The Miracle of Progress: My View of the History of Rectal Cancer Care

Rectal cancer treatment has evolved over the past 4 decades. Numerous advances in surgical technique, chemotherapy, and radiation therapy have fueled the changes. The surgeon, oncologist, radiation therapist, radiologist, and pathologist work as a team toward a multidisciplinary approach. This has led to individualized care for patients. Amazingly, the use of chemoradiotherapy after diagnosis has led to total regression of rectal cancer in about a third of patients. These patients are felt to be cured and are carefully watched and typically do not require surgery. These advancements have been led by inquisitive surgeons and caregivers who have observed a problem, studied ways to improve the situation, and reported on their conclusion. These individuals are dynamic intellectuals, thinking outside the box to discover these miraculous advancements. However, we still have work to do. This discussion will outline what I feel are the advancements during my professional career over the past 4 decades. I will also outline where I feel we now need to focus our inquisitive energy.