September

Rectal cancer outcomes are dependent on stage of cancer and appropriate management. The most important management that determines outcome is adequacy of surgical resection. Adjuvant radiation and chemotherapy also have an influence on the outcome. We have previously reported 1996 rectal cancer outcomes in BC.[1] We found that survival and recurrence rates were suboptimal relative to more recent reports from other centres.[2-4]

Total mesorectal excision (TME) is the surgical technique of choice for resection of rectal cancer. TME is associated with the lowest published recurrence rates—5% to 10%—for rectal cancer management.[1-4] Surgeon awareness of TME has increased principally due to championship by Dr Bill Heald of Basingstoke, UK. Dr Heald has promoted TME as a “specimen-oriented surgery” in order to emphasize that the surgeon must take great care to excise the rectal cancer within an intact mesorectal fascial envelope in order to minimize the likelihood of recurrent cancer.

The BCMA should be ashamed of the cover illustration for the leaflet “7800 Doctors Have Done Everything They Can.” Not for the inside copy, which was well written and organized, but for the picture of a physician, his face etched in pain, his mask hanging loosely around his neck, a pair of glasses in one hand. Had he just delivered the heartbreaking and tragic news to the parents of a child he could not save?

No, he was reacting to the doctors’ labor dispute with the provincial government. A labor dispute!

Those who have traveled the road to the River and stood on its very brink will reflect on their own emotions, emotions which are described with perception and sensitivity by Dr Erik Paterson, “Feelings on encountering a near-lethal illness,”[BCMJ 2002;44(5):278].