDRT with Dr. Austin Dove 
• Alvarez et al., Radiotherapy for Benign Conditions Contouring Atlas
• LDRT for arthritis PRIMR video

The Accelerators Podcast is a Photon Media production. 

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The Accelerators (Drs. Matt Spraker and Simul Parikh) host Dr. Stacy Wentworth, Radiation Oncologist, Author, and Podcaster!

We discuss her career and how she developed her voice as a physician content creator. Do not miss her Less Radical narrative podcast about the life of Bernie Fisher, it is a masterpiece!

In this episode, we cover our experiences with our evolving careers. As a radiation oncologists solidify their clinical and technical expertise, how can they expand their ability to help the world?

We discuss developing a voice outside the mainstream communication channels of medicine and academics, and going a different way. As radiation oncologists, it's in our DNA.

Editors note: Don't miss Simul's Substack post related to this show, "How to Publish Outside of the Academic 'Priesthood'".

Here are some other things mentioned during the show:

• Subscribe to Stacy's Substack, Cancer Culture
• Stacy's most popular article, Why Your Doctor is Leaving You
• Why Mars is Boring and Cancer is Not, by Stacy Wentworth
• Healthcare A to Z with Eric Bricker
• Zotero organizational software
• Eric Topol's Ground Truths 
• Will Dowd's monthly Lunar Dispatch
• How to start writing on Substack 
• An Inconvenient Truth, by Graypeace
• A biography of Juan Del Regato (ROI Institute)
• The NSABP
• Shibamoto and Takano, Non-surgical management of operable breast cancer review
• Hess et al., Phase 1 trial of low-dose radiotherapy for COVID-19

The Accelerators Podcast is a Photon Media production. 

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The Accelerators (Drs. Matt Spraker and Simul Parikh) host Dr. Donald Abrams, MD, Medical and Integrative Oncologist at the UCSF Oscher Center for Integrative Health.

Donald offers a comprehensive review of a very poorly understood topic!

We review the history of cannabis regulation in the US and globally, different delivery forms, and Donald's observations throughout his oncology practice.

We additionally discuss indications for use in cancer care; is smoking cannabis safer than taking sugary edibles?

Of course, we discuss cannabis misinformation. Right now Donald offers the best discussion of this topic that we have seen.

We close the episode with a dicussion of CBD, the future, and a bit on studies of psychedelic therapies and melatonin.

Don't miss the ASCO Cannabis and Cannabinoids guideline. 

Here are some other things we discussed during the show:

• The Marijuana Tax Act and AMA opposition
• The Controlled Substences Act
• Federal Marijuana Compassionate Use Program
• Braun et al., JCO, National Survey of Medical Oncologists Perceptions
• NASEM report on The Health Effects of Cannabis
• Tashkin, Annals ATS, Effects of marijana smoking on the lung
• Nabiximols
• Waissengren et al, TAMO, Effect of cannabis on oxaliplatin-induced peripheral neuropathy
• Overview of cannabis for peripheral neuropathy (Cleveland Clinic)
• Munson et al, JNCI, Antineoplastic Activity of Cannabinoids
• Guzmán et al., Br J Cancer, Pilot study of CBD for recurrent GBM
• Twelves et al., Br J Cancer, Phase 1b study of CBD for recurrent GBM
• Book Rec: The First Cell, Azra Raza
• Piper et al, Cancers, Regarding cannabinoids and immunotherapy

The Accelerators Podcast is a Photon Media production. 

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The Accelerators Podcast co-host Dr. Simul Parikh is heading back around the globe, this time to discuss breast cancer!

He hosts Drs. Anna Kirby (Royal Marsden Hospital & Institute of Cancer Research), Sushil Beriwal (Allegheny Health Network, Varian Medical Systems), and Revathy Krishnamurthy (Tata Memorial Centre), Radiation/Clinical Oncologists from the UK, US, and India.

The group kicks off it's discussion by comparing and contrasting breast cancer screening processes in their respective countries. 

Then they run cases, examining varied cases of breast cancer and techniques: early stage, locally advanced, triple negative, PMRT, VMAT and SIB, and the oligometastatic state.

Here are other things that were discussed in the show:

• The PRIMETIME Trial (UK)
• SOUND Trial Findings and Discussion, American Society of Breast Surgeons
• Omission of Sentinal Lymph Node Biopsy, American College of Surgeons]
• Hypo-G Breast Abstract, ESTRO 2024
• FAST-Forward Boost Trial (UK, PI Anna Kirby)

The Accelerators Podcast is a production of Photon Media, a division of the Cold Light Legacy Company.

If you'd like to support our efforts, please visit the Cold Light Legacy Company to learn more.

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Cameron Tharp, MPH, RTT joins The Accelerators (Drs. Matt Spraker and Simul Parikh), and we host radiation therapist Shaun Caldwell, EdD, RTT to discuss the Advanced Practice Radiation Therapist (APRT) role. 

Here are some things we discussed during the show:

• Mohan et al. on record and verify systems (1984)
• American Society of Radiologic Technologists (ASRT)
• American Registry of Radiologic Technologists (ARRT)
• Health Education England Advanced Clinical Practice Definition

Here are some peer reviewed publications on the APRT role:

• Lawlor and Leech. Scoping review of established APRT roles
• Skubish et al. Exploring possibilities for the APRT in the US

The Accelerators Podcast is a production of Photon Media, a division of the Cold Light Legacy Company.

If you'd like to support our efforts, please visit the Cold Light Legacy Company to learn more.