With the recent electronic publication of our editorial written for the BJUI USANZ supplement, we have been somewhat surprised with the Twitter response our title has generated with some very strong opinions expressed. Why would a radiation oncologist, who happens to be the Chair of their National Genito-Urinary group (“FROGG”) propose such a provocative title? The BJUI editorial board wisely suggested that we explain the origin of this title which would be lost on many outside Australia.
In mid-2014, a leading Australian urologist quipped that adjuvant post-prostatectomy radiotherapy was “the work of the Devil” when referring to some of the severe complications that can occur following post-prostatectomy radiation. This comment has become “infamous” in Australian Radiation Oncology circles leading to extensive discussions and interactions between our specialties with urologists stating that radiotherapy complications can occur late and be very challenging to treat and radiation oncologists stating that these complications are relatively uncommon and that overall quality of life is as good if not better when going down the radiotherapy pathway. This is the climate that the article by Ma et al was submitted to the BJUI describing the impact of radiotherapy complications on a tertiary urology service in Melbourne Australia over a 6 month period.
I was impressed that the BJUI approached a radiation oncologist to provide balance on such a paper. We provocatively titled the editorial “Is Radiotherapy the work of the Devil?” and were hoping the response to anyone reading the editorial would be a resounding “No”. However, many have only seen “the headline” and not read the editorial itself which appears to have created offence especially from some of our international Radiation Oncology colleagues. The aim of such a title is that it will encourage people to read both the original article and the editorial which we feel provides a balanced view on the impact of radiotherapy complications in contemporary practice. We hope that in future, the response to our title: “Is Radiotherapy the work of the Devil” is “No – the Devil is in the detail”.
A/Prof Andrew Kneebone
Department of Radiation Oncology, Royal North Shore Hospital and Chair of the Faculty Of Radiation Oncology Genito-Urinary Group (FROGG)