Radiation oncologists' scope of practice and role in cancer management in Australia, New Zealand, and Singapore: Are we clinicians or technicians?

INTRODUCTION: To evaluate the scope of practice and role in cancer management for radiation oncologists in Australia, New Zealand, and Singapore (ANZ). METHODS: A 27-question survey was emailed to all practicing radiation oncologists listed on the RANZCR database in mid-2021. RESULTS: There was a 54% response rate. Respondents reported managing symptoms associated with radiation therapy (96%), cancer-related symptoms (86%), writing narcotic and analgesic prescriptions (76%), being involved in palliative care (57%), prescribing non-cytotoxic systemic therapy (45%), and admitting patients (41%). Just over 20% wanted to expand their scope of practice, but for those who were unable to, insufficient time (35%), inter-specialty political difficulties (14%), and lack of support from the organisation (12%) were the major reasons. Over half of respondents (56.4%) thought they provided an opinion on the overall role of cancer management. Just under 20% provided a radiation therapy opinion only and <1% provided radiation therapy at the request of the referring clinician. The remainder reported a combination of these. Over 80% of respondents thought their ideal role was to be involved in overall cancer management and 20% believed they should be providing an opinion on radiation therapy only. The ideal role matched the actual role in over 87% of respondents and most respondents thought radiation oncology training enabled an opinion on overall cancer management. Over 90% of respondents were satisfied with their current role in cancer management. Radiation oncologists felt they were perceived as independent clinicians and the large majority (87%) thought radiation oncologists should be part of a multidisciplinary team rather than leaders in cancer management. CONCLUSION: This study has revealed a broad but expected scope of practice for ANZ radiation oncologists with the large majority providing an opinion on overall cancer management or radiation therapy and their ideal role matching their actual role.

Phytophthora species in forest streams in Oregon and Alaska.

Eighteen Phytophthora species and one species of Halophytophthora were identified in 113 forest streams in Alaska, western Oregon and southwestern Oregon that were sampled by baiting or filtration of stream water with isolation on selective media. Species were identified by morphology and DNA characterization with single strand conformational polymorphism, COX spacer sequence and ITS sequence. ITS Clade 6 species were most abundant overall, but only four species, P. gonapodyides (37% of all isolates), P. taxon Salixsoil, P. taxon Oaksoil and P. pseudosyringae, were found in all three regions. The species assemblages were similar in the two Oregon regions, but P. taxon Pgchlamydo was absent in Alaska and one new species present in Alaska was absent in Oregon streams. The number of Phytophthora propagules in Oregon streams varied by season and in SW Oregon, where sampling continued year round, P. taxon Salixsoil, P. nemorosa and P. siskiyouensis were recovered only in some seasons.