In 2006, a radiation oncologist in Inglewood, California, published a report on building a Lay Patient Navigator Program in collaboration with the @RANDCorporation. #radonc 1/ 🧵acsjournals.onlinelibrary.wiley.com/doi/epdf/10.10… 2/ The focus of this report was to describe how people with cancer who are not as privileged as those living in other areas of Los Angeles might benefit from lay patient navigators.

Dear @StephenVLiu, I’d be very careful when suggesting this to audiences who don’t understand the true forces of selection bias. Only 25 pts in the study had a generally good outcome after pneumonectomy. @gotoPER @FordePatrick @DoctorJSpicer 1/

https://twitter.com/StephenVLiu/status/1591419040341569536

It's always perilous to focus on the outcomes of only 7% enrolled (25/358) in a clinical trial. Yet, it's appropriate to cook the books and state we are actually considering 14% (25/179) who started with chemo-Nivo. 2/

I wish it wasn't so, but surgical procedures disrupt tumors leading to hematological dissemination and the need for more treatment. Here, a randomized trial reports efforts to reduce this risk. jtcvs.org/article/S0022-… 1/ 🧵 Sadly, contemporary trials show that surgical removal of even the smallest lung cancers (≤2 cm) cannot cure most patients. Note that neither of the DFS curves shows a sign of plateauing. @AltorkiNasser