Green Means Go: Increasing Sustainability in Radiation Oncology


Dr. Suh is the editor-in-chief of Applied Radiation Oncology , and professor and chairman, Department of Radiation Oncology at the Taussig Cancer Institute, Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH.


    Evolving over decades from a grassroots effort to a global movement, environmental sustainability has become a chief priority for many individuals and businesses alike. Health care—including radiation oncology—is no exception, especially as a significant contributor to global carbon emissions.

    With consequences comes responsibility, but are we doing our part? In this issue, several articles explore that question, examining gaps and solutions to reduce radiation oncology’s impact on climate change while improving patient and practitioner well-being in the process.

    Our lineup includes the timely research article Travel-Related Environmental Impact of Telemedicine in a Radiation Oncology Clinic , which illustrates how telemedicine substantially lowered carbon emissions for a large outpatient facility during COVID, while maintaining equitable access to care. The authors posit that by modifying transportation behavior of cancer patients overall, we can measurably reduce greenhouse gas emissions associated with health care.

    Discussing another facet of telemedicine is the CME-approved article Adapting to the Virtual World: An Analysis of Remote Work Policies in Academic Radiation Oncology . This intriguing study investigates the implementation of work-from-home policies in radiation oncology and explores how departmental gender composition factored into their development. It further highlights interesting and helpful findings involving physician satisfaction, burnout, patient care, and gender equity, noting that more equitable policies may be needed to support female physicians in remote work settings.

    A third research article, Assessing the Readiness for Climate Change Education in Radiation Oncology in the United States and Canada, assesses program and assistant program directors’ views on climate change and sustainability education, finding a discrepancy between awareness and action. This enlightening study also identifies barriers and facilitators to implementing climate change education in these programs, highlighting strategies to reach this goal.

    We are also pleased to present the Resident Voice editorial, Green-ifying Clinical Trials . With inefficiencies surrounding heavy travel, delivery of trial drugs, and patient enrollment, clinical trials leave a substantial carbon footprint, yet they are crucial to advancing cancer care. The article presents seven steps to mitigate environmental toxicity in US cancer clinical trials—a great resource, especially as federal guidelines in this area are not yet available.

    We hope these articles strengthen your interest and understanding of the imperative role of sustainability in radiation oncology. Special thanks to Katie Lichter, MD, MPH, Climate Health Fellow at the University of California San Francisco, for her assistance with this issue and her passion and leadership surrounding climate change and cancer care.

    Finally, I want to take this opportunity to announce that Applied Radiation Oncology has been accepted to the Committee on Publication Ethics (COPE), which is a tremendous achievement and affirms the journal’s editorial/publishing policies meet COPE’s rigorous standards! I want to thank our many contributors over the past 11 years, our advisory board, our readers, and Anderson Publishing—and especially thank Sharon Breske and Kieran Anderson for their diligence, focus, and passion in making this achievement possible.


    John Suh, MD, FASTRO, FACR. Green Means Go: Increasing Sustainability in Radiation Oncology. Appl Radiat Oncol. 2024;(1):4 - 4.

    March 1, 2024