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How Vera Peters revolutionized treatments for Hodgkin's, breast cancer

01/11/2015 05:00 EST | Updated 03/12/2015 05:59 EDT
When Charles Hayter's play "Radical" opened in Toronto, the lineup to get in ran round the block. There were physicians, scores of them, in that line - particularly women doctors. There were former cancer patients, even a Member of Parliament.

The playwright – who is also a radiation oncologist - was overwhelmed. He knew he had a good story, but never imagined that Vera Peters would be such a draw.

“I was overwhelmed,” Dr. Hayter says. “It was beyond any expectation, that people would be so interested in this subject and in her story.”

Dr. Peters - radiation oncologist, University of Toronto Class of 1934 - is not a household name, but she’s a member of Order of Canada and the Canadian medical hall of fame. The citation calls her “an outstanding clinical investigator who changed the management of Hodgkin’s disease and breast cancer."

That citation only hints at the quiet battles she waged.

When she was still in her thirties, Vera Peters turned Hodgkin’s Lymphoma from a death sentence to a treatable illness. In 1950, she issued a report that showed high-dose radiation could be an effective treatment for Hodgkin’s, which prior to that had been considered incurable.

But the international Hodgkin’s medical hierarchy didn't like sharing the spotlight. She was shut out by peers and sneered at – “go back to Toronto and do your women’s work” was the message.

And she did.

“People talked about Vera Peters and her work in Hodgkin’s Lymphoma, but she’s not so well known for the breast cancer part of the story,” says Dr. Hayter. “Here her work was sort of suppressed or ignored.”

8,000 files and a card table

Thanks to her pioneering scientific work at Princess Margaret cancer hospital in Toronto starting in the late 1950s, the "lumpectomy" became a viable option to radical mastectomies for women with early stage breast cancer.

“Don’t forget that the radical mastectomy removes more than the breast, it removes the breast and the pectoral muscle in the chest,” says Dr. Hayter.

“I remember seeing these women when I was a resident in the 1980s. They were mutilated on the side of the chest, you just saw the ribs, and they were often left with fat swollen arms from the damage under the armpit and damage to the nerves in the arm.”

When Vera Peters started investigating, radical mastectomy was the standard treatment for all types of breast cancer. But a small number of women – unable to have mastectomies due to other medical conditions – had the less invasive procedure. Peters was able to prove the effectiveness of lumpectomies by painstakingly gathering data for thousands of surgeries and comparing the survival results.

“I can see her sitting in basement at a card table, files all around her,”  says her daughter Jenny Ingram, also a doctor. “There’s a classic picture -  she’s in shorts, big sheepskin slippers and a  sweater  - cigarette going. She would just stay up late dong that kind of stuff.”

Dr. Peters brought home 8,000 files from the hospital, went through them all and charted her data by hand.

“She felt the way to convince the surgeons was to do good science,” says Dr. Ingram. “She did a very, very rigorous case control study.”

Dr. Peters presented her findings in 1975 to a meeting of 400 skeptical doctors from across Canada. Her daughter was there, and still marvels at her mother’s bravery challenging the views of the conservative 1970s medical community.

“For me that would be daunting even now,” Dr. Ingram says. “There was just a dead silence at the end of this. I don’t think anyone could believe it, they were just shocked (by the data). I remember so well saying to mum that by being conservative in your treatment you are offering a radical change in how things can be done.”

On the opening night of the play Radical, Charles Hayter recalls, “an  elderly man came up to me, clearly moved, and he said, ‘I was at that lecture in ‘75 where she presented breast cancer results. She was heckled.’ Not only that, he said, ‘I was a surgeon in Saskatchewan and had started to do lumpectomies and was called incompetent by colleagues.’”

“The whole principle of what she achieved, fighting the establishment ... was quite revolutionary at the time,” adds Dr. Gunesh Ege, who worked with Dr. Peters at Princess Margaret hospital.

This could have been the stuff of Nobel Prize nominations. Charles Hayter decided it was the stuff that plays are made of. 

“A  dramatist looks for a good protagonist who wants something and has obstacles,” he says.

“She was a medical scientist, but she also balanced it with listening to patients. That’s the  bigger story and her bigger contribution.”

(Listen to Karin Wells’ audio documentary Vera Peter MD, on CBC radio’s The Sunday Edition starting at 9 a.m. eastern on Sunday Jan. 11, or here.)

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