My initial response to the rejection letter:

September 20, 2001

James F. McCarthy Senior Vice President, Editorial
48 South Service Road
Melville, NY 11747

Dear Mr. McCarthy:

I am in receipt of your extraordinary fax of September 20, 2001. To say that I am stunned is an understatement. I thought before writing this of recent devastating events in this country. I don't want to appear to be complaining over what may appear to be a relatively trivial matter to some. But this honestly goes far beyond the matter of the personal disappointment of this author and material damages to this author. This affects the present and future well being of thousands of cancer patients and also the future of clinical cancer research.

The words of your letter state that you are rejecting my manuscript not because I have incorrectly reviewed the science, or because the science is not of great potential importance to cancer patients, but because "the subject is just too controversial."

Mr. McCarthy, the great issues in science and medicine are often controversial. But the response should not be to bury controversy, but to provide illumination. Of course you and your editorial board know this. And then you state that "the journal should not show the appearance of supporting the use of such testing." I don't understand. Isn't this what your journal's policy of publishing two peer review commentaries is supposed to address? If I provide what I believe to be a comprehensive and correct review and then provide a few editorial comments as part of my discussion, but if I am incorrect in the facts of my review or in the logic of my arguments, then your two reviewers can have the last word. They can criticize the science and puncture the faulty logic. And then the reader can make up his/her own mind. Or if there are faults with either the science or the discussion, then the journal can provide me with the reviewers' critiques and give me the opportunity to make revisions.

I just don't understand what happened in this case. You are correct that you did specifically invite me to write this paper. You have no idea how much work this entailed and how much time and expense was involved in researching this and then writing it. I did not expend this effort to receive a "promised honorarium of $500," but because of the promised opportunity to make a major and important contribution to science and cancer medicine, through exposure of the subject matter to the wide audience which you yourself described in your letter to me when you solicited my manuscript. This effort detracted from my other professional responsibilities and your arbitrary decision not to give me the customary courtesy of revising the manuscript for promised publication will cause me material and professional harm, as well. The fact is that, after a period of 4 months, all that you are providing to me is an explanation that the subject is "too controversial" (note that you say that the "subject" is controversial and not that my manuscript, which could obviously be revised, is controversial...if the subject were "too controversial," then why did you invite me to write the paper in the first place?).

It would appear that you and your journal made an error in due diligence in selecting this topic for review in the first place. This was entirely your error (assuming, for the sake of argument, that your explanation that the topic is "just too controversial" is, in any way, defensible). Your error, unfortunately, will have caused me considerable harm. But your error, I feel, was not with selecting the topic in the first place, and I did not make any errors (at least not any non-remedial errors) in what I wrote, but your error is in assuming the role of a censor, rather than of an editor.

I respectfully ask to be provided with the written reviews and/or comments of the editorial reviewers and for the opportunity to address any specific criticisms by revising the manuscript, as is the customary practice in biomedical publishing, particularly in the case of an invited manuscript, such as this.

Sincerely yours,

Larry M. Weisenthal, M.D., Ph.D.