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

Vera Peters was a pioneering Canadian doctor who radically changed the way breast cancer is treated, making lumpectomy an option for women with early stages of the disease. Her achievement is celebrated in a new play about her life.

Play about Canadian doctor's battles against medical establishment draws diverse crowd

Dr. Vera Peters - radiation oncologist, Class of 1934 from the University of Toronto - 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." (Courtesy University of Toronto)

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.

Playwright Charles Hayter (right) with the cast of his play Radical. The historical play, which made its debut at the Toronto Fringe Festival last year, looks at oncologist Dr. Vera Peters' struggle to have the medical establishment recognize new treatments for cancer in the 1970s. (Courtesy Sydney Helland/University of Toronto)

“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 doing 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.”

The whole principle of what she achieved, fighting the establishment ... was quite revolutionary at the time.- Dr. Gunesh Ege

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.”

Dr. Vera Peters studied alternatives for radical mastectomies for breast cancer patients. (Ontario Institute for Cancer Research)

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.)

This week on The Sunday Edition

On CBC Radio starting at 9 a.m. eastern on Sunday Jan. 11:

  • The state of democracy: The murderous attack on the staff of the magazine Charlie Hebdo raises painful questions about democracy, surveillance, immigration, press freedom and terrorism. Paul Rogers, Professor of Peace Studies at the University of Bradford, weighs in.
  • The mayor who ended homelessness: Ted Clugston, the mayor of Medicine Hat, talks about how the small Alberta city has embarked on an ambitious policy to end homelessness by simply providing housing for those in need.
  • Race, fear and the law: After a series of deaths of unarmed black men at the hands of police, author and law professor Patricia Williams from Columbia University helps explore the toxic mix of fear, race, and the use of deadly force in the United States.


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