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From 1 to 4 October 2023, the annual congress of the American Society for Therapeutic Radiology and Oncology (ASTRO) took place in sunny San Diego, California, USA. It was my second in-person visit to the North American “big sister” of our beloved ESTRO congress.

In 2015, I was an exchange PhD student in Saint Louis, Missouri, during the autumn. This gave me the perfect chance to attend ASTRO in San Antonio, Texas. I remember being impressed by the size of the congress centre and the freezing temperatures inside it despite the hot weather outside. But the scientific programme and the exhibition were equally impressive.

The situation was similar this year at the big convention centre by San Diego Bay. The packed programme covered all aspects of radiation oncology, from research to clinical practice, patient advocacy, and even policy.

Figure 1: The view of the San Diego Bay from the convention centre

A highlight for me was being able to join the editorial board meeting of the Red Journal on the first day at 7:30 am. Having joined the board during Covid, until then I had only been able to attend meetings online. It was the first time I got to meet other editors or the managing editors from Elsevier in person after exchanging countless emails.

Networking was a big highlight with the opportunity to see again some colleagues from the USA and Australia whom I had not seen for a long time. I also (finally) met colleagues from the USA in person. Having been in the field for some years, I was able to put faces to many familiar names. What is more, some of these brilliant people even knew who I was!

The mini-oral format was quite entertaining; all presentations were given one after the other without interruption, and afterwards, there was a panel discussion with questions to all authors at the end. The downside of this format is that it is difficult to mix and match sessions held at the same time. The upside is that discussions can go more in-depth between experts on one topic.

One highlight session for me was “Evolving Roles of Medical Physicists in Clinical Trials”, which covered the more traditional roles of physicists in quality assurance but also explored more unconventional roles that physicists can take in this context. For example, Lei Ren from the University of Maryland presented the many opportunities of virtual clinical trials.

Figure 2: From Lei Ren's talk on virtual clinical trials (VCTs)

I will admit that I was a bit disappointed by the physics programme. Although the work that was presented was of high quality, there were relatively few sessions on physics or technical topics. All the physics posters were presented at the same time, and this was the last session next to exhibition being dismounted . On the bright side, this meant that I had to stay an extra night in San Diego, and the extended stay offered the perfect excuse to spend the afternoon walking along the beach of La Jolla, which is inhabited by sea lions and seals. I was lucky to have found Nadine, a fellow European physicist at the congress and a companion for that afternoon’s enjoyment of the sun and the ocean of the West Coast.

Figure 3: Sea lions and seals enjoying the sun on the coast by La Jolla

Jenny Bertholet

Postdoc

Inselspital, Bern University Hospital and University of Bern

Switzerland

Jenny.bertholet@insel.ch

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My ASTRO experience in San Diego involved me stepping out of my comfort zone, embracing new perspectives, and learning from diverse voices in the field.

ASTRO offered experiences different to those of my “go-to” conferences, such as those organised by ESTRO or the Particle Therapy Co-Operative Group (PTCOG), which give me familiar faces and atmosphere. This time, I found myself on a solo mission, prompted by my research stay abroad in Boston at the Massachusetts General Hospital, without the comfort of friends, colleagues or fellow institution members. Furthermore, I couldn't help but notice that many participants were way more formally dressed than attendees at our more casual gatherings, which brought a level of formality that added a distinctive touch to the overall atmosphere.

Another noticeable difference between ASTRO and ESTRO was the distinct clinical focus. As a PhD student with a physics background, I got the impression that ASTRO's programme was less multidisciplinary than ESTRO’s; it felt more tailored to the oncologists, particularly with networking and mentoring opportunities predominantly targeted to those with a medical background.

These aspects made me see this conference as an opportunity to explore the unknown; to broaden my professional network and to deepen my understanding of radiotherapy from perspectives other than physics.

The highlight of my ASTRO journey was undoubtedly the presidential symposium, which featured sessions that almost resembled talk shows as the moderators and speakers shared their experiences while sitting in a round formation of chairs. At this symposium, the "Diversity in Clinical Trials" session explored the challenges and importance of involving underrepresented patient groups in clinical trials. The speakers in this session were outstanding and I could have listened much longer to their pearls of wisdom and takeaways. This session was complemented by one entitled "Patient Perspectives", which gave a voice to patient advocates and shared their experiences of participation in clinical trials. For me, this patient-centred session was enlightening, as it not only emphasised the overwhelming nature of the process and the crucial importance of offering the participants comfort and support but also clearly showed the disparities in study enrolment through the lens of the patients’ unique experiences.

Figure 4: The conference centre was next to the very lively “Gaslamp” quarter

I was positively surprised by ASTRO 2023’s commendable commitment to inclusivity. I attended a pre-meeting master class on "Safety is no accident: building inclusive cultures”. Additionally, there were events such as the "diversity, equity, and inclusion reception" and an LGBTQ+ and allies networking event, which highlighted ASTRO's dedication to creating a diverse and welcoming environment.

ASTRO 2023 provided an enriching glimpse into other perspectives of radiation oncology, but my physics roots are calling me back. I am looking forward to a stronger physics input and the familiar faces at ESTRO 2024 in Glasgow.

Nadine Vatterodt
PhD student
Danish Centre for Particle Therapy
Aarhus University Hospital & Department of Clinical Medicine
Aarhus University
Aarhus, Denmark
nadine.vatterodt@clin.au.dk