1 00:00:02,440 --> 00:00:05,640 Speaker 1: Happy Saturday. This week we had an episode on the 2 00:00:05,760 --> 00:00:09,800 Speaker 1: history of mimography, which did not have many women in 3 00:00:09,880 --> 00:00:13,520 Speaker 1: it considering its subject matter. So today we have our 4 00:00:13,640 --> 00:00:18,320 Speaker 1: past episode on doctor Vera Peters, who really revolutionized the 5 00:00:18,320 --> 00:00:21,599 Speaker 1: care of two different cancers, one of them being breast cancer. 6 00:00:21,640 --> 00:00:25,400 Speaker 1: Although the medical community's response to her research at the 7 00:00:25,440 --> 00:00:29,400 Speaker 1: time was pretty skeptical. She started publishing on this work 8 00:00:29,440 --> 00:00:31,880 Speaker 1: in nineteen sixty seven, so right in the middle of 9 00:00:31,920 --> 00:00:35,440 Speaker 1: some of what we talked about on this mimography episode, 10 00:00:35,600 --> 00:00:37,839 Speaker 1: and near the end of this episode we mentioned a 11 00:00:37,880 --> 00:00:41,159 Speaker 1: paper that cited her male co author as doctor but 12 00:00:41,280 --> 00:00:44,120 Speaker 1: cited her as miss and not being sure whether the 13 00:00:44,159 --> 00:00:47,360 Speaker 1: paper was published before or after she finished medical school. 14 00:00:47,680 --> 00:00:49,920 Speaker 1: And we just wanted to note that women with medical 15 00:00:49,960 --> 00:00:53,320 Speaker 1: degrees or doctorate's being called miss while their male colleagues 16 00:00:53,360 --> 00:00:55,720 Speaker 1: are called doctor. It is not a relic of the 17 00:00:55,760 --> 00:00:59,040 Speaker 1: past that still happens today. Yeah, when I listened to 18 00:00:59,040 --> 00:01:00,880 Speaker 1: the episode, I was like, kind of make it sound 19 00:01:00,960 --> 00:01:03,320 Speaker 1: like this is no longer a problem, But I sure 20 00:01:03,480 --> 00:01:07,560 Speaker 1: do know many women who are either doctors or have 21 00:01:07,720 --> 00:01:12,000 Speaker 1: doctoral degrees who are deeply frustrated by it, especially on 22 00:01:12,040 --> 00:01:16,160 Speaker 1: things like panels and paper titles and et cetera. This 23 00:01:16,200 --> 00:01:21,040 Speaker 1: episode originally came out March eighteenth, twenty fifteen, So enjoy 24 00:01:23,560 --> 00:01:26,480 Speaker 1: Welcome to Stuff You Missed in History Class, a production 25 00:01:26,600 --> 00:01:36,680 Speaker 1: of iHeartRadio. Hello, and welcome to the podcast. I'm Tracy V. 26 00:01:36,800 --> 00:01:40,600 Speaker 1: Wilson and I'm Holly Fryme. So we've mentioned quite a 27 00:01:40,680 --> 00:01:42,880 Speaker 1: number of times that we have an extensively long list 28 00:01:43,200 --> 00:01:47,280 Speaker 1: of to dos on the podcast. There are hundreds and 29 00:01:47,360 --> 00:01:50,760 Speaker 1: hundreds and hundreds of listeners submitted suggestions, and then we 30 00:01:50,800 --> 00:01:52,720 Speaker 1: have our own to do lists, and they are both 31 00:01:52,880 --> 00:01:57,960 Speaker 1: very long and sometimes sort of like when you're you 32 00:01:58,040 --> 00:02:00,960 Speaker 1: have access to hundreds of channels on the television, it 33 00:02:01,120 --> 00:02:05,520 Speaker 1: just feels like nothing's on. I scroll through all those things, 34 00:02:05,600 --> 00:02:07,440 Speaker 1: and there are so many great ideas on there, but 35 00:02:07,600 --> 00:02:11,160 Speaker 1: none of them are quite catching my attention that day. 36 00:02:11,600 --> 00:02:13,520 Speaker 1: And you and I both know from experience that the 37 00:02:13,520 --> 00:02:15,519 Speaker 1: best episodes come from when we're really engaged with what 38 00:02:15,560 --> 00:02:17,800 Speaker 1: we're talking about. Yeah, if you're just not in the 39 00:02:17,800 --> 00:02:19,760 Speaker 1: mood for a topic, even if it's an awesome topic, 40 00:02:19,919 --> 00:02:21,440 Speaker 1: it just won't turn out as well as if you 41 00:02:21,480 --> 00:02:23,200 Speaker 1: wait a little while and let it become the thing 42 00:02:23,240 --> 00:02:26,160 Speaker 1: that catches your mood. Right, and some of the things 43 00:02:26,200 --> 00:02:27,640 Speaker 1: I was in the mood to talk about were on 44 00:02:27,720 --> 00:02:31,160 Speaker 1: hold until uh stuff could come in from the library. 45 00:02:32,240 --> 00:02:35,000 Speaker 1: So I was browsing around the Internet and found a 46 00:02:35,160 --> 00:02:39,880 Speaker 1: post on Rejected Princesses about doctor Vera Peters, who was 47 00:02:39,880 --> 00:02:43,240 Speaker 1: one of the foremost oncologists in the world in her time. 48 00:02:43,919 --> 00:02:47,120 Speaker 1: Not only was she one of the only female oncologists 49 00:02:47,120 --> 00:02:49,840 Speaker 1: in the world, she completely changed the standard of care 50 00:02:49,960 --> 00:02:53,240 Speaker 1: for two different types of cancer. And she was one 51 00:02:53,320 --> 00:02:56,200 Speaker 1: of rejected Princesses modern worthies, and those are usually about 52 00:02:56,240 --> 00:02:58,840 Speaker 1: a woman who died within the last fifty years. The 53 00:02:58,960 --> 00:03:02,000 Speaker 1: Rejected Princesses Modern Worthies posts tend to be pretty brief, 54 00:03:02,040 --> 00:03:05,600 Speaker 1: so this one hits the highlights. Doctor Peters helped revolutionize 55 00:03:05,639 --> 00:03:08,920 Speaker 1: the treatment of both breast cancer and Hodgkins lymphoma, but 56 00:03:08,960 --> 00:03:10,920 Speaker 1: at the time that she did, her work was largely 57 00:03:11,000 --> 00:03:14,400 Speaker 1: ignored and dismissed. So naturally, immediately I wanted to know 58 00:03:14,440 --> 00:03:17,880 Speaker 1: a lot more about this person and what she did. Therefore, 59 00:03:17,919 --> 00:03:21,040 Speaker 1: we're going to have a whole episode on her today. Hooray, 60 00:03:22,080 --> 00:03:26,120 Speaker 1: We'll do the usual setup on early life. Mildred Vera 61 00:03:26,200 --> 00:03:29,680 Speaker 1: Peters was born in Rexdale, Ontario, on April twenty eighth 62 00:03:29,760 --> 00:03:33,160 Speaker 1: of nineteen eleven. She was one of seven children, and 63 00:03:33,240 --> 00:03:36,440 Speaker 1: her parents were dairy farmers. Her mother was also a teacher. 64 00:03:37,160 --> 00:03:39,520 Speaker 1: Vera and her siblings worked on the farm, starting at 65 00:03:39,560 --> 00:03:42,400 Speaker 1: a very early age, particularly after the sudden death of 66 00:03:42,440 --> 00:03:46,520 Speaker 1: their father. Her first education was in a one room schoolhouse. 67 00:03:47,560 --> 00:03:50,280 Speaker 1: She finished high school at sixteen, and she wanted She 68 00:03:50,320 --> 00:03:53,160 Speaker 1: knew already that she wanted to become a doctor. She 69 00:03:53,320 --> 00:03:55,840 Speaker 1: was too young to start medical school, though, so she 70 00:03:55,960 --> 00:03:59,120 Speaker 1: enrolled in the University of Toronto to study math and physics, 71 00:03:59,160 --> 00:04:02,200 Speaker 1: and then she trammedurred to the medical program the following year. 72 00:04:02,920 --> 00:04:05,280 Speaker 1: She worked summer jobs to save up her money, and 73 00:04:05,360 --> 00:04:07,920 Speaker 1: her brother and her sisters helped pay her way as well. 74 00:04:08,800 --> 00:04:11,600 Speaker 1: While she was working as a waitress on a tourist ship, 75 00:04:11,720 --> 00:04:13,920 Speaker 1: she met Ken Lobb, who was the man she would 76 00:04:14,000 --> 00:04:17,040 Speaker 1: later marry and they would eventually have two daughters together. 77 00:04:18,560 --> 00:04:21,279 Speaker 1: While she was still in medical school, her mother was 78 00:04:21,320 --> 00:04:24,560 Speaker 1: treated for breast cancer, and after a recurrence, she was 79 00:04:24,600 --> 00:04:27,400 Speaker 1: treated by doctor Gordon Richards, who at that point was 80 00:04:27,440 --> 00:04:29,800 Speaker 1: one of the most respected doctors in the field of 81 00:04:30,200 --> 00:04:35,000 Speaker 1: radiation oncology, which at that point was pretty early in 82 00:04:35,040 --> 00:04:38,880 Speaker 1: its development. Doctor Richards was also one of the doctors 83 00:04:38,920 --> 00:04:42,600 Speaker 1: that Vera studied under, and Vera's mother unfortunately did die 84 00:04:42,640 --> 00:04:44,960 Speaker 1: of her cancer, which was one of the things that 85 00:04:45,040 --> 00:04:47,520 Speaker 1: led Vera to want to study the disease later in 86 00:04:47,560 --> 00:04:51,919 Speaker 1: her life. Doctor Peters graduated from medical school in nineteen 87 00:04:52,000 --> 00:04:55,279 Speaker 1: thirty four and went on to a residency in radiology 88 00:04:55,279 --> 00:04:59,240 Speaker 1: at Toronto General Hospital. At this point in medicine, there 89 00:04:59,320 --> 00:05:03,479 Speaker 1: was no official training protocol or certification for radiotherapy, so 90 00:05:03,600 --> 00:05:07,239 Speaker 1: doctor Peters apprenticed with doctor Richards and she started working 91 00:05:07,240 --> 00:05:10,799 Speaker 1: at the Ontario Institute of Radiotherapy in nineteen thirty five, 92 00:05:11,279 --> 00:05:13,520 Speaker 1: and she continued to work with doctor Richards right up 93 00:05:13,560 --> 00:05:17,960 Speaker 1: until his death in January of nineteen forty nine. Before 94 00:05:18,040 --> 00:05:20,360 Speaker 1: we get into more of the specifics of her medical work, 95 00:05:20,400 --> 00:05:24,200 Speaker 1: here's a caveat Doctor Peters did really groundbreaking work and 96 00:05:24,279 --> 00:05:26,680 Speaker 1: the treatment of two different cancers, and we're going to 97 00:05:26,680 --> 00:05:29,000 Speaker 1: talk about them enough to give a sense of why 98 00:05:29,040 --> 00:05:31,919 Speaker 1: her work was so important. But this is absolutely not 99 00:05:32,040 --> 00:05:36,600 Speaker 1: meant to be a thorough exploration of either cancer even 100 00:05:36,839 --> 00:05:39,240 Speaker 1: or even of the human body systems that they involved. 101 00:05:40,120 --> 00:05:43,400 Speaker 1: This is also definitely not a thorough examination of how 102 00:05:43,440 --> 00:05:46,080 Speaker 1: these cancers are treated today because the whole field of 103 00:05:46,120 --> 00:05:50,400 Speaker 1: oncology has evolved tremendously since doctor Peters retired in nineteen 104 00:05:50,440 --> 00:05:53,720 Speaker 1: seventy six. So this is much more about how the 105 00:05:53,760 --> 00:05:58,040 Speaker 1: developments that doctor Peters launch changed the way medicine was 106 00:05:58,080 --> 00:06:00,960 Speaker 1: working at the time than about the diseases specifically or 107 00:06:00,960 --> 00:06:05,520 Speaker 1: how they're treated today. So doctor Peter's first groundbreaking work 108 00:06:05,960 --> 00:06:08,840 Speaker 1: was in the treatment of Hodgkin's disease, which was before 109 00:06:08,880 --> 00:06:13,480 Speaker 1: that point considered to be incurable. Now more commonly known 110 00:06:13,520 --> 00:06:16,360 Speaker 1: as Hodgkins lymphoma, this is a cancer that affects the 111 00:06:16,440 --> 00:06:20,680 Speaker 1: lymphatic system, its name for doctor Thomas Hodgkin, who described 112 00:06:20,680 --> 00:06:24,520 Speaker 1: it in eighteen thirty two. The major difference between Hodgkins 113 00:06:24,640 --> 00:06:28,080 Speaker 1: lymphoma and the more common non Hodgkins lymphoma is that 114 00:06:28,120 --> 00:06:33,160 Speaker 1: Hodgkins lymphoma involves large abnormal cells called reed Sternberg cells, 115 00:06:33,720 --> 00:06:37,080 Speaker 1: while these cells are not present in non Hodgkins lymphoma. 116 00:06:38,520 --> 00:06:42,320 Speaker 1: Between its first description in eighteen thirty two and nineteen 117 00:06:42,360 --> 00:06:46,360 Speaker 1: o two, no doctors reported any successful treatment of Hodgkins 118 00:06:46,520 --> 00:06:51,120 Speaker 1: lymphoma at all. The first somewhat successful treatment was which 119 00:06:51,160 --> 00:06:53,400 Speaker 1: was described in nineteen oh two, was the use of 120 00:06:53,640 --> 00:06:56,440 Speaker 1: X rays on the involved lymph nodes, and while this 121 00:06:56,560 --> 00:07:01,200 Speaker 1: did shrink the affected nodes somewhat, it did cure the disease, 122 00:07:01,320 --> 00:07:04,520 Speaker 1: it maybe bought people a little time. There were a 123 00:07:04,560 --> 00:07:07,640 Speaker 1: few advances between nineteen oh two and nineteen thirty nine, 124 00:07:07,680 --> 00:07:11,600 Speaker 1: when doctor Rene Gilbert of Geneva, Switzerland described treating the 125 00:07:11,600 --> 00:07:15,800 Speaker 1: affected lymph nodes with radiation. He treated both the affected 126 00:07:15,840 --> 00:07:18,200 Speaker 1: lymph nodes and other parts of the body that were 127 00:07:18,240 --> 00:07:21,800 Speaker 1: not apparently affected, and while some of his patients did improve, 128 00:07:21,920 --> 00:07:24,440 Speaker 1: many relapsed, and he didn't think of any of them 129 00:07:24,440 --> 00:07:28,920 Speaker 1: as having been cured. Doctor Peter's mentor, doctor Richards, who 130 00:07:28,960 --> 00:07:33,280 Speaker 1: we mentioned earlier, installed a four hundred killo radiation machine 131 00:07:33,280 --> 00:07:36,720 Speaker 1: at the Ontario Radiotherapy Institute in nineteen thirty seven, just 132 00:07:36,760 --> 00:07:40,440 Speaker 1: a couple of years before Jilbert's description of his method. 133 00:07:41,240 --> 00:07:44,480 Speaker 1: This was a higher voltage machine than what doctor Jilbert 134 00:07:44,600 --> 00:07:48,080 Speaker 1: was using, and doctor Richard used this machine to treat 135 00:07:48,160 --> 00:07:52,480 Speaker 1: his patients for a variety of cancers. Doctor Richard's method 136 00:07:52,520 --> 00:07:56,280 Speaker 1: with Hodgkin's lymphoma was to use extended field radiation on 137 00:07:56,320 --> 00:08:00,640 Speaker 1: the affected lymph nodes and adjacent nodes. Although some accounts 138 00:08:00,640 --> 00:08:05,040 Speaker 1: described this irradiation of nearby nodes as prophylactic. It wasn't 139 00:08:05,120 --> 00:08:08,480 Speaker 1: really to prevent disease, it was to kill cancerous cells 140 00:08:08,520 --> 00:08:12,200 Speaker 1: that had already spread to adjacent nodes but weren't yet detectable. 141 00:08:13,400 --> 00:08:17,080 Speaker 1: At first, doctor Peters primarily worked under doctor Richard's supervision. 142 00:08:17,120 --> 00:08:19,760 Speaker 1: She was kind of apprenticing to him, but as she 143 00:08:19,800 --> 00:08:22,360 Speaker 1: became more experienced as a doctor, she began to treat 144 00:08:22,400 --> 00:08:25,800 Speaker 1: patients on her own as well. In nineteen forty seven, 145 00:08:26,320 --> 00:08:29,120 Speaker 1: after ten years of treating lymphoma patients with the four 146 00:08:29,200 --> 00:08:33,920 Speaker 1: hundred kilovolt machine, doctor Richards made an observation to doctor Peters. 147 00:08:34,240 --> 00:08:36,400 Speaker 1: It seemed to him that some of their patients were 148 00:08:36,440 --> 00:08:39,760 Speaker 1: surviving a long time with no relapse, even though Hodgkins 149 00:08:39,880 --> 00:08:43,560 Speaker 1: lymphoma was supposedly incurable, and he asked her how she 150 00:08:43,640 --> 00:08:47,600 Speaker 1: wanted to evaluate their work on the matter. So there 151 00:08:47,600 --> 00:08:50,160 Speaker 1: are some people who interpret this as meaning that doctor 152 00:08:50,240 --> 00:08:53,200 Speaker 1: Richards should get credit for what happened next. After all, 153 00:08:53,320 --> 00:08:55,120 Speaker 1: especially at the beginning, he was the one who was 154 00:08:55,160 --> 00:08:59,439 Speaker 1: successfully treating the patients for their cancer. What he really 155 00:08:59,480 --> 00:09:02,840 Speaker 1: did was give doctor Peters a question to answer, and 156 00:09:02,880 --> 00:09:06,120 Speaker 1: the work she did to answer that question eventually changed 157 00:09:06,160 --> 00:09:10,120 Speaker 1: the perception of Hodgkins lymphoma from being an incurable disease 158 00:09:10,200 --> 00:09:14,800 Speaker 1: to a curable one. Doctor Peter spent two years studying 159 00:09:14,800 --> 00:09:18,520 Speaker 1: one hundred and thirteen patients who had been conclusively diagnosed 160 00:09:18,520 --> 00:09:22,240 Speaker 1: with Hodgkins lymphoma and treated with radiation at the hospital 161 00:09:22,280 --> 00:09:25,240 Speaker 1: where she worked. She largely did this by hand at 162 00:09:25,240 --> 00:09:28,280 Speaker 1: her dining room table. She was ready to present her 163 00:09:28,280 --> 00:09:31,160 Speaker 1: findings to her colleagues in nineteen forty nine, which was, 164 00:09:31,240 --> 00:09:36,600 Speaker 1: unfortunately after doctor Richards had already died. Her findings revealed, though, 165 00:09:36,640 --> 00:09:40,200 Speaker 1: that his theory was right. Their patients were living longer 166 00:09:40,240 --> 00:09:44,160 Speaker 1: than lymphoma patients at other hospitals. Their five year survival 167 00:09:44,240 --> 00:09:47,360 Speaker 1: rate had doubled and their ten year survival rate had tripled. 168 00:09:47,880 --> 00:09:50,840 Speaker 1: Patients in Stage one, which was the least advanced stage, 169 00:09:51,240 --> 00:09:54,880 Speaker 1: lived a median of eleven point six years, and she 170 00:09:54,920 --> 00:09:58,559 Speaker 1: didn't describe any of the patients as cured, but their 171 00:09:58,600 --> 00:10:01,400 Speaker 1: prognosis was really a lit better and her tone was 172 00:10:01,440 --> 00:10:04,320 Speaker 1: a lot more optimistic than any of the medical wisdom 173 00:10:04,440 --> 00:10:09,239 Speaker 1: on Hodgkins lymphoma at the time. The idea of approaching 174 00:10:09,280 --> 00:10:13,080 Speaker 1: Hodgkins lymphoma with the goal of curing it was revolutionary, 175 00:10:13,679 --> 00:10:16,480 Speaker 1: and even though doctor Peters had clear, compelling data to 176 00:10:16,520 --> 00:10:19,080 Speaker 1: back up what she was saying, it took about ten 177 00:10:19,160 --> 00:10:22,800 Speaker 1: years for the medical establishment to start taking this concept seriously. 178 00:10:24,559 --> 00:10:27,840 Speaker 1: Doctor Peters presented a follow up paper in nineteen fifty 179 00:10:27,840 --> 00:10:32,360 Speaker 1: six that included two hundred and ninety one Hodgkins lymphoma cases, 180 00:10:32,440 --> 00:10:35,280 Speaker 1: with all of the data just as solidly pointing to 181 00:10:35,320 --> 00:10:38,920 Speaker 1: the idea that Hodgkins disease could be cured, especially in 182 00:10:38,960 --> 00:10:42,320 Speaker 1: the early stages. But perceptions in the medical field didn't 183 00:10:42,360 --> 00:10:45,800 Speaker 1: really start to change until Eric C. Eesen and Mary 184 00:10:45,840 --> 00:10:49,800 Speaker 1: and H. Russell, using doctor Peter's data, confirmed her work 185 00:10:49,880 --> 00:10:53,600 Speaker 1: in their paper Cure of Hodgkins Disease that was in 186 00:10:53,679 --> 00:10:57,960 Speaker 1: nineteen sixty three. It took even longer than that for 187 00:10:58,040 --> 00:11:01,400 Speaker 1: the idea that Hodgkin's disease could be approached as something 188 00:11:01,440 --> 00:11:05,120 Speaker 1: that can be cured in a medical textbook. Treatments have 189 00:11:05,280 --> 00:11:09,599 Speaker 1: continued to advance today, especially if it's in the early stages. 190 00:11:10,040 --> 00:11:12,560 Speaker 1: Hodgkin's disease is considered to be one of the most 191 00:11:12,640 --> 00:11:17,840 Speaker 1: curable adult cancers. Having made these kinds of strides in 192 00:11:17,920 --> 00:11:21,080 Speaker 1: Hodgkin's disease, doctor Peters turned her focus to breast cancer, 193 00:11:21,120 --> 00:11:23,560 Speaker 1: which was personally important to her because of her mother, 194 00:11:23,960 --> 00:11:26,480 Speaker 1: And we'll talk about that work after a brief ad break. 195 00:11:35,559 --> 00:11:37,920 Speaker 1: So to get back to doctor Peters's work with breast cancer. 196 00:11:38,400 --> 00:11:41,720 Speaker 1: In nineteen fifty eight, the Ontario Cancer Institute at Princess 197 00:11:41,720 --> 00:11:45,520 Speaker 1: Margaret Hospital opened and patients and staff from Toronto General, 198 00:11:45,600 --> 00:11:50,200 Speaker 1: including doctor Peters and her patients, were transferred there. As 199 00:11:50,240 --> 00:11:52,720 Speaker 1: a side note, we're about to talk about breast cancer 200 00:11:52,760 --> 00:11:55,160 Speaker 1: for a while, and while men can and do get 201 00:11:55,200 --> 00:11:57,720 Speaker 1: breast cancer, we're really going to be talking about women 202 00:11:57,800 --> 00:12:00,760 Speaker 1: here because that's the work that doctor Peters was doing. 203 00:12:01,920 --> 00:12:04,640 Speaker 1: All of her focus was on breast cancer treatment in women, 204 00:12:04,720 --> 00:12:07,840 Speaker 1: not in men, so we're not excluding men for some 205 00:12:07,920 --> 00:12:10,959 Speaker 1: other reason. That's just the work that she was focused on. 206 00:12:12,040 --> 00:12:15,200 Speaker 1: So at this point, the overwhelming majority of patients who 207 00:12:15,240 --> 00:12:18,800 Speaker 1: were diagnosed with breast cancer were treated with a radical mastectomy, 208 00:12:19,280 --> 00:12:22,600 Speaker 1: also called the Halsted procedure for the doctor who popularized it. 209 00:12:23,080 --> 00:12:25,600 Speaker 1: Almost as soon as they were diagnosed, they would go 210 00:12:25,640 --> 00:12:28,479 Speaker 1: in for a biopsy, which was done under general anesthesia, 211 00:12:28,920 --> 00:12:31,480 Speaker 1: and if the lump was cancerous, they'd have the mestectomy 212 00:12:31,520 --> 00:12:35,080 Speaker 1: before they were gained consciousness. This made the possibility of 213 00:12:35,120 --> 00:12:39,920 Speaker 1: breast cancer particularly terrifying women got onto an operating table 214 00:12:40,040 --> 00:12:42,439 Speaker 1: not knowing if they had cancer or not, and not 215 00:12:42,559 --> 00:12:45,000 Speaker 1: knowing if they would wake up without a breast or not. 216 00:12:45,679 --> 00:12:49,280 Speaker 1: The mestectomy itself, which was the standard treatment regardless of 217 00:12:49,280 --> 00:12:52,679 Speaker 1: whether the cancer had spread beyond one tumor, was a 218 00:12:52,720 --> 00:12:57,200 Speaker 1: lot more involved than mestectamies typically are today. A radical 219 00:12:57,240 --> 00:13:00,320 Speaker 1: mastectomy removes more than just the breast. That also moves 220 00:13:00,360 --> 00:13:04,040 Speaker 1: the pectoral muscles under the breast, along with the lymph 221 00:13:04,080 --> 00:13:06,400 Speaker 1: nodes under the arm on the same side as the 222 00:13:06,400 --> 00:13:10,600 Speaker 1: affected breast. This idea was that the cancer was less 223 00:13:10,679 --> 00:13:13,200 Speaker 1: likely to spread if you literally removed all of the 224 00:13:13,200 --> 00:13:16,079 Speaker 1: things adjacent to it where it was most likely to spread. 225 00:13:16,720 --> 00:13:19,600 Speaker 1: And you know, while these are the places that cancer 226 00:13:19,880 --> 00:13:22,839 Speaker 1: is most likely to go after appearing in the breast, 227 00:13:23,679 --> 00:13:26,280 Speaker 1: this court was the course of action, regardless of whether 228 00:13:26,360 --> 00:13:30,839 Speaker 1: cancer had been detected in any of these other places. 229 00:13:30,840 --> 00:13:35,840 Speaker 1: Needless to say, a radical mastectomy permanently and significantly altered 230 00:13:35,880 --> 00:13:40,160 Speaker 1: the body. Even after the reconstruction, a woman's chest itself 231 00:13:40,160 --> 00:13:43,240 Speaker 1: would look a lot different. It would basically be concave 232 00:13:43,320 --> 00:13:46,520 Speaker 1: because of the loss of the pectoral muscle, wall over 233 00:13:46,559 --> 00:13:50,160 Speaker 1: and over again. Modern medical papers describe radical mass deectomies 234 00:13:50,280 --> 00:13:54,960 Speaker 1: of the past as and this is quote disfiguring. Such 235 00:13:54,960 --> 00:13:57,080 Speaker 1: a huge change to such a personal part of the 236 00:13:57,080 --> 00:14:00,920 Speaker 1: body was psychologically and emotionally damaging or many patients for 237 00:14:00,960 --> 00:14:04,920 Speaker 1: the rest of their lives. Could also be physically disabling 238 00:14:04,960 --> 00:14:07,480 Speaker 1: since it removed some of the muscles used to control 239 00:14:07,520 --> 00:14:11,360 Speaker 1: a person's arm, and the loss of lymph nodes can 240 00:14:11,440 --> 00:14:14,959 Speaker 1: lead to permanent swelling and an increased likelihood of infections 241 00:14:15,000 --> 00:14:18,720 Speaker 1: in the arm. Nerve damage was also a really frequent complication, 242 00:14:19,560 --> 00:14:22,960 Speaker 1: and this is why today radical mastectomy is extremely rare 243 00:14:23,080 --> 00:14:25,640 Speaker 1: and it's only performed when there really is cancer in 244 00:14:25,680 --> 00:14:29,320 Speaker 1: those adjacent tissues. When people have messt deectomies today, they're 245 00:14:29,400 --> 00:14:33,000 Speaker 1: usually what's considered a simple mastectomy, which removes the breast 246 00:14:33,480 --> 00:14:35,680 Speaker 1: but leaves at least some of the lymph nodes, or 247 00:14:35,800 --> 00:14:38,960 Speaker 1: a modified radical mastectomy, which removes the breast and lymph 248 00:14:39,040 --> 00:14:41,960 Speaker 1: nodes but only gets into the pectoral muscles if the 249 00:14:42,000 --> 00:14:46,960 Speaker 1: cancer has actually spread there. Even though a radical mastectomy 250 00:14:47,040 --> 00:14:49,640 Speaker 1: was a standard of care for breast cancer patients at 251 00:14:49,640 --> 00:14:52,120 Speaker 1: this point, there were a few people who didn't have 252 00:14:52,240 --> 00:14:55,360 Speaker 1: them because of other medical conditions, or, in a very 253 00:14:55,400 --> 00:14:58,280 Speaker 1: limited number of cases, the patients who just put their 254 00:14:58,320 --> 00:15:02,000 Speaker 1: foot down and refused to have more aggressive surgery. These 255 00:15:02,080 --> 00:15:05,160 Speaker 1: patients had surgeries that conserved more of their breast. It 256 00:15:05,200 --> 00:15:08,680 Speaker 1: was either a simple mastectomy or a lumpectomy. Unless there 257 00:15:08,760 --> 00:15:11,720 Speaker 1: was some medical reason why a woman could not have 258 00:15:11,800 --> 00:15:15,760 Speaker 1: a radical mastectomy, these options were pretty much always against 259 00:15:15,800 --> 00:15:20,640 Speaker 1: medical advice. Doctor Peter's previous work with lymphoma meant she 260 00:15:20,720 --> 00:15:23,960 Speaker 1: was particularly insightful when it came to how cancer spread 261 00:15:24,000 --> 00:15:27,720 Speaker 1: through the lymphatic system. Patients were often referred to her 262 00:15:27,760 --> 00:15:31,840 Speaker 1: for follow up radiation treatment after their surgery, and she 263 00:15:31,880 --> 00:15:35,440 Speaker 1: also had personal experience with how traumatic breast cancer treatment 264 00:15:35,440 --> 00:15:37,400 Speaker 1: could be after she had lost her mother to the 265 00:15:37,440 --> 00:15:40,680 Speaker 1: disease in nineteen thirty three, so she wanted to see 266 00:15:40,720 --> 00:15:43,600 Speaker 1: if less drastic treatments could prove to be as effective 267 00:15:43,640 --> 00:15:46,560 Speaker 1: as a mastectomy while still preserving as much of the 268 00:15:46,600 --> 00:15:50,440 Speaker 1: breast as possible. She published her first work on the 269 00:15:50,480 --> 00:15:53,040 Speaker 1: subject in nineteen sixty seven, and it was based on 270 00:15:53,120 --> 00:15:56,120 Speaker 1: comparing the survival rates for women who had been treated 271 00:15:56,960 --> 00:16:00,560 Speaker 1: for their cancer with different forms of treatment. She studied 272 00:16:00,560 --> 00:16:03,320 Speaker 1: the record of seven thousand patients who had been treated 273 00:16:03,320 --> 00:16:07,080 Speaker 1: between nineteen thirty five and nineteen sixty eight. Hundred and 274 00:16:07,080 --> 00:16:09,840 Speaker 1: fifty two of these patients had had their lump removed 275 00:16:09,960 --> 00:16:13,440 Speaker 1: during their biopsy. One hundred and twenty four of those 276 00:16:13,560 --> 00:16:16,600 Speaker 1: had radiation as their only follow up treatment, while the 277 00:16:16,640 --> 00:16:20,920 Speaker 1: others had some combination of a mastectomy and radiation. What 278 00:16:21,080 --> 00:16:23,880 Speaker 1: she found was that there was absolutely no difference in 279 00:16:23,920 --> 00:16:27,160 Speaker 1: the survival time between the women who had just had 280 00:16:27,200 --> 00:16:29,720 Speaker 1: a lumbectomy and the women who had had a mastectomy 281 00:16:30,680 --> 00:16:32,920 Speaker 1: when it came to women with stage one and stage 282 00:16:32,960 --> 00:16:36,680 Speaker 1: two breast cancer. In her opinion, the more conservative surgery 283 00:16:36,800 --> 00:16:40,080 Speaker 1: which preserved the woman's breast was just as viable a 284 00:16:40,120 --> 00:16:44,080 Speaker 1: medical option as a mastectomy. And this was a completely 285 00:16:44,120 --> 00:16:48,120 Speaker 1: controversial stance at the time. In her words, quote, I 286 00:16:48,240 --> 00:16:51,240 Speaker 1: was refuted and shunned by most of the outstanding surgeons 287 00:16:51,240 --> 00:16:55,200 Speaker 1: in the States, except for doctor George Cryle of Cleveland. 288 00:16:56,360 --> 00:16:59,400 Speaker 1: She was determined, though, and so she decided to do 289 00:16:59,520 --> 00:17:02,440 Speaker 1: a case a case control study of the records from 290 00:17:02,480 --> 00:17:05,560 Speaker 1: Princess Margaret Hospital. So while she had previously calmed through 291 00:17:05,640 --> 00:17:07,720 Speaker 1: all of the records and looked at them as a whole, 292 00:17:08,400 --> 00:17:11,000 Speaker 1: this time she controlled for the age of the patients, 293 00:17:11,200 --> 00:17:14,560 Speaker 1: their other health factors, whether they also had other cancers. 294 00:17:15,240 --> 00:17:17,920 Speaker 1: She narrowed it down to only patients with stage one 295 00:17:18,040 --> 00:17:20,880 Speaker 1: breast cancer, and then she meticulously matched up the ones 296 00:17:20,920 --> 00:17:24,320 Speaker 1: who had a lumpectomy in radiation with the ones who 297 00:17:24,400 --> 00:17:27,359 Speaker 1: had a mastectomy and radiation, and to match them up, 298 00:17:27,359 --> 00:17:30,080 Speaker 1: she looked at their ages, how large the tumor was, 299 00:17:30,200 --> 00:17:33,240 Speaker 1: and the year that the treatment took place. This gave 300 00:17:33,320 --> 00:17:36,359 Speaker 1: her one hundred and forty five pairs in which the 301 00:17:36,440 --> 00:17:40,960 Speaker 1: lumpectomy group had no statistically significant difference than the mastectomy group. 302 00:17:41,600 --> 00:17:44,719 Speaker 1: In fact, the lumpectomy group had slightly better survival than 303 00:17:44,760 --> 00:17:48,119 Speaker 1: the mastectomy group. In other words, for women with stage 304 00:17:48,119 --> 00:17:51,359 Speaker 1: one cancer, a more conservative treatment that preserved their breast 305 00:17:51,480 --> 00:17:55,760 Speaker 1: did not harm their chances of survival. Radical mastectomy was 306 00:17:55,800 --> 00:17:58,719 Speaker 1: not necessary when the disease had not started to spread. 307 00:18:00,119 --> 00:18:02,920 Speaker 1: In nineteen seventy five, she presented these findings at the 308 00:18:03,000 --> 00:18:07,160 Speaker 1: Royal College of Physicians and Surgeons of Canada meeting in Winnipeg, Manitoba. 309 00:18:08,080 --> 00:18:11,920 Speaker 1: Their response was really skeptical at best. Two years later, 310 00:18:12,040 --> 00:18:15,040 Speaker 1: doctor Peters published an updated version of the paper in 311 00:18:15,080 --> 00:18:18,359 Speaker 1: an international journal, which gave it more exposure and also 312 00:18:18,440 --> 00:18:21,479 Speaker 1: came to the exact same conclusions in that paper. She 313 00:18:21,560 --> 00:18:25,040 Speaker 1: was really direct in her opinion. She said, quote as 314 00:18:25,080 --> 00:18:28,360 Speaker 1: more and more conservative studies ripen, as more and more 315 00:18:28,440 --> 00:18:33,000 Speaker 1: concerned physicians observe the adverse effects of excessive treatment, as 316 00:18:33,000 --> 00:18:36,240 Speaker 1: more and more women become armed with knowledge, mastectomy and 317 00:18:36,320 --> 00:18:39,359 Speaker 1: early breast cancer may become as old fashioned as blood letting. 318 00:18:40,280 --> 00:18:43,440 Speaker 1: Doctor Peters retired from the hospital the year before that 319 00:18:43,480 --> 00:18:46,920 Speaker 1: revised paper was published, although she maintained a part time 320 00:18:46,960 --> 00:18:52,040 Speaker 1: practice and she continued to teach. But gradually oncologists did 321 00:18:52,080 --> 00:18:57,120 Speaker 1: start taking a more conservative approach to early stage breast cancers. Today, 322 00:18:57,320 --> 00:18:59,880 Speaker 1: women with early stage breast cancer generally have a mested 323 00:19:00,119 --> 00:19:04,480 Speaker 1: to me if there's some medical reason to do so. 324 00:19:04,600 --> 00:19:07,520 Speaker 1: Doctor Peter's impact on the medical field also went beyond 325 00:19:07,640 --> 00:19:10,120 Speaker 1: just the specific treatment of these two cancers. And we'll 326 00:19:10,119 --> 00:19:21,000 Speaker 1: talk about how after a brief ad break, so to 327 00:19:21,080 --> 00:19:24,720 Speaker 1: return to doctor Peters, a lot of people take the 328 00:19:24,800 --> 00:19:28,720 Speaker 1: idea of patient centered care to for granted today, even 329 00:19:28,720 --> 00:19:31,919 Speaker 1: if they've never heard that term specifically, I know that 330 00:19:32,000 --> 00:19:35,200 Speaker 1: lots of people have lots of different access to medical care, 331 00:19:35,320 --> 00:19:38,080 Speaker 1: depending on all kinds of factors, including their income level, 332 00:19:38,119 --> 00:19:40,600 Speaker 1: and their age, and their race and lots lots of 333 00:19:40,600 --> 00:19:43,000 Speaker 1: different issues. But for the most part, when people go 334 00:19:43,040 --> 00:19:45,159 Speaker 1: to the doctor, they kind of expect their doctor to 335 00:19:45,160 --> 00:19:47,199 Speaker 1: treat them like a human being and to listen to 336 00:19:47,240 --> 00:19:51,760 Speaker 1: them and to explain what's going on. And this was 337 00:19:51,840 --> 00:19:56,400 Speaker 1: not really how things worked. When doctor Peters started practicing medicine, 338 00:19:57,280 --> 00:20:00,800 Speaker 1: she was really a forerunner in the idea listening to 339 00:20:00,880 --> 00:20:04,440 Speaker 1: a patient's wishes and explaining to them and helping them 340 00:20:04,480 --> 00:20:08,720 Speaker 1: make decisions about their own treatment. This whole idea was 341 00:20:08,800 --> 00:20:13,760 Speaker 1: really far from standard when she was practicing medicine. Yeah, 342 00:20:13,800 --> 00:20:16,160 Speaker 1: she actually got to know her patients and she helped 343 00:20:16,200 --> 00:20:18,600 Speaker 1: them make decisions about their own health care rather than 344 00:20:18,680 --> 00:20:20,920 Speaker 1: just seeing them as a condition to treat and telling 345 00:20:20,920 --> 00:20:25,040 Speaker 1: them what to do. Another common attitude today is that 346 00:20:25,040 --> 00:20:26,840 Speaker 1: when you go to the doctor, you should get a 347 00:20:26,840 --> 00:20:29,160 Speaker 1: treatment that's going to be the right amount to solve 348 00:20:29,200 --> 00:20:32,159 Speaker 1: the problem, not something that's just going to be so 349 00:20:32,440 --> 00:20:35,480 Speaker 1: completely aggressive that it's going to blast the problem away 350 00:20:35,560 --> 00:20:38,520 Speaker 1: but then also leave you with potentially lots of scars 351 00:20:38,640 --> 00:20:42,040 Speaker 1: or huge side effects or you know, lots of adverse 352 00:20:42,080 --> 00:20:45,320 Speaker 1: effects to taking care of the problem. This was also 353 00:20:45,480 --> 00:20:48,680 Speaker 1: core to doctor Peter's philosophy. As a doctor, she wanted 354 00:20:48,720 --> 00:20:51,560 Speaker 1: to do the most conservative treatment to get the job done, 355 00:20:52,119 --> 00:20:53,840 Speaker 1: and it was really different from a lot of what 356 00:20:53,920 --> 00:20:57,200 Speaker 1: was going on at the time. Obviously, doctors were putting 357 00:20:57,200 --> 00:20:58,960 Speaker 1: women to sleep to do a biopsy and then taking 358 00:20:59,000 --> 00:21:01,600 Speaker 1: their entire breast in the case of really small tumors 359 00:21:01,600 --> 00:21:05,960 Speaker 1: that hadn't progressed anywhere. She really wanted to avoid the 360 00:21:06,080 --> 00:21:09,200 Speaker 1: risks that came of side effects and other complications by 361 00:21:09,240 --> 00:21:12,680 Speaker 1: doing a more minimal treatment but still trade into actual problem. 362 00:21:13,560 --> 00:21:16,000 Speaker 1: And she was also a role model for young women 363 00:21:16,040 --> 00:21:18,679 Speaker 1: who were interested in becoming doctors, not just because of 364 00:21:18,720 --> 00:21:21,680 Speaker 1: her success as a doctor, but also because she proved 365 00:21:21,680 --> 00:21:23,680 Speaker 1: that a woman could be a doctor while also being 366 00:21:23,680 --> 00:21:26,160 Speaker 1: a wife and mother, and that was something that really 367 00:21:26,200 --> 00:21:28,840 Speaker 1: needed proving at this point in history. She did a 368 00:21:28,840 --> 00:21:31,560 Speaker 1: lot of her research at home, so she was compiling 369 00:21:31,640 --> 00:21:33,480 Speaker 1: her work by hand. She wouldn't have been able to 370 00:21:33,520 --> 00:21:37,199 Speaker 1: make the breakthroughs that she did otherwise, But outside of 371 00:21:37,240 --> 00:21:40,000 Speaker 1: the medical world she was missus Lobb, mother of two. 372 00:21:41,400 --> 00:21:44,119 Speaker 1: I think a lot of the other female forerunners in 373 00:21:44,160 --> 00:21:46,560 Speaker 1: the world of medicine we've talked about have been women 374 00:21:46,600 --> 00:21:54,800 Speaker 1: who eschewed the more traditional, stereotypical feminine side, and so 375 00:21:54,920 --> 00:21:56,919 Speaker 1: it actually was a big deal that, in addition to 376 00:21:56,960 --> 00:22:01,160 Speaker 1: being a doctor, she got married and had children. All 377 00:22:01,200 --> 00:22:04,240 Speaker 1: of this work was additionally incredible because at this point 378 00:22:04,320 --> 00:22:07,399 Speaker 1: there were hardly any women doctors at all, let alone 379 00:22:07,400 --> 00:22:09,360 Speaker 1: women doctors who were on the cutting edge of their 380 00:22:09,400 --> 00:22:14,160 Speaker 1: field revolutionizing the treatment of multiple diseases. And Doctor Vera 381 00:22:14,240 --> 00:22:16,919 Speaker 1: Peters became an Officer of the Order of Canada in 382 00:22:17,040 --> 00:22:20,159 Speaker 1: nineteen seventy eight. She was awarded the Gold Medal from 383 00:22:20,160 --> 00:22:23,960 Speaker 1: the American Society of Therapeutic Radiology in nineteen seventy nine, 384 00:22:24,359 --> 00:22:26,800 Speaker 1: and the Woman of Distinction Award from the Canadian Breast 385 00:22:26,800 --> 00:22:31,399 Speaker 1: Cancer Foundation in nineteen eighty eight. Sadly, she died of 386 00:22:31,440 --> 00:22:34,320 Speaker 1: cancer on October first, nineteen ninety three, at the age 387 00:22:34,359 --> 00:22:38,000 Speaker 1: of eighty two. She died at Princess Margaret Hospital in Toronto, 388 00:22:38,119 --> 00:22:41,239 Speaker 1: where she had worked for most of her career, and 389 00:22:41,280 --> 00:22:44,080 Speaker 1: she was inducted into the Canadian Medical Hall of Fame 390 00:22:44,240 --> 00:22:47,520 Speaker 1: in twenty ten. It's kind of a side note there 391 00:22:47,600 --> 00:22:50,320 Speaker 1: was a play about her called Radical, which was written 392 00:22:50,320 --> 00:22:54,119 Speaker 1: by Charles Hayter, who was also an oncologist, that actually 393 00:22:54,160 --> 00:22:57,919 Speaker 1: premiered to just sell out standing room only crowd at 394 00:22:57,920 --> 00:23:02,760 Speaker 1: the Toronto French Festival in July two. Thank you, doctor 395 00:23:02,840 --> 00:23:07,399 Speaker 1: Vera Peters. I know you and I both have family 396 00:23:07,480 --> 00:23:11,160 Speaker 1: experience with breast cancer and the fact that somebody said, Okay, 397 00:23:11,200 --> 00:23:17,000 Speaker 1: we have got to just stop treating women as a 398 00:23:17,119 --> 00:23:18,960 Speaker 1: thing to put on a table and remove part of 399 00:23:18,960 --> 00:23:21,480 Speaker 1: their body without actually talking to them about it, like 400 00:23:22,119 --> 00:23:26,080 Speaker 1: that's a big deal. Yeah. The idea of not being 401 00:23:26,160 --> 00:23:29,639 Speaker 1: asked questions about treatment is so alien to me that 402 00:23:29,720 --> 00:23:36,280 Speaker 1: it's shocking. Yeah. Yeah, uh and you. I said this 403 00:23:36,359 --> 00:23:37,760 Speaker 1: to you off Mike, and now I'm just gonna say 404 00:23:37,800 --> 00:23:41,000 Speaker 1: it on Mike. As I was researching this, I found 405 00:23:41,080 --> 00:23:45,320 Speaker 1: a citation of that cure for Hodgkins disease paper. It 406 00:23:45,440 --> 00:23:47,879 Speaker 1: was like a citation of the paper that was in another, uh, 407 00:23:49,119 --> 00:23:52,359 Speaker 1: another journal, and it cited the male doctor is doctor 408 00:23:53,520 --> 00:23:55,600 Speaker 1: and the female author of the paper is missed. And 409 00:23:55,680 --> 00:23:58,639 Speaker 1: I could not figure out whether she was actually a 410 00:23:58,720 --> 00:24:04,119 Speaker 1: doctor when that notation was published or not, because it 411 00:24:04,200 --> 00:24:06,199 Speaker 1: is possible that she was credited on a paper but 412 00:24:06,480 --> 00:24:11,679 Speaker 1: was not yet a medical doctor. But I sincerely wonder, 413 00:24:11,720 --> 00:24:13,200 Speaker 1: based on all of the other things that were going 414 00:24:13,240 --> 00:24:15,639 Speaker 1: on at the time, whether she was just credited as 415 00:24:15,720 --> 00:24:19,960 Speaker 1: miss instead of doctor because she was a woman. Yeah, 416 00:24:20,280 --> 00:24:28,720 Speaker 1: so that's a mystery that remains to be solved. Thanks 417 00:24:28,720 --> 00:24:31,399 Speaker 1: so much for joining us on this Saturday. Since this 418 00:24:31,480 --> 00:24:33,480 Speaker 1: episode is out of the archive, if you heard an 419 00:24:33,520 --> 00:24:36,440 Speaker 1: email address or a Facebook RL or something similar over 420 00:24:36,480 --> 00:24:39,120 Speaker 1: the course of the show, that could be obsolete now. 421 00:24:39,560 --> 00:24:45,280 Speaker 1: Our current email address is History podcast at iHeartRadio dot com. 422 00:24:45,680 --> 00:24:48,200 Speaker 1: You can find us all over social media at missed 423 00:24:48,280 --> 00:24:51,280 Speaker 1: in History, and you can subscribe to our show on 424 00:24:51,359 --> 00:24:55,560 Speaker 1: Apple podcasts, Google podcasts, the iHeartRadio app, and wherever else 425 00:24:55,640 --> 00:25:01,080 Speaker 1: you listen to podcasts. Stuffy Missed in History Class is 426 00:25:01,080 --> 00:25:05,440 Speaker 1: a production of iHeartRadio. For more podcasts from iHeartRadio, visit 427 00:25:05,480 --> 00:25:08,919 Speaker 1: the iHeartRadio app, Apple podcasts, or wherever you listen to 428 00:25:08,960 --> 00:25:09,840 Speaker 1: your favorite shows.