I am an academic radiaiton oncologist. I agree and disagree with what was mentioned. I agree that we are treating a lot of metastatic cases but on the other hand, we cure a significant proportion of patients with RT. Examples like prostate cancer, breast cancer, brain tumors, lymphomas, head and neck cancer, gynecologic malignancies, testicular cancer, sarcomas, GI cancers, bladder cancer, pediatric cancers and much more. I find it to be a really fascinating field. The amount of training in oncology is extremely extensive. The board examination is among one of the toughest. Overall, only about 50-60% of the first time takers get thru' the written and oral boards (70-80% of first time takers passed the writtens and the same percentage passed the orals the first time). The amount of information you need to register in your brain is phenomenal. You need to know about every single clinical trial that is regarded as important. When I was preparing for my boards, I had 16 boxes of articles. We always base our treatment recommendation on data from the literature. This is a specialty that truely qualifies as evidence-based medicine. Technically, we need to have an excellent grasp of radiology, physics and radiobiology. Radiation oncologists are not just pressing buttons as what other physicians think.
I don't believe RT will become obselete in our lifetime. But I think RT could be enhanced by incorporating systemic therapy in the treatment. I am also trained in medical oncology, so I know both sides of the story. I find radiation oncology more stimulating, so I decided to do rad onc instead of med onc. Radiation oncologists are like surgeons. We need to know the anatomy of the body very well in order to give good radiation therapy. We also do procedures like radiosurgery and brachytherapy. If you are thinking about doing rad onc, check it out by doing a rotation. You'll like it.