A model theme issue

Every so often I end up doing something I said I would never do. Generally the philosophical compromise is a few Hail Marys short of a cardinal sin, and usually involves paying way too much for something I didn’t need. For the most part these moral/ethical/philosophical hiccups are more about servicing desperate wants, and as expected, once the initial warmth of possession has waned, the replacement emotion is more angst than ebullience.

In this instance, however, I have decided to write an editorial about the theme of this month’s BCMJ, something I said I would never do (if the truth be known I think I actually did this at least one other time). In fact, several editorials ago I wrote that the BCMJ’s cadre of editorialists are never thematically challenged to the point where they need to resort to hanging an editorial on one of the journal’s core articles. It seems that this stentorian pontification is about to bite me, but I am so impressed with this month’s theme issue on rectal carcinoma that I will throw editorial caution to the wind and once again allow compromise to exaggerate the blur of what were once razor-sharp editorial boundaries.

This month’s theme issue, guest edited by Dr Terry Phang, is an excellent example of what a theme issue should provide for a sophisticated readership. Dr Phang and colleagues have delivered a well-written set of articles that very nicely document the current recommendations concerning preoperative investigations, possible preoperative cancer modification treatment, current surgical technique recommendations (total mesorectal excision, or TME), the pathological grading of the surgical specimen, and postoperative chemoradiation recommendations.

I like theme issues for a number of reasons, but basically they should provide all of us with current knowledge, current recommendations, identify “areas of concern” in our current management paradigm, and, if possible, provide scientifically validated solutions for areas of recognized deficiency. Dr Phang and his coauthors have successfully covered all of these bases with this erudite rendering of the current approach to a malignancy that until now has had an abysmally poor track record of recurrence and rapid decline. I hope that this theme issue—because of the length, breadth, and quality of the information provided—will have virtually universal appeal to all physicians, regardless of professional persuasion. I also hope that as a result, docs in BC will ensure that the necessary changes in the management of rectal carcinoma will be quickly incorporated and properly funded throughout the province.

—JAW