RadOnc on the Run

8: What is The State of Radiation Oncology in Head and Neck Cancers?

In observance of Head and Neck Cancer Awareness Month in April, RadOnc on the Run host Brandon Mancini, MD, MBA, FACRO, spoke with Henry S. Park, MD, MPH about the past, present, and future of radiotherapy as a tool for managing different head and neck malignancies. The experts discussed considerations for delivering timely diagnoses to patients and forming personalized treatment plans that balance efficacy with quality of life. Regarding the overall head and neck cancer landscape, Park noted that it is now possible to cure many patients of their disease thanks to advances in radiotherapy, chemotherapy, immunotherapy, and surgery. In certain cases, he said, patients may be eligible to de-escalate portions of their therapy to help minimize the risk of toxicity. Other key areas in the field included the management of adverse effects such as fatigue, sore throat, difficulty swallowing, and weight loss, which often involves collaboration with team members in supportive care to maintain one’s function and quality of life. As part of balancing hope with realism among patients, Park expressed that clinicians should be transparent about the potential toxicity that may occur with modalities like radiation and chemotherapy. In the end, Park emphasized that patients should be open about any potential disease symptoms they have to avoid late diagnoses. “[Patients should] not be shy about [their] symptoms…If we catch it early enough, it is certainly possible to cure many of these cancers,” Park stated. “I highly encourage [patients] to be upfront about any concerns [they] have because they may not always be apparent immediately during the initial patient encounter.” Mancini is the medical director at Bold Advanced Medical Future Health, a clinical associate professor in the Department of Radiology at Michigan State University College of Human Medicine, and the editor at large for RadOnc Review, a supplement of the journal ONCOLOGY®. Park is a professor of Therapeutic Radiology and vice chair for Clinical Research, Health Services Research, and Faculty Development for Therapeutic Radiology at Yale School of Medicine and Yale New Haven Hospital.

7: Elevating Individualized Care on Colorectal Cancer Awareness Month

During National Colorectal Cancer Awareness Month in March, Brandon Mancini, MD, MBA, FACRO, spoke with Krishan R. Jethwa, MD, MPH, about key themes that have emerged with the use of radiotherapy in the field. Among several topics discussed in this episode of RadOnc on the Run, the experts highlighted how the treatment paradigm has evolved to encompass more individualized treatment decision-making, particularly for patients with rectal cancer. More than a decade ago, the standard of care for patients with locally advanced rectal cancer entailed a “cookie cutter” treatment pathway consisting of long-course chemoradiotherapy, surgery, and adjuvant systemic therapy, according to Jethwa. Over time, the field began to adopt more personalized treatment algorithms depending on patient goals, wishes, and values to optimize cancer control while protecting long-term quality of life and function.  Jethwa also touched upon strategies for mitigating acute and long-term toxicities, which range from fatigue and diarrhea in the short term to incontinence and bowel-related issues later down the line. Other topics of conversation included the evolution of imaging, genomics, and genetics in the field, as well as the potential next steps for researching risk stratification.  “Rectal cancer is a highly heterogeneous disease [with] a broad spectrum of local risk and a broad spectrum of risk for distant metastasis. Having the optimal treatment approach does require multidisciplinary care,” Jethwa said. “In 2026 and beyond, the care of patients is no longer one-size-fits-all. It's very much tailored to the individual. Contemporary practice utilizes all sorts of tools from a genomics imaging perspective, as well as multidisciplinary treatment approaches. It’s important for us to work together as colleagues and teammates to best care for our patients.” Mancini is the medical director at Bold Advanced Medical Future Health, a clinical associate professor in the Department of Radiology at Michigan State University College of Human Medicine, and the editor at large for RadOnc Review, a supplement of the journal ONCOLOGY®. Jethwa is an assistant professor of Radiation Oncology at Mayo Clinic Rochester.

6: Exploring the Role of Radiation Oncology in Kidney Cancer Awareness Month

In light of Kidney Cancer Awareness Month in March, Brandon Mancini, MD, MBA, FACRO, spoke with Chad Tang, MD, about broad developments and themes in the care of different kidney cancer populations. Together, in this week’s episode of RadOnc on the Run, the experts highlighted technological advances, safety considerations, and other areas that may elevate the quality of care across the field.  Despite previous historical data showing that kidney cancer may not respond to radiotherapy, Tang noted that being able to achieve better targeting with modern high-dose radiation modalities may push back against the notion that radiation doesn’t have a role in kidney cancer management. Describing a “renaissance” across the last 5 to 10 years in the field, Tang said that radiation oncology can play a role at every level of kidney cancer care, including definitive, localized treatment as well as palliative care. The conversation also touched upon optimizing dosing fractionation and schedules, with Tang outlining a preference for 3- or 5-fraction radiation delivery, depending on tumor size and tissue structures. As part of the treatment process, he emphasized that kidney tumors may not respond quickly to radiation due to their mitotically inactive natures, as tumors may reflect shrinkage after the first 3 to 6 months of beginning treatment.  Looking towards the future of the field, the experts pointed towards the importance of localized therapies as well as biomarkers to help guide treatment decision-making for those with kidney cancer. “The local therapies are going to be even more important as we move [around] those nests of resistance and reservoirs of disease. It’s going to happen at every stage of the kidney cancer lifespan, even more so because it’s [not always] the fastest growing disease,” Tang said. “It will be exciting to do that and get biomarkers [that] tell us when we’re doing it correctly.” Mancini is the medical director at Bold Advanced Medical Future Health, a clinical associate professor in the Department of Radiology at Michigan State University College of Human Medicine, and the editor at large for RadOnc Review, a supplement of the journal ONCOLOGY®. Tang is an associate professor in the Department of Genitourinary Radiation Oncology of the Division of Radiation Oncology at The University of Texas MD Anderson Cancer Center.

5: Unpacking Advances Across Radiation Oncology From ASCO GU 2026

At the 2026 ASCO Genitourinary Cancers Symposium, [https://www.cancernetwork.com/conference/asco-genitourinary-cancer-symposium] RadOnc on the Run host Brandon Mancini, MD, MBA, FACRO, reviewed several key presentations on the growing roles that radiotherapeutic modalities could play in the management of genitourinary malignancies. He spoke in San Francisco, CA, to highlight oral abstracts and poster sessions exploring the intersection between radiation oncology and prostate cancer, kidney cancer, and other patient populations. Among numerous abstracts, Mancini, director at Bold Advanced Medical Future Health, clinical associate professor in the Department of Radiology at Michigan State University College of Human Medicine, and editor at large for RadOnc Review, a supplement of the journal ONCOLOGY®, highlighted the following: How Do Pre-Visit Educational Videos Impact Prostate Cancer Radiation Consultations? One presentation explored whether provider-developed educational videos could minimize the amount of time that radiation oncology clinicians, residents, and nurses dedicate to patients for prostate cancer consults, thereby boosting clinical efficiency. Data showed that administering videos alone without changing provider approaches may not be sufficient to improve clinical efficiency, although educational videos may give patients more resources to develop questions before a clinical visit. Findings from this study, Mancini said, may prompt clinicians to reconsider how to prepare patients more effectively for their consults. How Safe is Immunotherapy Plus Radiation in High-Risk Prostate Cancer? As part of another presentation, investigators of a phase 2 trial (NCT05568550) evaluated the safety of pembrolizumab (Keytruda) plus radiotherapy and androgen deprivation therapy (ADT) with or without olaparib (Lynparza) among those with high-risk localized prostate cancer. The investigators noted that pembrolizumab plus radiation/ADT was feasible and typically tolerable, and that adding olaparib to this regimen did not increase the incidence of high-grade adverse effects, although low-grade urinary toxicities were more common. Mancini said that these results may warrant further investigation of pembrolizumab-based treatment to determine whether patient outcomes can improve in the long term. Can LLMs Help Grade Radiation-Related Toxicities? In another study presented at the meeting, investigators evaluated the ability of large language models (LLMs) to extract and grade toxicities from clinical notes and patient-reported outcomes among those who underwent radiotherapy for prostate cancer in a phase 2 trial (NCT02874014). Overall, the investigator’s ensemble model achieved strong performance metrics, supporting the conclusion that LLMs could feasibly extract and grade toxicity in this population. Besides supporting LLMs as potential assistants in one’s workflow, Mancini described how this study reflects the need to capture “every last ounce” of data from patients in radiation oncology practice. References 1. Martin SA, Amin SA, Strudthoff E, Baine M. Impact of pre-visit educational videos on clinic efficiency for prostate cancer radiation oncology consultations. J Clin Oncol. 2026;44(suppl 7):332. doi:10.1200/JCO.2026.44.7_suppl.332 2. Myint ZW, Yan D, Strup S, et al. Interim safety analysis of a randomized phase II trial comparing pembrolizumab with radiation versus pembrolizumab, olaparib, and radiation in localized high risk prostate cancer. J Clin Oncol. 2026;44(suppl 7):362. doi:10.1200/JCO.2026.44.7_suppl.362 3. Wilson R, Mastroleo F, Osorio MB, et al. Using large language models for grading CTCAE toxicity after radiation therapy for prostate cancer. J Clin Oncol. 2026;44(suppl 7):357. doi:10.1200/JCO.2026.44.7_suppl.357

4: Reducing Disease Risk on National Cancer Prevention Month

As part of honoring National Cancer Prevention Month in February, RadOnc on the Run host Brandon Mancini MD, MBA, spoke with Jenni Beamer about a broad range of topics dedicated to proactively treating patients who are at risk of developing cancer.  Beamer, senior executive director for the state of Michigan at the American Cancer Society (ACS), emphasized the importance of having a designated month to educate the public regarding lifestyle choices, regular screenings, and other modifiable risk factors that may influence the likelihood of a cancer diagnosis. Regarding specific campaigns focused on cancer prevention, she brought attention to ACS CancerRisk360, a free digital tool that provides a comprehensive cancer risk evaluation based on key areas like genetic risk, family history, screening adherence, and daily life factors.  Mancini highlighted how the challenges surrounding cancer prevention have evolved as environmental and exposure-related risk factors have transformed over time. For example, while rates of smoking—a common risk factor for lung cancer—have decreased, vaping has appeared to pick up, which may cause long-term complications in terms of cancer risk. Beamer and colleagues stay up to date on strategies for managing these modifiable risk factors via national roundtables, which also cover areas like breast cancer screening and HPV vaccination. “Just yesterday, we reported out a 27% decline in cervical cancer incidence rates that are directly related to the implementation of the vaccine. That just gives me chills to know,” Beamer stated. “That’s why my 3 kids have that cancer vaccine. Progress is happening, and it’s in the stories of the everyday people that want to make a difference. I’m so motivated and proud of everyone’s collective energy and work around this.” Mancini is director at Bold Advanced Medical Future (BAMF) Health, clinical associate professor in the Department of Radiology at Michigan State University College of Human Medicine, and editor-at-large for the RadOnc Review, a supplement of the journal ONCOLOGY®. Reference Declines in cervical cancer incidence in U.S. varied substantially by state, aligning with HPV vaccination rates, new ACS study finds. News release. American Cancer Society. February 23, 2026. Accessed February 25, 2026. https://tinyurl.com/57rykdvk [https://tinyurl.com/57rykdvk]