BACKGROUND: High rates of burnout are observed among health care professionals worldwide, which could have negative consequences on personal and organizational levels. We aimed to evaluate the burnout prevalence and factors associated with burnout among oncologists in Poland.
METHODS: An online survey was conducted using the validated Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and additional work/lifestyle questions. Descriptive statistics, parametric and nonparametric tests, and multivariate logistic regression were used to identify factors associated with burnout.
RESULTS: A total of 228 physicians participated in the survey, including 168 medical oncologists, 43 radiation oncologists, and 17 from other specialties. Data collected from 211 medical and radiation oncologists were included in the final analyses. Most participants were female (71.6%) and ≤40 years of age (70.1%). A self-reported feeling of burnout was present in 65.9% of participants. Based on the MBI-HSS, 74.9% showed evidence of burnout with burnout subdomains as follows: depersonalization 37.0%; emotional exhaustion 64.5%; low accomplishment 43.1%. There were no differences in burnout rates based on specialization (oncology/haematology-75.6%, radiotherapy-72.1%), career stage, gender, or age groups. Lack of work-life balance was the only significant factor associated with the risk of burnout in the logistic regression (relative risk 2.6, 95% confidence interval 1.3-5.4). Only 20.9% of physicians had access to psychological support in their workplace; however, 70.1% desired such support. Three main factors impacting burnout in cancer care workers were: bureaucracy and administrative duties overload, admissions of many patients, and poor work culture.
CONCLUSIONS: Burnout is common among medical and radiation oncologists in Poland. There is a high demand for psychological support and organizational changes in the workplace to reduce risk and mitigate the adverse effects of burnout among health care professionals.

BACKGROUND: Radiation therapy treatment for breast cancer may negatively impact patients\' health-related quality of life. Evidence suggests exercise and nutrition interventions may be beneficial to patients experiencing compromised health-related quality of life. This study investigates whether radiation oncology practitioners support the implementation of a tailored exercise and nutrition intervention for patients and explores their interest in participating in training for exercise and nutrition as interventions.
METHODS: Data were collected by an online survey, deployed to public and private radiation oncology departments, across three Australian states (Australian Capital Territory, New South Wales, Queensland). The survey was completed between June and August 2020. Radiation oncologists, radiation oncology registrars, radiation therapists and radiation oncology nurses completed the survey. The survey included demographics, patient assessment and questions regarding the radiation oncology practitioners\' use of exercise and nutrition as interventions.
RESULTS: Of 192 practitioners targeted, 76 completed the survey, for a response rate of 40%. Of 76 respondents, 42% \'sometimes\' recommended exercise and 41% \'sometimes\' recommended nutrition as health-related quality of life interventions to their patients. The majority indicated they would benefit from more training in these subjects, with 58% for exercise and 55% for nutrition. 47 per cent of respondents thought patients would benefit from a tailored exercise and nutrition programme and 62% agreed they would refer patients to a programme if it were available.
CONCLUSIONS: Radiation oncology practitioners reported they need training in exercise and nutrition to better understand how this can benefit the health-related quality of life of breast cancer patients. Also, the findings indicate that if such an exercise and nutrition intervention were readily available, practitioners would refer patients who may benefit from this intervention.

BACKGROUND: To evaluate the scope of practice and role in cancer management for radiation oncologists in Australia, New Zealand, and Singapore (ANZ).
METHODS: A 27-question survey was emailed to all practicing radiation oncologists listed on the RANZCR database in mid-2021.
RESULTS: There was a 54% response rate. Respondents reported managing symptoms associated with radiation therapy (96%), cancer-related symptoms (86%), writing narcotic and analgesic prescriptions (76%), being involved in palliative care (57%), prescribing non-cytotoxic systemic therapy (45%), and admitting patients (41%). Just over 20% wanted to expand their scope of practice, but for those who were unable to, insufficient time (35%), inter-specialty political difficulties (14%), and lack of support from the organisation (12%) were the major reasons. Over half of respondents (56.4%) thought they provided an opinion on the overall role of cancer management. Just under 20% provided a radiation therapy opinion only and <1% provided radiation therapy at the request of the referring clinician. The remainder reported a combination of these. Over 80% of respondents thought their ideal role was to be involved in overall cancer management and 20% believed they should be providing an opinion on radiation therapy only. The ideal role matched the actual role in over 87% of respondents and most respondents thought radiation oncology training enabled an opinion on overall cancer management. Over 90% of respondents were satisfied with their current role in cancer management. Radiation oncologists felt they were perceived as independent clinicians and the large majority (87%) thought radiation oncologists should be part of a multidisciplinary team rather than leaders in cancer management.
CONCLUSIONS: This study has revealed a broad but expected scope of practice for ANZ radiation oncologists with the large majority providing an opinion on overall cancer management or radiation therapy and their ideal role matching their actual role.

To forecast oropharyngeal carcinoma (OPC) incidence with otolaryngologist and radiation oncologist numbers per population by rural and urban counties through 2030.
Incident OPC cases were abstracted from the Surveillance, Epidemiology, and End Results 19 database, and otolaryngologists and radiation oncologists from the Area Health Resources File by county from 2000 to 2018. Variables were analyzed by metropolitan counties with over 1,000,000 people (large metros), rural counties adjacent to a metro (rural adjacent), and rural counties not adjacent to a metro (rural not adjacent). Data were forecasted via an unobserved components model with regression slope comparisons.
Per 100,000 population, forecasted OPC incidence increased from 2000 to 2030 (large metro: 3.6 to 10.6 cases; rural adjacent: 4.2 to 11.9; rural not adjacent: 4.3 to 10.1). Otolaryngologists remained stable for large metros (2.9 to 2.9) but declined in rural adjacent (0.7 to 0.2) and rural not adjacent (0.8 to 0.7). Radiation oncologists increased from 1.0 to 1.3 in large metros, while rural adjacent remained similar (0.2 to 0.2) and rural not adjacent increased (0.2 to 0.6). Compared to large metros, regression slope comparisons indicated similar forecasted OPC incidence for rural not adjacent (p = 0.58), but greater for rural adjacent (p < 0.001, r = 0.96). Otolaryngologists declined for rural regions (p < 0.001 and p < 0.001, r = -0.56, and r = -0.58 for rural adjacent and not adjacent, respectively). Radiation oncologists declined in rural adjacent (p < 0.001, r = -0.61), while increasing at a lesser rate for rural not adjacent (p = 0.002, r = 0.96).
Rural OPC incidence disparities will grow while the relevant, rural health care workforce declines.
NA Laryngoscope, 134:136-142, 2024.

OBJECTIVE: To identify secular trends in the use of radiotherapy prostheses in the Clinic for Maxillofacial Prosthetics at Tokyo Medical and Dental University Hospital and to ascertain patient characteristics and future needs.
METHODS: The study included all patients who visited the clinic between January 1, 2000, and December 31, 2019. Data on numbers of cases, gender and age, numbers and types of radiotherapy prostheses, primary cancer site, and time required for prosthesis fabrication during the study period were collected from medical records and retrospectively analyzed.
RESULTS: During the 20-year study period, 1,066 prostheses were fabricated for 1,135 cases. In most years, at least 60% of cases were male. The mean age increased from 60.6 to 67.1 years during the study period, and the number of cases older than 70 years increased over time. The most common cancer site was the tongue, and the most common type of radiotherapy prosthesis was a spacer. The mean time for spacer fabrication was 11 days.
CONCLUSIONS: During a recent 20-year period, mean age and the proportion of elderly patients requiring savers increased. When treating elderly patients, prosthodontists responsible for fabricating radiotherapy prostheses must collaborate effectively with radiation oncologists.

BACKGROUND: Social media connects people globally and may enhance access to radiation oncology information. We characterized the global growth of the radiation oncology Twitter community using the hashtag #radonc.
METHODS: We analyzed all public tweets bearing the hashtag #radonc from 2014 to 2019 using Symplur Signals. We collected data on #radonc activity and growth, stakeholder distribution, user geolocation, and languages. We obtained global Twitter user data and calculated average annual growth rates for users and tweets. We analyzed growth rates by stakeholder. We conducted thematic analysis on a sample of tweets in each three-year period using frequently occurring two-word combinations.
RESULTS: We identified 193,115 tweets including #radonc composed by 16,645 Twitter users. Globally, users wrote in 35 languages and came from 122 countries, with the known highest users from the United States, United Kingdom, and Spain. Use of #radonc expanded from 23 countries in 2014 to 116 in 2019. The average annual growth rate in #radonc users and tweets was 70.5% and 69.2%, respectively. The annual growth rate of #radonc users was significantly higher than for all Twitter users (p = 0.004). While doctors were the source of 46.9% of all tweets, research and government organizations had annual increases in tweet volume of 84.6% and 211.4%, respectively. From 2014 to 2016, promotion of the radiation oncology community was the most active theme, though this dropped to 7th in 2017-2019 as discussion increased regarding aspects of radiation and treated disease sites.
CONCLUSIONS: Use of #radonc has grown rapidly into a global community. Focused discussion related to radiation oncology has outpaced the growth of general Twitter use, both among physicians and non-physicians. #radonc has grown into a self-sustaining community. Further research is necessary to define the risks and benefits of social media in medicine and to determine whether it adds value to oncology practice.

BACKGROUND: Unsolicited patient complaints (UPCs) about physician practices are nonrandomly associated with malpractice claims and clinical quality. The authors evaluated the distributions and types of UPCs associated with oncologists by specialty and assessed oncologist characteristics associated with UPCs.
METHODS: This retrospective study reviewed UPCs associated with US radiation oncologists (ROs), medical oncologists (MOs), and surgical oncologists (SOs) from 35 health care systems from 2015 to 2018. Average total UPCs were compared by specialty in addition to sex, medical school graduation year, degree, medical school location, residency location, practice setting, and practice region. For continuous variables, linear regression was used to test for an association with total complaints.
RESULTS: The study included 1576 physicians: 318 ROs, 1020 MOs, and 238 SOs. The average number of UPCs per physician was different and depended on the oncologic specialty: ROs had significantly fewer complaints (1.28; 95% confidence interval [CI], 1.02-1.54) than MOs (3.81; 95% CI, 3.52-4.10) and SOs (6.89; 95% CI, 5.99-7.79; P < .0001). In a multivariable analysis, oncologic specialty, recency of graduation, and academic practice were predictive of higher total UPCs (P < .05). UPCs described concerns with care and treatment (42.8%), communication (26.4%), accessibility (17.5%), concern for patient (10.3%), and billing (2.9%).
CONCLUSIONS: ROs had significantly fewer complaints than MOs and SOs and may have a lower risk of malpractice claims as a group. In addition to oncologic specialty, a more recent year of medical school graduation and working at an academic center were independent risk factors for UPCs. Further research is needed to clarify the reasons underlying these associations and to identify interventions that decrease UPCs and associated risks.
UNASSIGNED: This study of 1576 oncologists found that radiation oncologists had significantly fewer complaints than medical oncologists, who in turn had significantly fewer complaints than surgical oncologists. Other characteristics associated with more patient complaints included recency of medical school graduation and practice in an academic setting. Oncologists\' patient complaints provide information that may have practical applications for patient safety and risk management. Understanding and addressing the characteristics that increase the risk for complaints could improve patients\' experiences and outcomes.

UNASSIGNED: COVID-19 has affected the lives of every medical professional including oncologists. The goal of this survey was to evaluate the impact of COVID-19 on the work routine, psychological state and radiotherapy practice of radiation oncologists.
UNASSIGNED: An anonymous survey consisting of 23 questions regarding the lives of radiation oncologists during the COVID-19 pandemic was distributed online via social media from July 14 to July 21, 2020. Statistical analysis was performed with Statistical Package for the Social Sciences 18.0 software and basic descriptive statistics were applied.
UNASSIGNED: A total of 82 radiation oncologists responded to the survey. The majority were professors (28/82; 34.1%) and residents (28/82; 34.1%) and <50 years old (70/82; 85.4%). Cancer screening programs (57/62; 91.9%) and number of new cases reduced (44/82; 53.7%) in many institutes. Follow-up was still done in-person by 73.2% respondents. 35/82 (42.7%) respondents were satisfied about their safety during COVID-19, at the same time 36/82 (43.9%) were worried about the patient\'s safety. The fear of contracting COVID-19 (57/82; 69.5%) and infecting their families (64/82; 78%) was high. Physical presence during case implementation (59/82; 72%) and daily setup verification (60/82; 73.2%) remained the same during COVID-19. Half of the respondents adopted new fractionation schedules, commonly in breast and palliative cases. Time spent on research had reduced by 62.2%. Only 41.4% respondents were satisfied with the patient care provided by them during the COVID-19 pandemic.
UNASSIGNED: COVID-19 has significantly altered the work routine, radiotherapy practice and mental state of radiation oncologists.

Cancer care can be taxing. Alexithymia, a personality construct characterized by difficulties in identifying and describing feeling and emotions, an externally-oriented thinking style and scarcity of imagination and fantasy, is significantly correlated with higher levels of both secondary traumatic stress (STS) and burnout and lower levels of compassion satisfaction in medical professionals in radiation oncology. In this study, we aimed to assess the difference in professional quality of life (QoL) and the association with alexithymia in this multidisciplinary field depending on the specific profession (radiation/clinical oncologist, RO; medical physicist, MP; radiation therapist, RTT).
The study was conducted via an online questionnaire, receiving 1500 submissions between May and October 2018. Alexithymia was assessed via the Toronto Alexithymia Scale (TAS-20) and professional QoL was evaluated using the Professional Quality of Life Scale (ProQoL) version 5. Comparisons between the RO, RTT, and MP groups were performed by ANOVA or MANOVA, followed by Bonferroni corrected ANOVAs for continuous variables, and Pearson\'s chi-square test for categorical variables. The effect size was determined by calculating partial eta-squared (η2).
Profession had a moderator role on the correlation between alexithymia and STS, with RO being at a higher risk than MP and RTT. Further, the results of this study demonstrate the relevant point prevalence of decreased well-being at work even for professional categories such as MP despite the more technical profile and reduced interaction with patients.
This study demonstrates the importance of alexithymia as a factor contributing to decreased professional QoL amongst radiation oncology professionals. Alexithymic ROs are impacted to a higher extent compared to MPs and RTTs by the indirect exposure to patients suffering. It is worth addressing these observations in professional education, aiming to improve QoL for healthcare personnel.

UNASSIGNED: There is no consensus regarding the management and postoperative follow-up of non-functioning pituitary adenomas (NFAs) in the setting of recurrent or residual disease. Subsequent treatment options include continued follow-up, re-resection or radiotherapy. To address this gap and better understand current practice patterns, we surveyed neurosurgeons and radiation oncologists in Canada.
UNASSIGNED: Neurosurgeons and radiation oncologists (ROs) across Canada were invited to complete a standardized online questionnaire. Summary statistics were computed, and Fisher\'s Exact tests were performed to assess significance. Qualitative analyses were performed through open and axial coding.
UNASSIGNED: Thirty-three participants completed the questionnaires, with neurosurgeons representing a majority of respondents (n = 20 vs n = 13). When treating giant (>3 cm) tumors, 90.9% of neurosurgeons in practice for less than 10 years reported using an endoscopic approach, as compared to only 66.7% of neurosurgeons in practice for 10 years of more. Additionally, neurosurgeons who were newer to practice had a greater tendency to advocate for stereotactic radiosurgery (SRS) or re-resection (54.5% and 36.4%, respectively), as compared to older surgeons who showed a higher propensity (22.2%) to advocate for observation. The presence of cavernous sinus extension appeared to encourage ROs to offer radiotherapy sooner (61.4%), as compared to 40% of neurosurgeons.
UNASSIGNED: Our results identified both variations and commonalities in practice amongst Canadian neurosurgeons. Approaches deviated in the setting of residual tumor based on years of practice. This work provides a critical foundation for future studies aiming to define evidence-based best practices in the management of NFAs.