What Early Career Physicians Need to Know About Building New Radiation Oncology Service Lines

Early career physicians are often handed a program to build before they have built anything. Asked what advice she would give them, Parul N. Barry, MD, FACRO, clinical assistant professor of radiation oncology in the Department of Radiation Oncology at the University of Pittsburgh and a radiation oncologist at University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center at UPMC Magee-Womens Hospital, started with 2 instructions: trust in yourself, and lean on your mentors. The conversation happened at the 2026 UPMC Hillman Cancer Center Radiation Oncology Symposium.

She was direct about the difficulty. Opening a new program can be very scary, she said, particularly when the challenge is elucidating what you need, or explaining the why to people who do not share your vocabulary. Radiation oncology can seem like a niche field to hospital administrators and to colleagues in nuclear medicine, medical oncology, and surgery, and those groups may not understand the value or importance of what is being proposed.

Her answer to that problem was not a communication strategy but a clinical example, drawn from her own breast practice. A patient taking anastrozole or another aromatase inhibitor (AI) may see an exacerbation of osteoarthritic symptoms. Barry noted that such patients sometimes discontinue the AI while on treatment, and that discontinuation may affect their cancer outcomes. Treating those symptoms with low-dose radiotherapy, she said, raises tolerance substantially and can improve compliance. The argument for the service line, in other words, runs through an oncologic end point a medical oncologist already cares about, not through the radiation technique itself.

She extended the same logic to radiopharmaceutical therapy, describing conversations with medical oncologists about integrating it and working as a team to deliver it for patients with cancer. That, she said, is another way to build genuinely multidisciplinary care, and it involves staff on both the medical oncology and radiation oncology sides.

Transcript:

CancerNetwork: Early career physicians are often asked to build out new programs without much leadership experience. What advice would you give them?

What I would say is to trust in yourself and lean on your mentors. It can be very scary to open new programs, especially if you run into challenges, perhaps even elucidating what you need, or telling people and explaining the why. Sometimes, especially with radiation oncology, which can seem like a niche field to administrators and people outside the field, in the multidisciplinary sectors of nuclear medicine, medical oncology, and surgery, they may not understand the value or importance.

But what I can say, even as a breast radiation oncologist, is that, for example, someone who’s on anastrozole or another aromatase inhibitor [AI], they see exacerbation in their osteoarthritic symptoms. Often, these patients, while on treatment, may discontinue their AI, and that affects their cancer outcomes. If we can just treat these people with low-dose radiotherapy and help alleviate their symptoms, their tolerance goes way up, and their compliance can certainly improve.

Similarly, talking to medical oncologists about radiopharmaceutical therapies and integrating that, working as a team with medical oncologists on delivering this for our [patients with cancer], is another great way to really work on that multidisciplinary care. That involves all sorts of staff, both on the medical oncology and radiation oncology side, [including] administrators, among others.