Climate Change: A New Challenge for Radiation Oncology

By Katie Lichter, MD, MPH, Co-chair, Climate Change and Health Equity Task Force

As an intern physician in September 2020, I walked home after a night shift in the intensive care unit with my N95 mask still tightly secured. That morning, we had been advised not to remove our masks despite being outdoors. The air was thick with a reddish-brown haze, an ominous blanket covering San Francisco. It was 8:30 a.m., yet the morning light struggled to penetrate the thick smoke from the Northern California wildfires that drifted downwards over the Bay. Overnight, an elderly man with advanced non-small cell lung cancer had been admitted with disease progression. Due to the wildfires, he had missed several crucial weeks of chemoradiation weeks as he was lost to follow-up, in addition to losing his home and supportive community.

In that moment, I realized that climate change would significantly impact my ability to provide care to patients in the decades ahead. Vulnerable patients and communities were already subject to increasing climate-fueled disasters. Just as COVID-19 had tested the limits of the health care system, I understood that climate change will undoubtedly present new and unexpected challenges for health care professionals and communities alike to navigate.

Over the past few years, radiation oncologists have increasingly faced the fragility of our nation's health care infrastructure due to the pandemic and extreme weather events such as hurricanes, wildfires and flooding. Anna Paulsson, MD, summed it up well when she recently stated, "Practices deal with wildfires and other climate change-fueled disasters events every year, but it is challenging to know how to respond, prepare for clinics and patients, and react to these events." These events can cause radiation oncology facilities to shut down, upending the lives of patients, physicians and care teams crucial to treatment. In 2017, in response to Hurricane Maria, ASTRO collaborated with other health care organizations to direct patients to radiation oncology clinics that could accept displaced patients. However, unmet and growing concerns remain about the impact of climate change on patient care and the need for increased environmentally sustainable practices within radiation oncology.

These concerns are shared by other physician specialty organizations, including the American Medical Association, the American Society for Clinical Oncology and the American College of Radiology. To address these concerns, ASTRO joined the Medical Society Consortium on Climate and Health to advocate for climate change solutions that protect and promote public health. The Consortium also provides educational resources to inform health care professionals about the effects of climate change on patient health and guidance on sustainability best practices.

ASTRO task force to study impact of climate change
In January, the ASTRO Board of Directors approved the establishment of a Climate Change and Health Equity Task Force to explore the impact of climate change on radiation oncology. This task force is charged with developing a policy statement describing ASTRO's commitment to addressing climate change, its impact on radiation oncology and vice versa. The statement will include several key focus areas that will inform future activities. The group has reviewed literature on the impact of climate change on radiation oncology, cancer care and public health, as well as the activities of allied organizations, many of which are still evolving. Emerging from these discussions are areas of interest that include patient and provider education, disaster preparedness, building resiliency, sustainability and decarbonization, and identifying and addressing environmental justice and health equity.

In the coming months, the task force will explore these areas further to determine their impact on radiation oncology. Through these efforts, ASTRO hopes to mitigate the effects of climate change on patient care and promote environmental sustainability practices within our field, and even lead the way in doing so. By prioritizing environmental health and sustainability from a health equity lens, radiation oncologists can ensure equitable delivery of cancer care to all patients and communities, despite a changing climate.

Posted: April 18, 2023 | 4 comments

Engaging with ASTRO – Getting the most out of your ASTRO membership

By Jeff M. Michalski, MD, MBA, FASTRO, ASTRO President-elect

Getting involved with ASTRO is the best way to ensure that your Society is representing your needs and the needs of our members. There are many ways to become involved, and I am excited to share with you a few suggestions, so please read on to learn how you too can get involved.

One of the most obvious ways to engage with ASTRO is to volunteer for a committee. This is a formalized process that begins with a “call for volunteers” in March — which is why I am authoring this blog today. As ASTRO president-elect, one of my first responsibilities is to review the list of committee members and volunteers that come in through the call. Staff liaisons and committee chairs vet the volunteer list to ensure no conflict of interest exists and to ensure diversity of occupation, gender, race disease-site specialty, practice type, etc. So, please be sure your ASTRO profile is up to date. The Call for Volunteers will be announced in the March 2, ASTROgram. Be sure to click on the link in the announcement to view the more than 30 committees that are accepting volunteers ranging from bylaws and ethics to communications, health policy, education, research and more!

Are you concerned that you may be too junior in the field to get involved? Recent data show that 35% of volunteers are 10 years or less out of residency. My first volunteer opportunity came in 1997 when I was six years out of residency. I joined the ASTRO Communications Committee and learned about the issues that were confronting our society and how membership could drive change in our specialty.

In addition to participating on a committee, there are many other ways to increase your involvement and engagement with ASTRO.

  • Journals reviewer: Peer review is an integral part of scholarly publishing and is also a great way to get involved with an ASTRO journal. The journals also offer two reviewer training programs, including the Resident Peer Reviewer Training Program and the Practical Radiation Oncology Reviewer Apprenticeship.
  • Share your voice and expertise: Provide comments on ASTRO guidelines and white papers. The calls for comment are disseminated in the weekly ASTROgrams and on ASTRO.org.
  • Participate in surveys: ASTRO uses the data from surveys to better serve our membership, including enhancing existing programs, creating new initiatives and improving the membership experience.
  • Enjoy the benefits of mentorship with ASTRO’s new program, MentorMatch. Whether you’re a mentor or a mentee, mentorships are beneficial to all parties involved and a different way to get more involved with the Society and your fellow members.
  • ASTRO has a robust and active social media presence. Follow the Society on Twitter, Facebook, Instagram and YouTube to share content, converse across platforms and stay abreast of hot topics.
  • Join the conversations on the ROhub: This exclusive member forum is built to enhance networking and information sharing among ASTRO members. I encourage you to start a thread or comment on an existing one. The two-way dialogue facilitated on the ROhub is a great way to keep a pulse on hot button issues affecting your colleagues and a great source for networking.
  • Participate in grassroots advocacy efforts: Help make an impact on national and state legislation by becoming a radiation oncology advocate.
  • Become an APEx surveyor: ASTRO’s accreditation program seeks members to serve as site surveyors. APEx surveyors participate in a one-day facility visit as part of the accreditation process.

No matter your interests, there are many ways you can engage with your Society and be an active member of ASTRO. Still not sure where to start? Please reach out to me directly at Jeff.Michalski@astro.org. I’d be thrilled to hear from you and discuss the opportunities available.

Learn more about the committee service selection process.

Posted: February 15, 2022 | 0 comments