Jay Detsky MD
@jaydetsky
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Staff Radiation Oncologist @sunnybrook treating CNS and GU tumors; Assistant Professor @UofTDRO; https://t.co/5hMkgosF4D
Toronto, ON
Joined August 2010
There are cases of GG1 disease that is still high risk (eg PSA>20) which almost always means higher grade disease was missed at the time of biopsy. GG1 disease is not “associated with int or high risk disease” 🤦♂️
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This is the most poorly worded tweet from a medical journal I’ve ever seen and completely misconstrues the point of the article, which itself is confusing
Grade group 1 prostate cancer detected on biopsy is associated with intermediate or high-risk disease, leading to heterogeneous long-term outcomes, adverse pathology, and increased prostate cancer-specific mortality, https://t.co/qEA6CkPxZh
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✋🏻 When it comes to medical conferences or papers ⚠️ Why do people write posts like this? ✅It makes it really hard to read 👀 Type things out normally; 🚨Just my two cents!
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If you guessed 40–70%, you're right! Want to learn more about this breakthrough in high-grade glioma treatment? Tune in to hear @SahgalArjun on the latest episode of our podcast, Spilling the RT ➡️
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You can’t take our country — and you can’t take our game.
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This is beyond disgusting. Setting aside that Michael was such a kind and giving man, the degree of anti-Semitism in Toronto is shocking. I stand with my Jewish friends and colleagues and agree Marco that government and police need to do more.
Abhorrent. Michael Mostyn dedicated his life to the Jewish community and building a better Canada. The attempts to dehumanize his legacy and the Jewish community are flagrant antisemitism and must stop now.
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What a privilege to give grand rounds at @MSKCancerCenter and share our @Sunnybrook @Elekta @MRLinac @jaydetsky UNITED #glioblastoma experience. We continue to shape the future of radiation for #GBM through volume and dose reduction using online real-time MR guided radiation.
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TL;DR Caution is warranted for patients aged ~85-86 and above for spine SBRT re: risk of VCF. Those under 85 have the same risk as younger patients. @IJROBP
https://t.co/3BXpzXWQNd /end
pubmed.ncbi.nlm.nih.gov
Spine SBRT should be considered in a geriatric population; however, for those 86 and older, we suggest caution due to the significant risk of VCF.
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Local failure in the spine at 2-yrs was 14.3%. There were zero cases of myelopathy, and 5-yr actuarial rate of peripheral neuropathy of 2.3% /8
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Gradually decreasing overall survival (OS) was observed with increasing age. OS was influenced by age, time from SBRT to local failure, oligo-metastatic dz, prior RT to same site, and histology /7
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Predictors of VCF on MVA include age > 86, pre-existing VCF, and dose escalation beyond 24 Gy / 2 fractions. Interestingly, gender and bisphosphonate use had no impact on VCF /6
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Median time to fracture was 12.8 months for patients younger than 86, and 3.4 months for age 86+ /5
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Drilling down more as age is a continuous variable, splitting into age groups of 5 yrs (70-75, 75-80 etc): 70-85 year olds have same risk of VCF, and then risk rises 85+ /4
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The 2-yr risk of VCF for ages 70-85 is 11.2%, similar to the general population; the risk jumps to 30.3% for those aged 86+ /3
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Led by my former fellow Adrian Chan, using 252 patients with 580 treated segments with spine #SBRT in patients aged 70 and above, we found 86 yo as the optimal cutoff above which risk of VCF skyrockets /2
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"What is 'too old' for spine SBRT re: risk of vertebral compression fracture (VCF)?" is something colleagues and I debated at tumor boards on many occasions. We now have the answer (OPEN access) @IJROBP @UofTDRO @SahgalArjun #radonc #SBRT
https://t.co/ySNm3CiC3T 1/x
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The amazing @UofTDRO @Sunnybrook #superstar fellow @DMoorePalhares giving his award winning talk on monitoring radiologic biomarkers of response in GBM patients at the @mr_linac annual meeting
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2. I soundly reject the ageism displayed in this comment that men 70+ yo don’t warrant the same opportunity to decide how their prostate ca is treated. Again just to be clear I am very pro-AS. /END
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