ASTRO 2019 elections results
Congratulations to the following newly elected members of ASTRO's Board of Directors. The new officers' terms will begin at the Annual Business Meeting at ASTRO's 61st Annual Meeting in Chicago.
Radiation oncology is an under-utilized, highly effective therapy that most cancer patients benefit from at some point in the course of their disease. Unfortunately, not all patients have access to radiation therapy, and there is a need for improved public awareness about its benefits. Together, radiation oncologists from all backgrounds (community/academic, rural/urban, early/late career, from US and beyond) can work together to improve the profile of radiation oncology towards ASTRO’s vision that radiation oncology becomes the recognized leader in quality, innovation, and value in multidisciplinary cancer care, ultimately resulting in improved patient outcomes.
Bring a part of the radiation oncology team is incredibly rewarding; however, with increasing indications for radiation therapy, increasing demands (e.g., prior Authorization) and less resources, it is becoming more challenging to provide quality care. A recent survey (VW Osborn et al, IJROBP May 2019) reported an alarming rate of burnout in U.S. female radiation oncology residents. ASTRO should aim to eliminate gender-based obstacles and develop strategies for improving engagement and mitigating burnout. We need to preserve our own well-being, so that we can more effectively influence change and serve our patients. Novel, efficient and shared models of cancer care that welcome new members of cancer care team, such as data scientists, are needed, and more efficient strategies for follow-up, including telemedicine and remote patient monitoring may be more convenient for patients and caregivers.
What can I offer ASTRO, and how would I plan to aid in bringing the ASTRO strategic plan to fruition? If elected, I will passionately advocate for our specialty and rally behind ASTRO’s priority goals. I will empower, motivate and support others, especially those with complimentary skill sets to mine (e.g., ASTRO leaders with expertise in policy development and government lobbying). I will advocate for approaches to increase diversity of ASTRO leadership, as different perspectives and opinions are needed to be most successful in accomplishing our goals. I will support advancement of junior and/or underrepresented ASTRO members, who may have innovative ideas. I hope to increase ASTRO collaborations with other oncology societies, including ASCO, CARO, ESTRO and RANZCR, on common goals (e.g., need for increased NIH research funding and a public awareness campaign). There are many exciting radiation research questions that need to be answered (e.g., dose/fraction specific response, biomarker discovery, sequencing of radiation therapy with immunotherapy,..); thus, we need to support our clinician scientists and increase collaborations with radiobiologists and basic scientists to advance our field and gain more recognition as a leading oncology specialty. Together, we are more likely to make a larger impact and to deliver effective and safe radiation therapy to our patients.
Radiation Therapy Oncology Group (RTOG)/NRG
National Cancer Institute (NCI)/National Institute of Health (NIH)
Gastrointestinal Cancers Symposium
Canadian Association of Radiation Oncology (CARO)
American Association of Physicists in Medicine
After finishing her radiation oncology residency at the University of Toronto, Dr. Dawson completed a fellowship in high precision radiation therapy at the University of Michigan, where she developed an interest in liver cancer radiation therapy. Today, she is an active radiation oncologist and the upper gastrointestinal cancer multi-disciplinary site lead at the Princess Margaret Cancer Centre, and Professor of Radiation Oncology at the University of Toronto. She leads the palliative radiation oncology program (PROP) and treats patients with gastrointestinal malignancies and patients with oligo-metastases from a variety of malignancies. Her primary clinical and research focus continues to be on liver cancer patients, who historically were not candidates for radiation therapy.
Dr. Dawson’s scholarly activities involve the implementation and evaluation of technological developments in radiotherapy, such as IGRT and SBRT/SABR. She is an active trialist, and has led numerous phase I, II and more recently phase III, potentially practice changing clinical trials of personalized SBRT/SABR for liver cancer. She enjoys teaching, and has mentored many radiation oncologists, physicists and radiation therapists from around the world who have gone on to develop their own oligo-metastases and liver cancer SBRT/SABR programs.
Outside of oncology, Dr. Dawson enjoys playing hockey and spending time at her cottage with her husband and three boys, who are avid hockey players.
I am humbled by this nomination and opportunity to serve our radiation oncology (RO) community on a larger scale. ASTRO’s Strategic Plan embodies a fundamental vision: RO is the recognized leader in quality, innovation and value in multidisciplinary cancer care. To maintain this prominent role for our specialty within the larger healthcare sphere requires ongoing reflection and proactive adaptation. My longstanding interest in compassionate clinical care, high-quality education and collaborative research is not unique among ASTRO members. These interests comprise our shared professional commitment to this continuous process of introspection and improvement. Yet certain challenges to progress are unique to our field, and ASTRO represents a powerful platform to help identify and address barriers to realizing its own vision.
Throughout my career, I have been fortunate to experience leadership opportunities within and outside RO, enabling me to connect with thought leaders worldwide, to better understand how RO team members view their own capabilities and contributions, and to recognize how these views compare to the perceptions of patients, the public, medical students, and colleagues from other disciplines. I’ve practiced how to listen, mentor, and guide – and when to do which – throughout my roles as an Advisory Dean, then Assistant Dean of Student Affairs, and now incoming Dean of Admissions at University of Pennsylvania’s School of Medicine. I’ve benefitted from invaluable interactions with faculty, staff and trainees during my tenure on the Executive Committee of ASTRO’s Association of Directors of RO Programs (ADROP), where I spearheaded new initiatives like shared educational resource pilots, member retreats, and annual meeting networking events, all designed to foster a greater sense of community among programs. I’ve also gained considerable perspective from surgical and medical oncology colleagues through my interdisciplinary work on ASCO’s scientific program and education committees, as co-chair of the ECOG-ACRIN GU subcommittee, and as a member of NCI’s Prostate Cancer Task Force.
Our profession is currently engaged in difficult conversations: increasing challenges in health care economics, hope and threat of artificial intelligence, and renewed questions about our previous understanding of tumor and radiobiology in an era of increasing hypofractionation. We are also facing a sad and real crisis in global care access that deserves a substantial amount of resources and attention to help alleviate avoidable suffering.
Fortunately, there is also reason for enthusiasm in our field. Our technologies are more targeted than ever before, with design adaptations for more rapid distribution in developing nations. We now have multiple lines of evidence across different cancer types that demonstrate radiotherapy can prolong life in patients with metastatic disease, an idea that was considered heresy not that long ago. And our ability to complement systemic therapies remains of interest as patients experience better overall outcomes.
If given the opportunity to serve, I will strive to hear all stakeholders, examine how our scope of practice has evolved, and consider the obstacles we face. I will leverage the knowledge and connections I have cultivated to search for viable solutions as we navigate the dynamic landscape ahead. I believe a consistent growth mindset will allow us to reinforce our seat at any table pertaining to cancer patients, and to reinforce that effective, compassionate, innovative, research-driven cancer care is our specialty’s specialty.
Neha Vapiwala, MD, FACR, is currently an associate professor and vice-chair of education in the Department of Radiation Oncology and newly-appointed dean of admissions at the Perelman School of Medicine at University of Pennsylvania.
Upon earning her undergraduate degree from Johns Hopkins University, Dr. Vapiwala spent a year working as a full-time high school science and math teacher in Maryland. She subsequently matriculated at the University of Pennsylvania (Penn) School of Medicine as a Twenty-first Century Scholar before embarking upon her training and career in radiation oncology at Penn. During her tenure as faculty, Dr. Vapiwala has specialized in the treatment of patients with genitourinary malignancies. She has an active practice and has been named to national and regional Top Doctors’ lists annually from 2015 to 2019. She was recently inducted into the Academy of Master Clinicians at Penn, the highest institutional honor awarded to physicians for exceptional patient care, and was the 2019 co-recipient of the Headstrong Foundation Achievement Award along with her radiation oncologist-husband, Dr. John Plastaras.
Dr. Vapiwala is the principal investigator of several investigator-, industry- and cooperative group-led clinical trials. Her research efforts have focused on the clinical management of genitourinary and breast cancers, novel imaging studies, and incorporation of integrative therapies for symptom management. She has directed several international oncology-related training courses and written extensively on a variety of issues affecting medical education from undergraduate to professional levels. More recently, Dr. Vapiwala has engaged with multiple colleagues across disciplines to explore the existing and future role of radiation oncologists as key members of the oncology care team.
Her passion for learning from and collaborating with mentors, peers and trainees from a variety of backgrounds and with a range of perspectives is a critical source of motivation and satisfaction in her career, as are her incredibly supportive life partner and their three young kids who always help to put even the toughest day at work into amazing perspective.
ASTRO’s Strategic Plan serves an important purpose for our professional society in establishing pragmatic goals for its members. And although some goals may appear to be stated somewhat imprecisely (“protect access to effective radiation oncology treatments for patients”; “facilitate Radiation Oncologists’ ability to successfully participate in quality and value based incentive programs”), they are an unambiguous call to action during this period of transitioning health care payment systems. Looking forward, radiation oncology and other fields of medicine will be held increasingly to account for the value of their services to the well being of the patient. In the end, there will be a distribution of winners and losers, and that distribution is likely to be determined by how effectively each medical field advocates for its clinical merits.
The Strategic Plan and its stated Health Policy goals focus and inspire me to think about how we as radiation oncologists can promote our services compellingly and convincingly. It’s not enough to know the great value of our care for the cancer patient and expect that others who govern our payments see it as clearly as we do. In next few years, there will be a growing competition among different types of cancer care providers that may also include various industry groups, all of whom will be making an argument for fair reimbursement for their services and products. Health Policy plays a crucial role in this scenario, preparing information that supports our cause and helping to organize an effective advocacy through which that information may be transmitted to key policy and decision makers in government and within key private entities.
As I look at the current state of radiation oncology, I am very encouraged for our future. We are lucky to have been bequeathed this field of medicine from our predecessors, who wisely navigated us through previous transitions in payment method and have placed us in a good position to plan for the years ahead.We continue to attract smart and talented people into our field in excess proportion to our small numbers. Further, we have a broad representation of background and experience at multiple levels through the organization and a cooperative spirit among our many groups. We will need all these advantages in the near future, and the Strategic Plan’s goals provide us the direction and momentum with which we can apply them to our patients’ benefit and ours.
After completing residency, I entered private practice in 2000 and joined a large single-specialty practice in Florida. Since then, my physician practice has grown into a very large multi-specialty oncology services company. During this period of growth, I was fortunate to become involved in various key administrative projects related to payer contracting, revenue cycle management, business intelligence and compliance and to have been mentored by smart people in each of these functions that are critical to the business of medicine. One specific project worth mentioning is my company’s design and execution of an alternative payment model for radiation oncology in 2012, which was a first between a practice and a commercial insurer. That agreement remains active today, and our company has executed similar agreements since then with other private payers.
Over time, it became clear to me that ASTRO’s Health Policy committees were addressing many of the same problems – improper claims denials, incorrect coding, out-of-date coverage policies, and others – that I needed to solve within my administrative capacity for my company. I first joined the Payer Relation Committee and was impressed with the seriousness and efficiency with which the group worked in effectively managing coverage problems related to Medicare and private insurance policies. I have since worked on all other Health Policy committees and currently serve as Health Policy Co-chair. Looking ahead, I believe that Health Policy staff and members have accrued valuable knowledge that will be brought to bear on the upcoming challenges of payment reform in our specialty.
The core purpose of the strategic plan is to advance the field of radiation oncology. The inclusion of engaged radiobiologists within ASTRO, and its leadership, is essential to implement this core purpose, and also meet the core values of ASTRO: Excellence in patient care, improved outcomes, innovation, integrity and diversity and inclusion. Radiobiology remains an evolving and important scientific discipline within ASTRO, and provides biological innovation for ASTRO. The advent of new radiation technologies that deliver FLASH-RT and hypofractionation, along with the biological and mechanistic advancements in immunotherapy, have produced a wave of new radiobiology and radiation oncology questions that need to be investigated, along with a need for further education.
The function of the ASTRO Science Council is to educate all ASTRO members about these innovations in radiation oncology, and ensure the membership are kept up-to-date with these scientific advances, both at the Annual Meeting and special topic workshops. The Science Council also promotes research engagement with other national societies, and the public, to ensure the expertise of ASTRO members remains at the forefront of these enterprises.
I have a long-track record of engagement within ASTRO, through its education and research committees, and this will continue as the prospective Biology Vice-chair of the Science Council. My priority is to increase the visibility of radiobiology and cancer biology education and research at the Annual Meeting, and reinvigorate radiobiology and cancer biology membership within ASTRO by engagement with other radiation-based professional societies. This would improve the radiobiological educational environmental and appreciation of scientific innovation for resident trainees and members.
Dr. Marples is a research professor and director of radiobiology of the Department of Radiation Oncology at University of Miami Miller School of Medicine. His laboratory research is funded by the NIH/NCI and multiple foundations, most recently the Live Like Bella Foundation, and he has received past funding from the Department of Defense. His research focuses on the mechanisms of radiation injury in the kidney, as well as low-dose radiation responses in tumors and normal tissues. Dr. Marples is the senior biology editor for the International Journal of Radiation Oncology Biology Physics. He has demonstrated his commitment to the education and mentoring of Radiation Oncology residents by his service on the ACR TXiT in-service and ABR Board Certification Qualification Exam committees. His past service for ASTRO has included Education and Radiobiology Committees, Annual Meeting Program Development Committee and he most recently chaired the Science Education and Program Development Committee.