I am coming up on the end of my spring break and so many of my friends have taken this time to get their wisdom teeth out. A lot of them, like me when I got mine taken out around four(?) years ago, were more afraid of getting put under than the actual fact that bones were going to be ripped from their mouths.
I remember I had to go to an appointment before hand where they showed me a bunch of videos about what they were going to do and they asked a bunch of questions to make sure I was comfortable with what was going to happen. Still, it was so scary when I showed up to the surgery and they stuck a needle in my arm and told me to count down from 10 and I can’t remember even saying the word “five.”
Then I woke up in a different room with a different nurse and was shuffled out the back door where my parents were waiting in our minivan like it was a get away car and we were off.
A lot of that patient-centered practice and care is thanks to today’s subject, Dr. Vera Peters, a medical doctor who made huge discoveries in the way both Hodgkin’s lymphoma and breast cancer were treated.
But before we get into her life and accomplishments, allow me to set the scene of what treatment for each of these diseases was like in the early twentieth century before Vera came along.
Hodgkin’s disease, known more commonly as Hodgkin’s lymphoma nowadays, is a cancer of the lymphatic system, and until Vera’s time, was thought to be incurable. After the disease was described by Dr. Thomas Hodgkin in 1832, none of the treatments for the disease were successful until, in 1902, x-rays were used on the affected lymph nodes and appeared to shrink them. However, it didn’t eradicate them or cure the disease, it just temporarily slowed it down.
Breast cancer treatment, on the other hand, went a little too far in terms of eradicating the disease. A woman (or man, in some cases) who was diagnosed with breast cancer, would be put under general anesthesia for a biopsy. However, if the lump was cancerous, the patient would undergo something called a radical mastectomy right there on the spot. Going beyond just removing the breast, this treatment took out the pectoral muscles and the lymph nodes under the arm around the affected breast. The logic here was that the disease couldn’t spread to adjacent areas if there were no areas to spread to, regardless of whether or not cancer could be traced in any of the areas in the first place.
This was a significant operation that is frequently described in medical journals today as “disfiguring.” Because the pectoral muscle wall was removed, even after reconstruction the breast area would appear concave. Beyond just appearances, it was physically disabling because many patients lost the normal control over their arms and the loss of lymph nodes increased possibly of infections, could create permanent swelling and could result in nerve damage.
Not much was discussed with the patient and few questions were asked beyond identifying any contraindicating medical conditions. This made the process difficult emotionally and psychologically because the patient was put under anesthesia not knowing whether or not she had cancer and then not knowing what she would wake up to, taking my fear of my wisdom teeth operation to horrifying heights.
That’s why I am so very happy to introduce to you Dr. Vera Peters.
She was born in Rexdale, Ontario on April 28, 1911 to dairy farmers. After her father passed away suddenly early in her life, she and six siblings worked on the farm. She was taught in a one room schoolhouse and finished high school when she was 16. She knew pretty early on that she wanted to be a doctor.
She was too young to enroll in medical school so she began at the University of Toronto studying physics and math and then transferred into the medical program one year later. She worked odd jobs to make enough money to pay for school and her siblings helped to contribute.
During her time in medical school, her mother began treatment for breast cancer with Dr. Gordon Richards, at the time, one of the shining stars of the relatively new field of radiation oncology. Unfortunately, Vera’s mother did pass away but the experience taught Vera that there was much to improve upon in the way the disease was treated.
In 1934, she graduated from medical school and became a resident in radiation at the Toronto General Hospital. Because the field of radiation oncology was so new, there weren’t any training protocols in place so she also worked as Dr. Richards’ apprentice at the Toronto Institute for Radiotherapy and continued to work with him at various institutes until his death in 1949.
Dr. Richards installed a 400-kilovolt radiation machine at the Ontario Radiation Institute in 1937 and began to use it to treat many different cancers in his patients in the affected and adjacent lymph nodes. Vera began to treat patients of her own.
It suddenly seemed that the patients undergoing their treatment were living longer and without any relapses, which seemed odd since Hodgkin’s lymphoma was thought to be incurable. Dr. Richards asked Vera about the best way to assess the potential of their treatment.
For over two years, Vera studied 113 patients with Hodgkin’s and were in radiation treatment at the hospital. During this process, Dr. Richards passed away, but Vera was nonetheless ready to share her discoveries with other doctors in the field of oncology. She found out that patients from their hospital were living longer than those in other hospitals. None of the patients were described as cured but the optimistic outlook of the report, slowly shifted the medical world’s perception of the disease.
It was the first time that somebody had proposed the idea that Hodgkin’s lymphoma could be cured. Most people had their doubts and, despite Vera’s hard evidence, didn’t take her seriously. Even a follow up paper that Vera wrote seven years later with nearly twice the amount of patient cases, each backing up her point, didn’t seem to win anyone over. It wasn’t until her work was cited in a paper written in 1963 by Eric C. Easson and Marian H. Russell, that people began to consider the idea.
Today, the disease is thought to be one of the most curable adult cancers, particularly if it is treated in the early stages.
Next, Vera set her sights on breast cancer and was transferred to the Ontario Cancer Institute of Princess Margaret Hospital in 1958 when it opened. Knowing a great deal about the way cancer spread through the lymphatic system, Vera wondered if a less substantial treatment could be just as effective as a radical mastectomy and protect as much of the breast as possible.
She studied 7,000 records of patients treated from 1935 to 1960 and compared the survival rates of women from different types of treatment. She discovered that there was no difference whatsoever in the survival time between a lumpectomy (removing just the affected area) and a mastectomy. Therefore, in the early stages of breast cancer, a more conservative surgery would work just as well as a radical mastectomy while avoiding all of the adverse and disfiguring results.
This was a wildly controversial thing to say at that point in medical history. Many people attempted to discredit Vera and shunned her for suggesting such a ridiculous idea.
But Vera was committed to proving her point so she returned to the records from Princess Margaret hospital and did a case controlled study, looking at the patients’ ages, health factors, evidence of other cancers, the size of the tumor and the year the treatment took place. Looking only at cases of Stage 1 breast cancer, she paired women who were similar in each of these areas together, one who had a lumpectomy and radiation and the other who had a mastectomy and radiation.
In the end, she had 145 pairs. The women who underwent lumpectomies were not statistically different in their results than those who underwent mastectomies. In fact, they had slightly better survival rates than those who had mastectomies, proving that radical mastectomies were nowhere near necessary in early stages of the disease.
She shared these discoveries with the Royal Physicians and Scientists of Canada in 1975 and they too were hesitant to believe her. So she updated a paper discussing these findings two years later and published it in an international journal. She made no bones about her opinion in the paper, saying “as more and more conservative studies ripen, as more and more concerned physicians observe the adverse effects of excessive treatment, as more and more women become armed with knowledge, mastectomy and early breast cancer may become as old fashioned as bloodletting.” Gradually, people started to listen and today, women only have a mastectomy in early stages of breast cancer if there is some huge reason to do so.
The year before she published the paper, she retired from the Princess Margaret Hospital, where she continued to teach and oversee a part time practice. She became an officer of the Order of Canada in 1978 and the American Society of Therapeutic Radiology gave her the gold metal in 1979. She also won the Woman of Distinction award from the Canadian Breast Cancer Foundation in 1988 and was posthumously inducted into the Canadian Medical Hall of Fame in 2010.
Vera died of cancer on October 1, 1993 at Princess Margaret Hospital leaving behind a legacy not only of her work with Hodgkin’s lymphoma and breast cancer, but also of the idea of patient centered care and success being both a career and family woman.
As strange as it may sound, it wasn’t really common practice for doctors to treat their patients as actually people. Their patients were more like problems to solve, conditions to cure, and they never really asked too many questions, understood their preferences or ensured the patient felt they could make their own decisions about their treatment. Obviously Vera wasn’t the only doctor who recognized this but her work and her goal of creating the most effective yet least risky form of treatment set into motion a change in the relationship between doctors and patients.
She also was a prime example that a woman can be highly successful in her job but also raise a family. I waited to mention this until now but Vera met a man named Ken Lobb while she was waitressing to earn money for school and the two married and had two daughters. It was really crucial for many girls to see a woman able to be both a good doctor and a good mother because, not only were there not many prominent female doctors but most of the ones who preceded Vera never endeavored to become a wife or mother.
So, despite the fact that getting your wisdom teeth out is not nearly as scary or involved as breast or lymphatic cancer, on behalf of myself and my friends who are still puffy-cheeked from their operations and on behalf of all the brave men and women in a fight against cancer, I say, “Thank you, Dr. Vera Peters for showing us what wisdom and compassion can accomplish.”
I have been overjoyed at the number of recommendations for extraordinary women that people have been sending my way to feature on the site! If you have a woman in mind, please feel free to email me at email@example.com. Also, if you want to geek out with me about any kind of books, films or other awesome representations of women throughout history, I would be delighted to hear about them as well.