ASTRO leadership has been listening carefully to the questions and varied opinions shared about meeting locations, including our upcoming Annual Meeting in San Antonio, Texas, set to take place in just three months. Despite our collective desire to share the latest research and clinical trial results, we've heard from some that they are uncomfortable visiting Texas, as its laws make them feel unsafe or unwelcome.

Attempting to move the Annual Meeting to a new city at this late date would be a herculean challenge with immense and extraordinary ramifications, including significant financial implications and detriment in the quality of presentations, education and engagement. ASTRO leadership made the difficult decision to hold the meeting as planned. For those of you who choose to not travel to Texas, we respect your decision. We expanded our virtual offering to give you complete access to the entire meeting, which will be fully livestreamed for the first time this year. Additionally, all registrants, both in-person and virtual, have full access to the onDemand recordings as part of their registrations.

We are pleased to announce that our 2023 meeting will be in San Diego, California. For future meeting locations, we understand your concerns, and these considerations are at the forefront of our decision-making process.

The health care landscape in this post-Roe era is ever evolving, with varying implications on a per-state basis, and in some cases possibly within states. ASTRO is monitoring the situation attentively, and as members identify needed resources, we will look to meet those needs. We also encourage continued dialogue on these important issues; please continue to access ROhub to respectfully share your perspective.

As a community, we responded well to the unexpected challenges caused by the COVID-19 pandemic. As medical professionals, we hope the ASTRO community will again rise to the occasion and continue to prioritize the health care of its patients and members.

For this year’s Annual Meeting, we have 11 attendees who will serve as Social Champions. Two #ASTRO21 Social Champions, Amishi Bajaj, MD, and Laura Dover, MD, share what they look forward to at the Annual Meeting in Chicago, October 24-27.

Amishi Bajaj, MD

Dr. Bajaj: This year’s Annual Meeting promises to be particularly special because it’s the first time we’ll all be gathering in one place since the onset of the pandemic. There is no better time and place to satiate one’s hunger for self-improvement and continued excellence in radiation oncology than the ASTRO Annual Meeting. It’s a five-day buffet featuring the most delectable bites of information, carefully curated for indulgence by all. Being a PGY-4 resident, and having such vast interests, I plan to cover general radiation oncology because it means I get to sample a bit of everything!

I will be sitting at the edge of my seat anxiously awaiting novel, practice-altering data, so I can’t wait for the Plenary session on October 25 with insights into the management of prostate cancer, HPV-positive oropharyngeal cancer and node-positive breast cancer. I am also extremely excited for the ASTRO/NCI Diversity Symposium on October 24 (and the Diversity, Equity and Inclusion in Health Care session on October 25 — there’s a DEIH track now!) as well as the disease-site specific, case-based sessions addressing nuances underlying treatment considerations throughout the conference, the biology session on genomic and molecular biomarkers (October 24), the ASTRO/RSS session on heterogeneous tumor dosing and spatial fractionated radiotherapy (October 25) and both Keynotes. As the Junior Chair of Communications for ARRO, I look forward to the ARRO programming on October 23, and as the proud presenter of two posters on early-stage breast cancer and glioblastoma (October 25 and October 27), I can’t wait to also check out the wonderful work done by others, both within breast and CNS radiation oncology, as well as within other areas of study.

I look forward to the practice-changing data, the cutting-edge technology presented by industry exhibitors and the cool Zen Den sessions happening daily in Room W180 as well as the camaraderie with my colleagues. I’m sure the other attendees share our sincerest hopes to optimize therapeutic ratios, feel the same consternation when faced with rock-and-a-hard-place re-irradiation cases and experience the same electrifying jolt evaluating the hotspot on a heterogeneous, ablative SBRT plan for an oligometastasis.

What makes the conference experience so deeply enriching is the ability to discuss presentations with people in real time, so I’m enthusiastically awaiting the opportunity to re-experience that this year for the first time in 19 months.

Laura Dover, MD

Dr. Dover: As editor and co-founder of QuadShot News, I use social media to keep a finger on the pulse of what radiation oncologists are curious about, struggling with or celebrating. QuadShot News was created to help keep busy radiation oncologists informed of recent literature and policy updates relevant to their clinical practices. Social media is particularly helpful in broadening familiarity with a variety of strategies of treatment for those who are only exposed to a single practice pattern. Perhaps most importantly, it provides camaraderie among a small field that is often widely dispersed in small pockets throughout the country.

We (co-founder Caleb Dulaney and I) were surprised when a reader nominated us as an ASTRO 2021 Social Champion and are excited to share our ASTRO experience with everyone on social media throughout the meeting. As the largest annual conference for radiation oncology, ASTRO attendees — virtual or in person — can easily be overwhelmed in their attempts to digest the most practice-changing highlights of the conference. We’re here to help. We will be sharing our take-aways in real time across as many disciplines as possible so you can feel like you’re right there with us. Please reach out to us directly if there is a particular trial or concept you’d like us to cover!

Follow the Social Champions and @ASTRO_org with our official hashtag #ASTRO21.

By Andrea Ng, MD, MPH, Chair, Annual Meeting Scientific Program Committee, and Christina Tsien, MD, Chair, Annual Meeting Education Committee

Words matter. As research has indicated and has been highlighted in a recent ASTRO Blog, it is important to use professional introductions, correct pronunciations of names and correct use of pronouns as well as respectful language around patients when presenting research at meetings. In an effort to improve the practice of using respectful language regarding patients and colleagues, the ASTRO Annual Meeting Steering Committee, in collaboration with the Committee on Health Equity, Diversity and Inclusion, developed Culture of Respect guidelines for presenters at the Annual Meeting.

The guidelines provide examples of appropriate and inappropriate language presenters and moderators can use to prepare presentations. We encourage all ASTRO members to review the Culture of Respect guidelines below and adhere to them when preparing presentations for the Annual Meeting and to continue to use them for all ASTRO meetings. In addition, these guidelines can help you think about the words you use when speaking with patients and their families. The guidelines can also be found under the Speaker Resources section of the Annual Meeting website.

Building a Culture of Respect at the ASTRO Annual Meeting: Language is Action

Historically, health care language has not consistently been centered on patient sensitivity. Insensitive health care language can have the inadvertent consequence of alienating and dehumanizing patients. It is increasingly recognized that “words matter” and can shape and reflect our behavior, and appropriate language is imperative to ensure that our patients and their families are treated with respect and dignity. Adopting language of respect extends also to the treatment of our colleagues. Recent studies have uncovered inconsistencies in the use of formal titles in the introduction of speakers at national and international conferences.

With an expanding audience due to increasing use of virtual technology and social media, and in order to foster a respectful, inclusive and bias-free culture, ASTRO and its 2021 President pledge to raise awareness, provide guidance and standardize appropriate language use at the ASTRO Annual Meeting. As such, the following directives, which will be continually evaluated, updated and modified, have been developed for participants of the ASTRO Annual Meeting during all ASTRO sessions and presentations:

1. When describing research findings, or presenting the case of a patient, avoid language that:
   (i) Imply patients are responsible for their condition or outcome

• Instead of: “20% of patients failed treatment”
  Appropriate language: “20% of patients had tumors that did not respond to treatment”
  Instead of: “20% of patients progressed”
  Appropriate language: “The tumors progressed in 20% of patients”

2. Dehumanize patients

• Instead of: “A 42 year-old paraplegic”
  Appropriate language: “A 42 year-old patient with paraplegia”

3. Stigmatize patients

• Instead of: “Substance abuser”
  Appropriate language: “Patient with a history of substance use disorder”

2. When introducing or addressing speakers:

1. Speakers who have a doctoral degree (e.g., MD, PhD, ScD, DMD, PharmD) should be introduced and addressed as Dr. Full Name or Dr. Last Name.
2. All other speakers should be introduced as Mr./Ms./Mx. Full Name or Mr./Ms./Mx. Last Name
3. Formal titles should be used throughout the entire session, including Q&A, in a consistent manner, regardless of the level of familiarity with each other
4. Whenever possible, we strongly encourage session, panel or workshop chairs, moderators and all other speakers, to confirm ahead of time the correct pronunciation of the speakers’ names and their gender pronouns. Visit https://www.mypronouns.org/how for more information on pronouns.

ASTRO Leadership greatly appreciates the valuable contributions from all ASTRO Annual Meeting Faculty members, and their commitment to support a culture of respectful, collegial and inclusive interactions.

By Laura A. Dawson, MD, FASTRO, ASTRO President

I’d like to continue to share insights with you about ASTRO 2021. Today, I’ll be focusing on the Presidential Symposium. The theme is Advancing Person-Centered Care Through Innovation — innovating for clinically meaningful benefits that matter to patients. While this is innate in what we do, we sometimes don’t aim high enough or consider the patient perspective as well as we should. Let’s ask patients what matters to them.

The symposium will open on Sunday, October 24, with an introduction by me to be followed by Dr. Shekinah Elmore, who will eloquently discuss innovating with compassion. Then the session “Harnessing Scientific Innovation to Improve Person-Centered Care,” moderated by Dr. Curtiland Deville and Dr. Kristy Brock, will have a cast of world-class speakers discussing artificial intelligence, innovations in radiation delivery and imaging, ultra-high dose rate/FLASH, advanced imaging for bioadaptive radiotherapy, patient-centered radiopharmaceutical therapy and personalizing radiation therapy using molecular biomarkers. A patient advocate will help us put these inspiring talks in context.

The second session focuses on how digital health improves patient outcomes and experiences. We’ll hear from human factors engineer, Dr. Jen Horonjeff who will talk about patients and crowdsourcing. Next, Dr. Debra Schrag, a medical oncologist leader in patient reported outcomes and measurements will discuss PROMs and PREMs as the true north — why/when/how. Dr. Edmondo Robinson will discuss reducing disparities with digital innovations. Then, Dr. Ale Berlin will highlight how he helped move in-person health visits to digital health visits at a large cancer center over just a few weeks in response to COVID-19. A panel will follow, discussing how to make user-friendly changes quickly and how to innovate equitably, using advances in digital health. Dr. Nitin Ohri will share how he’s implemented wearables (e.g., Fitbits) in the radiation oncology clinic. How can we use these tools to improve patient experiences and outcomes?

Session three asks what are some of the potential future applications of radiation therapy that may expand the role of radiation therapy and improve patient outcomes? Radiation replacing surgery, for example for liver cancer — while we aren’t there yet, there is potential. Dr. Jinsil Seong will delve into this topic. This session will keep us thinking. How can we use radiation therapy in new settings with the goal of cure? How do we get there? A talk by Dr. Chandan Guha will discuss innovative targeting of the immune system and microenvironment, for example using radiation as a vaccine. Dr. David Palma will look into the future of oligometastases SBRT, beyond three, 10 and even more metastases. In another talk, Dr. Stuart Burri will challenge us to rethink pre-operative radiation therapy. Dr. Yaacov Lawrence will share how to treat the celiac plexus with SBRT to improve cancer pain. Again, a patient advocate will provide their important perspective.

The final session will be entertaining and educational. How do we best obtain evidence for new applications of radiation therapy? Traditionally we’ve use randomized clinical trials. Can trials be more efficient and equitable? Can we learn from clinical real-world data that is searchable and inclusive of patients who are not eligible for trials? A lively debate on randomized clinical trials versus real world data will be moderated by Dr. Sue Yom and Dr. Gita Suneja. Four speakers will offer points/counterpoints for randomized clinical trials versus real world data, and Jill Feldman, a lung cancer patient advocate and survivor, will provide her thoughts on this challenging topic. This will be an engaging and interesting opportunity for audience input.

The Presidential Symposium will highlight exciting advances in radiation technologies and teams who can successfully deliver high-precision treatment, keeping the goal on where we want to be and what outcomes matter to patients. Let’s elevate our specialty beyond delivery of high-tech treatment together to advance person-centered care. I hope this provides you with some sessions to look forward to during the Presidential Symposium. If you aren’t yet registered, I encourage you to learn more and make plans now to join us in person or virtually for the Annual Meeting. The Presidential Symposium will be available as part of the Digital XP programming. If there are other topics you’d like to learn more about, I invite you to drop me a note.

Learn more about ASTRO 2021 from my first blog: Embracing Change: Advancing Person-Centered Care at ASTRO 2021

By Laura A. Dawson, MD, FASTRO, ASTRO President

Not only am I embracing change, but I’m stepping outside of my comfort zone as I write my first blog post about ASTRO 2021, our Annual Meeting. I was so pleased to announce on July 8 that registration and housing have opened. We’re back in person in Chicago, and I can’t wait to see you there, as we start to step out of our “COVID hibernation.” If you’re unable to travel to the meeting, we’ve added a virtual option called Digital XP. And we’re also offering risk-free registration through September 30, so you can take advantage of early-bird registration rates (see registration fees and policies on the meeting website for more information). I encourage you to learn more about the meeting and make plans to participate!

Today, I’m excited to share my personal thoughts with you about the Annual Meeting and the meeting themes of “person-centered care” and “embracing change.” I will start with person-centered care, which focuses on the whole person as a unique individual, beyond their cancer diagnosis. Patients are someone’s child, friend, partner and/or parent. A person’s work and hobbies are often disrupted by a cancer diagnosis and treatment, and we are in a unique position to care for and support people during some of the most challenging times of their lives. Placing an individual at the center of their care, partnering with them and personalizing treatment based on a more holistic approach that incorporates various dimensions to well‐being, including a person's individual preferences and beliefs, is “person- centered.” This approach acknowledges physical and financial barriers to care and other determinants of health. It should lead to more compassionate care and trusting relationships with patients and their families and ultimately, can help to improve health care system efficiency and effectiveness for the whole community.

A special person-centered session at this year’s meeting will be The Science of Hope: Why and How to Approach the Most Difficult Situations in Oncology. It’s sure to be inspiring. Hope is important to patients; it’s appropriate, necessary and a critical component of quality care. In this session, we’ll cover why hope matters, the psychoneuroimmunologic basis of hope and finally, how to cultivate and sustain hope in clinical practice and in clinical trials.

No matter what scientific innovation is being discussed at the meeting, it should come back to a person-centered approach. Let’s aim high — for clinically important improvements in outcomes and experiences that matter to patients and their families. We also need to look after ourselves and have empathy for each other, as we have had different degrees of loss and burnout, especially during the past year and a half. Creating a more supportive, nimble work environment may allow us to be more accessible to patients, which should in turn improve the patient experience and outcomes, as well as caregiver satisfaction and wellness. 

The second theme is embracing change. I picked this topic because I’d like to see us be more open to new ideas and different ways of thinking to help shape the future of radiation oncology. Let’s prioritize strategies to improve diversity in our field, which will help to improve person-centered care. Be open minded when someone suggests an idea that conflicts with your own inherent biases and thoughts. Let’s think of new ways to more efficiently demonstrate the benefits of radiation therapy innovations and applications, for example, with novel pragmatic trial design and/or new ways of producing evidence.

As we think about change and the profession, we can also think about new roles and new team members. Radiation oncology is a team involving physicists, radiation therapists, engineers, other oncologists, nurses, social workers, dieticians and other health care professionals. Radiation oncologists never work in isolation. As we implement new technologies and artificial intelligence (AI), all our roles will continue to evolve, and we must continue to advocate for clinically important advances. Who should be part of the team to ensure that such change occurs in an equitable manner, reducing disparities in access to treatment and cancer outcomes?
Computer scientists who are experts in machine learning and AI are playing an increasingly important role in radiation oncology, making them an obvious new team member to radiation oncology departments. One of our Keynote speakers, Dr. Fei-Fei Li, an expert in AI and computer vision, will share her views on the future of AI in health care as part of the Digital XP program (also available to all full conference registrants).

We also can learn from human factors engineers, implementation scientists, behavioral scientists and economists. I’m excited about Dr. Dan Ariely’s Keynote that will address why people do the things they do, which is a consideration in how to provide the best care for patients, how to successfully implement innovations and how to advocate for our specialty. His book, “Predictably Irrational: The Hidden Forces That Shape Our Decisions,” focuses on the behavioral research behind decision making. I expect to gain some great insights into behavior during this address.

Dr. Wendy Dean, a social scientist, will talk about the structure of medicine and how some structural changes have led to burnout and languishing during her Keynote address. We don’t usually have a social scientist on the stage, so this will be a treat. There’s so much that they and other scientists have to offer to the field. Let’s learn from them about how to improve person-centered care. Learn more about the three Keynote speakers.

I’ve provided some background and an overview of select sessions we have planned for ASTRO 2021. I hope you’ve enjoyed learning more about what you have to look forward to this year. In my next blog post, I will share more information about the Presidential Symposium. If there are other topics you’d like to learn more about, I invite you to drop me a note or even better, talk to me in person in Chicago!

Registration is open with many options to attend “your way!”