Your art could be on the cover of the Red Journal

By Jennifer Bellon, MD

While our flagship journal, the International Journal of Radiation Oncology • Biology • Physics (IJROBP), nicknamed “The Red Journal,” is best known for practice-changing science, cover art offers a welcome contrast — an opportunity to celebrate and embrace our humanity.

Cover art began under the tenure of Anthony Zietman, MD, FASTRO, in 2012 when he first solicited non-science related images to display on the cover of the journal. Today, we continue that tradition, publishing selected images of art on the cover of each of our 15 yearly issues.

We have represented a large diversity of mediums over the past decade, including painting, drawing, sculpture, fabric and leather work, musical compositions, collage and photography. Not only do we encourage art in all forms, but we also very strongly encourage submissions from the entire radiation oncology community —including physicians, therapists, physicists, nurses, dosimetrists and researchers, both in the U.S. and worldwide. This is an excellent way to bring us together as a community focused on our common humanity.

To submit an art image to IJROBP, please visit the submission system website, designating the article type as “Image.” Interested artists are encouraged to submit multiple images for consideration. There is no fee for submission, and artists may email questions.

Following are some examples of the diversity of work that has been recently featured on our covers.


Vol 114, No 1.
"The Garden and the Quail"
by Shari Bodofsky, MD

Medium: Acrylic painting
Dr. Bodofsky was a medical student at Robert Wood Johnson Medical School, about to start residency at Yale New Haven Hospital, when she submitted this painting. Her painting draws on botanical imagery and textile themes. She also sews and makes plushies. This painting was intended to express harmony during a tumultuous pandemic.

Vol 114, No 4.
"Needlepoint Precision"
by Ane L. Appelt, PhD

Medium: Embroidery
Dr. Appelt is a medical physicist and associate professor at University of Leeds in the United Kingdom. She has contributed to multiple national and international trials and also researches outcome modeling, AI for toxicity prediction, and re-irradiation. This cross stitch represents a lung stereotactic ablative radiotherapy (SABR) dose distribution made up of approximately 6,000 individual stitches, 1.5mm each, in 30 different colors.

Vol 116, No 2.
"Tres Veces"
by Gary V. Walker, MD, MPH

Medium: Pottery
Dr. Walker is a radiation oncologist at Banner MD Anderson Cancer Center and an adjunct associate professor at The University of Texas MD Anderson Cancer Center. He treats patients with head and neck as well as gastrointestinal malignancies. His first exposure to ceramics was in a high school art class and he has since created thousands of pieces, mostly functional ware including plates, bowls and mugs.

Vol 116, No. 5.
"Faces in the Darkness"
by Tony Orlina, CMD.

Medium: Acrylic painting
Tony Orlina is a dosimetrist at Brigham and Women's Hospital in Boston. He has been an avid painter for over 20 years, finding it an enjoyable outlet to the stress of daily life. He presented this acrylic painting representing faces in the darkness.

Vol 117, No 1.
"Past Paste"
by Anna (Annie) LaVigne, MD

Medium: Charcoal on paper, sculpture
Dr. Anna (Annie) LaVigne was chief resident at Johns Hopkins University when she submitted this artwork portraying the interaction between toothpaste and small, paper-related objects referencing travel, things collected, and the passage of time. As a previous Johns Hopkins Health Humanities Distinction Track scholar, she is passionate about forging intersections between the health humanities and radiation oncology.

Vol 117, No 2.
"Lion Cub"
by Jennifer Bellon, MD

Medium: Digital photograph
And last, as an avid wildlife photographer with a focus on Alaska and Southern/East Africa, I photographed this lion in the Maasai Mara, Kenya, with my camera held against the ground to emphasize the eye level connection with the lion cub.

Dr. Bellon serves as the Art Editor of the Red Journal and is a former Associate Editor and Section Editor of the Breast Cancers section and a radiation oncologist at Dana-Farber Cancer Institute and Brigham and Women's Hospital, specializing in the treatment of breast cancer.

Posted: January 11, 2024 | 0 comments

Final Updates from the 2022 Survivor Circle Grants Awardees based in Texas

By Jennifer Jang, ASTRO Communications

In fall of 2022, two Texas-based organizations, Breast Cancer Resource Center (BCRC) and Thrivewell Cancer Foundation were selected as ASTRO’s Survivor Circle grant winners for the services they provide to cancer patients, their families and caregivers. Each organization received a $10,000 grant in October and were honored at the 64th Annual Meeting in San Antonio. Specifically, the Survivor Circle Grant Program provides financial gifts to two cancer support organizations in the state hosting ASTRO’s Annual Meeting. ASTRO followed up with both organizations to learn more about how the grants provided tangible support in the past year.

Based in San Antonio, ThriveWell Cancer Foundation offers programs and support to improve the quality of life for patients and their families in San Antonio and the Bexar County community. They carry out their mission by providing the following: financial assistance to help offset treatment-related expenses, a complimentary fitness and nutrition program called Diva&Dude, and cancer research funding for local researchers.

ThriveWell used the Survivor Circle award to expand their Patient Assistance Program, which served a record number of patients in their community, 575 to be exact, a 30% increase in patients served over the same time frame the prior year. The grant specifically helped 10 cancer patients pay for their radiation treatment co-payments of up to $1,000 each, allowing the patients to fully comply with their treatment plan. Patient Graciela C. shared, “At a time when I felt my most vulnerable with this disease and everything that comes along with it, it was so comforting to have the support and assistance that ThriveWell provided. I am so grateful to the entire staff and donors who made it possible for me to get through my treatment. I will be forever grateful, and I hope to reciprocate what this foundation has done for me.”

BCRC has provided services for over 28 years in Central Texas. BCRC runs a Patient Navigation program that provides guidance and education to people diagnosed with breast cancer in their community. In addition to their one-on-one patient navigation, BCRC provides support to their clients, including monthly support groups, online forums and their Compass Crew program for health and wellness.

This past year, multiple Compass Crew events were very successful including Healing with Horses and Rowing, and this past spring, they had their infusion room volunteers begin, providing over 580 hours in five infusion centers comforting cancer patients. BCRC held their annual Art Bra Austin event in May and had over 600 attendees cheer on models who are all BCRC clients. They coordinated a retreat for their metastatic clients in August and 33 attended. A survey afterward captured that 92% said it felt good to be with people going through the same thing as they are. BCRC used the Survivor Circle grant to support their patient navigators, individuals who are critical to the BCRC mission of empowering those affected by breast cancer with personalized support and compassion.

The Survivor Circle grant has allowed these two special organizations to multiply their impact. We encourage cancer support organizations in next year’s Annual Meeting region, DC-Maryland-Virginia (DMV), to consider how they too might bolster their support. Applications are open and due in the spring. 

Read about the 2023 California-based Survivor Circle grant recipients. These two organizations received their grants in October at the 2023 ASTRO Annual Meeting in San Diego.

Posted: December 12, 2023 | 0 comments

ROI's 12 Days of gRADitude

This year, more than one million Americans received radiation treatment as part of their cancer care. That’s why the Radiation Oncology Institute (ROI) — ASTRO’s foundation — believes in the power of radiation therapy to save and improve lives and the essential need for more personalized technologies, techniques, tools and resources.

As the only charity dedicated to advancing research and education on radiation therapy to directly impact people living with cancer, ROI champions passionate investigators who employ bold, innovative approaches to solve oncology’s biggest challenges.

From Monday, December 4 through Friday, December 15, ROI is celebrating the 12 days of gRADitude! Each day, we’ll share an amazing milestone from our ROI-funded researchers. And, we invite you to join us in amplifying radiation therapy’s impact by making a tax-deductible donation.

In addition, Frank Wilson, MD, FASTRO, and members of the ROI Board of Trustees are offering to match all donations received up to $12,000!  Help us raise vital funds, celebrate our successes, and prepare to give new grants and awards in 2024.

On the twelfth day of gRADitude


On the eleventh day of gRADitude


On the tenth day of gRADitude


On the ninth day of gRADitude


On the eight day of gRADitude


On the seventh day of gRADitude


On the sixth day of gRADitude


On the fifth day of gRADitude


On the fourth day of gRADitude


On the third day of gRADitude


On the second day of gRADitude, ROI shared with me


On the first day of gRADitude, ROI shared with me


Follow the 12 days here or on the ROI social channels — X (formerly Twitter), Facebook and LinkedIn — and make your personal gift to accelerate radiation oncology research and education at ROInstitute.org/donate.

Posted: December 1, 2023 | 0 comments

Navigating the APEx Journey: Insights from the Radiation Oncology Community

Embarking on the path toward ASTRO’s APEx – Accreditation Program for Excellence® is a transformative endeavor for any radiation oncology practice. This rigorous process sets a high standard for quality and safety in patient care. In this blog, we have the privilege of hearing from five members of the radiation oncology community who have successfully achieved APEx accreditation or are in the process of doing so. Their experiences shed light on how they learned about APEx, the pivotal factors that led to their decision to change accrediting bodies, and the challenges and triumphs encountered. Additionally, we gain insight into the unique aspects of APEx that set it apart from their previous accreditation experiences, like the Self-Assessment. Their collective experiences offer a roadmap for other practices that may be considering APEx. For more detailed information about each phase of the APEx process, visit About APEx.

About your decision to switch:

Douglas Prah, PhD: Was there a specific tipping point or deciding factor in changing accreditation programs?

Colleen A. F. Lawton, MD, FASTRO: I was involved in ASTRO leadership and wanted to be part of this critical initiative as soon as possible. We were ACR accredited since it began and highly value the accreditation process. The APEx process was more involved than ACR and thus we wanted to have this new level of accreditation that was Safety is No Accident based. So as soon as our ACR Accreditation was expiring we just changed to APEx.

Virginia Lockamy, PhD: Since our practice is in New Jersey, we had to wait for the state to recognize APEx before switching our accrediting body. [APEx has been accepted in all 50 states since 2021.]

Jennifer Tietz, RT(T) and Kileigh Peturis, MS: Participation in the RO-ILS program, excellent publications such as Safety is No Accident, and professional recommendations drove the switch. The radiation safety emphasis and APEx Standards were also factors.

Chris Channels, RT(T): In the last three cycles, ACR would approve us “conditionally,” creating much more work for us. It was almost as if that was their standard operating procedure, as we have always felt we do things correctly. We looked at other options, and APEx was very attractive to us.

Prah: Were there any key advocates for switching? What were the reasons voiced by your practice staff for or against changing accreditation programs? 

Tietz/Peturis: At the beginning of the process, there was apprehension about switching programs because the current agency was known, and we had built a solid relationship with the organization. In hearing from colleagues across the [Texas Oncology] network, APEx was comprehensive, patient-focused and streamlined with less administrative burden during the initial application process.

Channels: Our Medical Director and Radiation Director were the key advocates for switching programs. We wanted to make a change for two reasons. First, ACR kept giving us “conditional” approvals each cycle, so we decided to look at other options. Second, being under the ASTRO umbrella, we knew that APEx would be radiation oncology-focused, whereas ACR has a much broader scope. In addition, APEx’s attention to safety and quality attracted us, as that is our focus at HOA. It also allowed us to deeply dive into all our policies and procedures to update and improve upon what we were already doing. The guidance provided by APEx made this an easy process overall.

Lockamy: Fortunately, we had buy-in from the entire team. As a current APEx Surveyor, I was able to explain the benefits of the program and answer any questions/concerns. Our partners at Penn Medicine were also supportive of our switch to APEx as they are currently accredited by APEx as well. We felt that this program was more robust and more specific to radiation oncology as it was developed by ASTRO.

APEx Process — Team and Timing:

Prah: Who was involved in the actual APEx process? How was the work managed at your practice?

Tietz/Peturis: The Director of Radiation Services, Regional Chief Physicist and Chief Radiation Therapists were involved in completing the Self-Assessment. Monthly meetings are hosted. All electronic documentation is saved on SharePoint, and general information is shared via MS Teams.

Lawton: Physics, dosimetry, therapists, department managers and radiation oncologists. Initially, we had weekly meetings. Once we got accredited, roughly monthly.

Channels: Chief Physicist, Chief Radiation Therapist, Lead RTT and myself. Monthly meetings started about six months before our facility visit.

Lockamy: Our Assistant Vice President of Radiation Oncology, Director of Physics, Medical Director, two site managers, and one site supervisor were all part of the APEx Self-Assessment. We also enlisted a few therapists to assist with the chart review preparation. We met weekly to review our progress. We tracked our work in a spreadsheet and assigned owners to each section of the Self-Assessment.

Prah: How long did the Self-Assessment take? Was that more or less than your expectations? Why? 

Lockamy: The Self-Assessment took us three months to complete. This also included the medical record review preparation. The Medical Record Review [of the Self-Assessment] took the longest for us to complete, which was longer than we expected. The reason is that it was a more thorough and comprehensive review of the charts than required by our previous accrediting body.

Lawton: The Self-Assessment took longer than expected as many of our safety procedures were not documented well and needed to be added or updated.

Prah: What are some unique aspects of APEx compared to your previous experience? What changes did you see at your practice? 

Lawton: The discussions alone were helpful as we started to document and/or update documents of safety protocols. Once we had our documents done and accreditation obtained, updating the documents for future accreditation was much easier.

Lockamy: The entire process, from preparation to on-site facility visit, was more robust than our previous experiences. We implemented multiple changes to our practice in response to our preparation for the survey. For instance, our physicians were not always documenting pertinent negatives during their consults. We also reviewed our existing policies and procedures. Based on the guidelines provided by APEx, we revised multiple ones and developed new ones we lacked.

Prah: Were there any unexpected challenges in the transition process? If so, what? 

Channels: At first, applying for accreditation seemed daunting, but APEx makes the process seamless, and the ASTRO staff support was excellent. Any questions we had were answered in a timely manner, which helped us to keep moving forward. We were unsure how the Self-Assessment document upload would be reviewed. We kind of took the approach of “here is what we have” and submitted it. We did not pass the first time, but we refocused our efforts so that we could successfully complete that step of the process. 

Lawton: The biggest challenge was the time needed to do the initial work for the first APEx Accreditation. Having ACR Accreditation, we thought, would make this initial work for APEx easy, but that was wrong. APEx is much more detailed and totally worth the effort.

Prah: How was your experience with APEx Surveyors and the facility visit? 

Channels: Our experience with the [APEx] surveyors and facility visit was excellent. The surveyors did not seem to be looking for things that were wrong; they were more interested in how and why we did things at our facilities. We felt they were working with us instead of dissecting every little thing.

Prah: What was identified as a low-performing area during the Self-Assessment? How has your practice addressed that before or after the facility visit? Was there any unexpected feedback from the Self-Assessment or facility visit?

Lawton: A significant area of improvement was written documentation. This was especially true for our standing committees that performed valuable functions for our department, but whose function and operation were never explicitly documented. We mandated that committee charters be drafted, including a purview, scope, membership guidelines, quorum guidelines, procedural and operational format, and standing agenda outline. We renamed our Safety Committee to the Patient Safety and Quality Committee, including our Comprehensive Quality Management Program. We also formalized our Service and Technology and Implementation and Review Committee. The formalization also encouraged better communication within the greater department and more thorough documentation of meetings. Another significant improvement was the standardization of documentation across the practice within the medical record for consults and follow-up notes, as well as improving our written planning directive. The good news is that once the Self-Assessment is done, your site will have an excellent idea of your ability to get APEx accredited or what you need to do to improve.

Lockamy: We knew going into both the Self-Assessment and on-site facility visit that we were going to be marked as low-performing on the documented patient-specific planning directive. Our physicians were alerting our dosimetrists to what dose constraints they wanted but not in a formalized document. We had templates built and implemented by the facility visit to demonstrate to the surveyors.

Prah: How was the customer service from ASTRO? 

Channels: Overall, the experience was great. The material on the APEx website was very detailed and helped guide us through the process.

Lockamy: We had a few questions throughout the process and were able to reach out to APExSupport to have them addressed, whether through email or a meeting.

Tietz/Peturis: Thus far, the customer service has been prompt and professional, and has provided clear instructions for all inquiries.

Are you interested in transitioning to APEx from another radiation oncology accrediting body? Schedule a free one-on-one session with ASTRO staff to discover how APEx can benefit your practice. During the call, ASTRO staff will provide information tailored to your practice’s needs and goals. You can also request a teleconference with a knowledgeable radiation oncology professional from your chosen discipline by completing the peer-to-peer request form. This meeting will allow you to hear from your colleagues who have completed the APEx process. You can ask specific questions and learn from their experiences.




Douglas Prah, PhD
Associate Professor and Director of Advance Care and Technology
Department of Radiation Oncology
Froedtert & Medical College of Wisconsin
Milwaukee, Wisconsin

APEx Surveyor, ASTRO Practice Accreditation Subcommittee Member
Past Accreditation: ACR (1995-2018)
Current Accreditation: APEx (2019-2027)



Chris Channels, RT(T)
Director of Radiation and Imaging Services
Hematology-Oncology Associates of CNY
Syracuse, New York

Past Accreditation: ACR (2013-2022)
Current Accreditation: APEx (2022-2026)

Colleen A. F. Lawton, MD, FASTRO
Professor and Vice-Chair
Department of Radiation Oncology
Froedtert & Medical College of Wisconsin
Milwaukee, Wisconsin

Past Accreditation: ACR (1995-2018)
Current Accreditation: APEx (2019-2027)

Virginia Lockamy, PhD
Virtua Director of Physics and Penn Medicine Chief of Network Physics
Penn Medicine I Virtua Radiation Oncology
Voorhees, New Jersey

APEx Surveyor since 2019
Past Accreditation: ACR (2016-2022)
Current Accreditation: APEx (2022-2026)

Jennifer Tietz, RT(T)
Director of Radiation Services
Texas Oncology – Central Texas
Austin, Texas

Past Accreditation: ACRO (2017-2023)
Current Accreditation: APEx (Active Application)

Kileigh Peturis, MS
Chief Medical Physicist
Texas Oncology – Central Texas
Austin, Texas

Past Accreditation: ACRO (2017-2023)
Current Accreditation: APEx (Active Application)
Posted: November 14, 2023 | 0 comments

Wildlife Paintings and Rooms with a View: Patient-Centered Care at a Finnish Cancer Center

By Lisa Braverman, PhD, Senior Managing Editor, ASTRO Journals

This past summer, I had the opportunity to spend a week in Finland. While the trip was mostly a vacation, I was inspired to visit a cancer treatment facility by the recent ASTROnews issue, “Personalizing the Patient Experience.” The articles about Danish and Australian centers made me wonder: What decisions were made in the design of a Finnish treatment facility, and why?

Shortly before my travels, I contacted Docrates Cancer Hospital in Helsinki and was graciously invited to visit. My time there revealed beauty, efficiency and an exceptionally well-curated cultivation of calmness.

Private cubby waiting area in Docrates Cancer Hospital, Helsinki, Finland.I was first struck by how separate the patient waiting areas were from the administrative centers of the hospital. Nearly every waiting room I have visited in the United States is open concept to a fault: dozens of chairs comingle with stations to check in, check out, provide information and pay. Waiting areas were abundant in Docrates, all of which were small and intimate. The ones near windows were flooded with light; others outside infusion rooms were designed to look like living rooms. For patients seeking more privacy, cubbies with desks were provided. Walls of greenery were ubiquitous, promoting calm and obvious references to the world outside. As with nearly everywhere I visited in Finland, Docrates was noticeably quiet. Juha Kononen, MD, PhD, Chief Clinical Director of Personalized Oncology, said a quiet soundscape was intentional and “very Finnish”; having a low sound burden was meant to enhance healing and lessen the hardships of treatment.

View of water near Docrates Cancer HospitalDr. Kononen showed me his office and vacant infusion beds. All faced the same direction: outward toward the Baltic Sea. Doctors sat with their backs to the sea, so patients could look at the water. He explained that this was done on purpose, so patients would have something nice to look at while they were undergoing treatment. The floors were wood to evoke feelings of home; stunningly detailed paintings of wildlife adorned patient room doorways in an effort to keep the mood light.

In terms of radiation therapy treatment, Dr. Kononen confirmed that the center mostly sees prostate cancer and breast cancer patients and occasionally head and neck cancer patients.

One goal of cancer treatment at Docrates is to offer highly personalized care to each individual’s disease. Dr. Kononen noted that Docrates’ approach to prostate cancer treatment, for example, is more aggressive than most. Strong emphases are placed upon understanding the tumor microenvironment and using radiopharmaceutical therapies. The center offers an in-house cyclotron in order to be able to deliver nucleotides in the most efficient way possible.

When speaking with members of the Docrates team, I was struck by everyone’s unwavering commitment to ensuring a positive patient experience. A patient’s doctor and nursing staff remain with them throughout the entirety of treatment. Schedulers empathize with patients’ time pressures and proactively work to have them seen as quickly as possible; administrative staff have medical training so they are able to answer treatment-related questions during off-hours. All of Docrates’ actions, Dr. Kononen said, are done “with the best interest of the patients at the center.”

Visiting a cancer treatment center was an extremely informative way not just to learn about RT practice outside the United States, but to learn more about Finnish culture. I hope to make such visits part of my vacation routine in the future!

Lisa Braverman assists with the publication of ASTRO's three scientific journals. She holds a PhD in Communication and Culture, and she enjoys interfacing with ASTRO members from all over the world.

Posted: August 29, 2023 | 0 comments