Tom Treasure was a general Cardiothoracic Surgeon in London from 1982 to 2001 and then returned to his alma mater, Guy’s Hospital, to take an academic lead in (non-cardiac) Thoracic Surgery. He led and published the MARS trial which is internationally accepted as drawing line under extrapleural pneumonectomy as an effective treatment for pleural mesothelioma. The trial of lung metastasectomy (PulMiCC) is being analysed at present. Radical changes in practice are in fact commonplace and resistance to change is usual (see “Ending Medical Reversal” Prasad & Cifu 2015). Well known examples are blood letting and radical mastectomy and both were ‘pillars of practice’.