Personalising treatment – a new paradigm in the management of rectal cancer

The management of rectal cancer has undergone significant evolution over the past decade, with an increasing recognition that traditional surgery may not always represent the optimal approach, particularly for patients with early-stage low and mid-rectal cancers. Historically, surgery—often involving radical excision and the formation of a stoma—was universally considered the gold standard of care. However, a combination of patient advocacy, growing awareness of the lasting impact surgery can have on quality of life, and advances in non-surgical options has prompted clinicians and patients alike to seek alternative, less invasive treatments.Modern patients are better informed than ever and often prioritize preservation of quality of life, even when this may come at a slight reduction in survival probability or cure rates. Many are willing to consider the trade-off of slightly lower oncologic outcomes in exchange for avoiding the psychological and physical burdens of rectal surgery and permanent stoma formation.In this special edition, titled ‘Personalising Treatment – A New Paradigm in the Management of Rectal Cancer’, we aim to explore the emerging landscape of individualized care. We will present a comprehensive overview of organ-preserving strategies, including watch-and-wait protocols, local excision, advanced chemoradiotherapy, and other non-extirpative modalities. To provide a broad and authoritative perspective, we have invited leading international experts in the field to share their clinical experiences, research findings, and practical guidance. Our goal is to equip clinicians and patients with up-to-date information and evidence that can support shared decision-making about the most appropriate, patient-centered therapeutic pathways.It is now widely recognized that rectal cancer is not a ‘one size fits all’ disease. A multitude of factors—including patient age, comorbidities, tumor stage, and patient preference—must guide the selection of therapy. Recent literature has highlighted the risks of surgical intervention, noting higher mortality and morbidity rates, especially among elderly patients and those with multiple comorbidities. As the global population ages, these considerations become increasingly pressing. This special issue intends to serve as a vital resource, promoting awareness of alternative, organ-preserving treatment options that maximize both survival and quality of life. Topic editors: Arthur Sun Myint, Jean-Pierre Gérard Source: https://www.frontiersin.org/research-topics/74697/personalising-treatment---a-new-paradigm-in-the-management-of-rectal-cancer