It should be acknowledged, in terms of ethics, that the decision to irradiate patients instead of operating endoscopically is one of those situations where we are weighing the public health risk, including the risk to the surgical team, and transferring risk to another setting with limited data to support it. The risk to the patient, in particular, of 6 weeks of radiation with multiple trips to the facility has not been proven to be less than a single endoscopic intervention. Since there are risks associated with an inpatient stay and possible lack of access to medical resources during a surge, in addition to risk of viral exposure, it is very hard to quantify this “moving target” relative to 30 to 35 visits to radiation oncology. Some have pointed out that for immunocompromised patients in particular, multiple trips to the hospital also represent a significant risk, 33  but the answer is just not known.