Vera Peters: “Cutting the Gordian Knot”

Vera PetersOriginally published in the ebook A Passion for Science: Stories of Discovery and Invention.

by Joan Reinhardt-Reiss

The Royal College of Physicians and Surgeons of Canada was a secure male bastion whose ramparts were rarely breached by women. At the 1975 annual meeting, M Vera Peters, MD was the only female speaker. Her superb resume contained more than a hundred publications and globetrotting lectures. Yet, she possessed three major impediments: she was female, unassertive, and endowed with a soft, sometime quavering voice. Her presence was perfection with neatly coiffed brown hair, twinkling eyes behind large, plastic rimmed glasses, a quick smile and a paragon of haute couture. In high school she replaced her archaic name Mildred with the simple letter M. From her bank accounts to a myriad of scientific papers, the signature would forever be M Vera Peters with initials MVP – truly a Most Valuable Player in medicine.

Vera Peters, an expert breast cancer specialist, always found verbal presentation to be a daunting challenge. Among the few friendly faces in the Winnipeg Holiday Inn ballroom was Peters’ physician-daughter, Jenny, who had spent time rehearsing with her mom. Jenny recalled her mother’s nervous recitations, “The night before she practiced repeatedly and smoked cigarettes in between. Now I sat in the back watching the enormous audience of four hundred – mostly men.”

Vera Peters stepped onto the podium to present Cutting the Gordian Knot in Early Breast Cancer. Her speech was punctuated with soft, delicate tones. She poetically stated the analogous relationship between Alexander the Great slicing his sword through the fabled knot and new modalities in breast cancer.

“I am setting out to capture acceptability… by those concerned with taking the risky adventure out of the treatment of early breast cancer,” Peters said in a presentation to the Royal College of Physicians and Surgeons, in Winnipeg, Canada, in January 1975.

Vera Peters was a conservative radical. Her mild Canadian approach belied her rigorous challenge to the surgical lodestar for breast cancer, radical mastectomy or ‘Halsted mastectomy’. The first such procedure was performed in 1882 by William Halsted, a Johns Hopkins surgeon, and was the dominant treatment for almost a century. The surgeon removed the breast, underlying chest muscles, and adjacent lymph nodes, and Halsted himself referred to his ability to “flay the patient’s chest”.

After a Halsted procedure, the cancer was considered cured, although it could still later recur, which contradicted the notion of a ‘cure’.

Peters had described alternatives to risky, radical mastectomy as early as 1953 by systematically categorizing the stages of breast cancer. Now, she detailed her 30-year study, which had involved hundreds of lumpectomy patients and an equal number of matched controls where excision and minimal radiation were compared with the prevailing radical mastectomy and increased radiation. Measured by survival years and absence of recurrence, her minimalist approach produced results equal to or slightly better than the traditional treatment. Peters concluded, “Prophylactic radiation and prophylactic mastectomy could, with few exceptions, be eliminated in early breast cancer.”

Jenny recalled, “She was exceedingly nervous but I felt she had presented well. Everyone listened politely and when she concluded there was reasonable applause, but they were not warmly enthusiastic. I was unaware how upset the audience was.”

The talk ended but audacity lingered – subdued Vera Peters had quietly disputed the need for total mastectomy, the surgeon’s breast cancer elixir. Her statement, that “…radical methods are not in the best interest of the patients” inflamed the male medical world who worshipped the 11th commandment, doctor dictates. The skirmish that began in Winnipeg continued for decades.

Transforming events

Peters made the decision to become a radiation therapist during medical school, when she heard fascinating lectures from the chief of radiology, Gordon Richards. As a student, she found him to be brilliant but formidable.

“He was a big man with red hair, very commanding and quite good-looking,” she said. “The staff was frightened of him because he was so precise but he was a good teacher and very, very ingenious.”

Richards was chairman of the radiology department. He directed both diagnostic and “therapeutic radiology”, later renamed radiation therapy. Richards taught Peters the most current treatments for cancer patients. As a former military man, the gruff exterior was ever-present, but a gentle side dominated with his adoring patients. He also entered Peters’ life in a personal way.

During her medical school tenure, Vera’s mother, Rebecca, was diagnosed with breast cancer and underwent a Halsted mastectomy. Vera had seen mastectomy scars before, but it was difficult to look at her mother’s debilitated state. When Rebecca finally sat up in bed, her face was pale and drawn. Vera applied fresh dressing to the wounds.

“Mother’s chest appeared concave with enormous scars, a complete mutilation. A single breast remained but the pectoral muscle was removed. She had difficulty lifting one arm. I hoped that this surgical assault cured her cancer.”

After seeing her mother, Peters thought that a more benign way to cure breast cancer must exist. Unfortunately, Rebecca’s surgical procedure was unsuccessful.

“When mother began to get recurrences in the chest wall after the major surgery, she was referred to Dr Gordon Richards who was my chief. He impressed me because he seemed so interested and communicative.”

Richards had recognised the curative powers of radium prior to treating Rebecca Peters’ breast cancer, and successfully campaigned for the hospital to buy an infinitesimal amount of radium at an exorbitant price. He had already achieved some positive results by using a plaster cast embedded with radium needles, but when treating Rebecca, he replaced the plaster cast with a more comfortable cotton jacket.

Vera Peters recalled, “The corset involved skin breakdown and created a burning which was awful. Shortly after that therapy, the distant spread of the cancer became evident.”

When breast cancer became personal, Peters knew she was destined to be a radiation therapist and applied for an apprenticeship with Richards. He already had experience with his first female apprentice, Helen Bell-Milburn, who became a breast cancer specialist at Women’s College Hospital in Toronto. This unique hospital began in 1898 as a women’s clinic, but quickly expanded, and from inception until 1960, the entire staff was female. A likely role model for Peters was the Radiology Chief at Women’s College, Eleanor Stewart, Canada’s first female radiologist.

Richards recognised in Peters traits of curiosity, intelligence and diligence. Her starting salary was $100 a month. After several years, she moved from apprentice to staff.

Vera Peters was an inveterate smoker and the ever-present cigarette had a collegial role in her life. The staff lunchroom at Princess Margaret Hospital was so filled with smoke that it was difficult to distinguish faces. With so few women in medicine, Vera’s smoking became a social interaction with the male medical fraternity.

Curing another cancer

Few physicians ever have a major impact in two diseases. Adding to her work in breast cancer, Vera Peters initiated the earliest cure for Hodgkin’s disease, previously thought to be a uniformly fatal malignancy. The first use of radiation therapy in Hodgkin’s disease is credited to Swiss physician René Gilbert. In 1939, he reported long-term survival rates for certain Hodgkin’s disease patients. Like Gilbert, Gordon Richards and Vera Peters determined that radiation therapy was critical for both the involved lymph nodes as well as adjacent nodes. Richards had purchased a 400-kilowatt X-ray machine that was considered to be state of the art. With this technology, higher radiation doses could be safely delivered without skin damage.

In 1947, a decade after joining Gordon Richards’ staff, he and Vera Peters were striding down the hall when Richards said, “Dr Peters, how would you like to review our experience with Hodgkin’s disease? All our textbooks say that it is a fatal disease, but we seem to be seeing patients who are cured.”

Fueled by coffee, cigarettes and an occasional power nap, Peters began a clinical research odyssey. On her large dining room table, she plotted each patient’s data on five square feet of graph paper using the computer tools of that era: a slide rule and adding machine. After two years of late nights, she declared, “I had demonstrated… through Dr Richards’ experience… that Hodgkin’s disease had a potential for cure.”

In 1949, Vera Peters submitted her report to the Toronto General Hospital staff. A pathologist conducted a microscopic cellular examination and confirmed each Hodgkin’s disease diagnosis. Peters analysed 100 cases that used the Toronto radiation therapy approach and dramatically concluded:

“The overall five year survival rate of 51 percent and the ten year survival rate of 35 percent in this series is considerably better than any other survival rate reported in the literature to date.”

A pale Gordon Richards attended in a wheelchair and felt a surge of pride as his protégée presented their pioneering results. Vera Peters continued alone, as the ailing Gordon Richards died soon after from leukemia, a common disease of radiologists in that radium-exposed era. Yet, Richards’ name will be ever-present as the innovator who established radiation therapy as a bona fide specialty in North America.

Peters submitted the radiation therapy cure for Hodgkin’s disease to the Canadian Medical Journal. The editors rejected the paper for containing “too many tables”. Years later, Peters stated her belief that the submission was rejected due to her gender. Eventually, this 1950 landmark treatise was accepted by an American journal.

Throughout her career, Peters continued to research, publish and lecture. She developed an international reputation as one of the world’s preeminent radiation therapists. In 1969, Robin Farkas, a New York department store executive, was 36 years old when he was diagnosed with Hodgkin’s disease and was referred to Peters. After a consultation in Toronto, Peters travelled to New York to attend Farkas’ exploratory surgery, which revealed extensive Hodgkin’s disease with numerous lymph nodes involved.

During the 1960s, chemotherapy was starting to be used to treat Hodgkin’s disease. Farkas said, “Dr Peters recommended a chemotherapy protocol being done at Sloan-Kettering in New York. When I asked how long I had to live, she told me two or three years. I asked what determines the length of time?”

Peters softly replied, “The treatment is so caustic that it’s a race to see which one dies first, the disease or you.”

“After each awful treatment, I would spend the next hours throwing up my guts. I kept in touch with Dr Peters and she decided to help me break the chemotherapy protocol, a serious decision since it upset the entire study.”

Farkas then went to Toronto on a regular basis where Peters treated him with extensive radiation therapy. He is almost 80 years old now and has had no recurrence of disease.

“I have the fondest memories of Dr Peters. She was kind, gentle, and professional. She helped me stay calm.”

Early days

The trajectory of Vera Peters’ life began in 1911, the year Marie Curie received her second Nobel Prize. Mildred Vera Peters was born in a rural area outside Toronto, the fifth and youngest child of a poor cattle farmer Charles Peters and former teacher, Rebecca Mair.

Maintaining the farm was a struggle in the depression era, and income barely exceeded a subsistence level. Clothes were made by hand; electricity and a telephone were unaffordable. Mother Rebecca emphasised the importance of excellent grades and the highest level of schooling. The result was a family poor in consumer goods but rich in educational values.

Tragedy arrived early. “My father died when I was 11 from an intestinal obstruction,” she said. “The nearest farm was one mile away so we couldn’t get a doctor.”

That summer, with her brother away, young Vera ran the farm. She milked cows at 4am and drove the tractor. Vera’s oldest sister Catherine headed the household and assigned chores to her siblings creating numerous family arguments. Vera resisted all confrontation whether it was family or, later, in medicine, saying, “An argument is just two people trying to prove they are right. If you know you’re right, what’s the point in arguing? I would just walk away and say nothing.”

Always an excellent student, Peters even found time for athletics like ice hockey and basketball. After high school graduation, she entered a university maths and physics program, but quickly realised that teaching was the only end result. Three weeks later, after a family conference and assistance from a professor-friend, she enrolled in the only Ontario medical school that accepted women, the University of Toronto. Her three teacher-sisters, and her brother, who now ran the family farm, pooled resources to pay for her tuition.

Peters embarked upon six years of medical study. Women in medical school were often considered superfluous in the male fraternity of students and faculty, and were outnumbered 10:1 by men. Even so, Canada was relatively enlightened – the US ratio was 20:1. Peters recalled a dean who was particularly disdainful of women. When she answered a query in class, he replied, “That’s a very female answer.”

Confronting the orthodoxy

In an approach that many male physicians considered heresy, Peters involved her patients in treatment decisions. She remembered all the suffering women who cried in her office after their radical procedures, and never forgot her mother’s agony. She understood the distress and defeminisation that women described after the disfiguring loss of a breast. Most male surgeons believed that a radical mastectomy gave women new life, so cosmetic and emotional concerns were dismissed.

A National Cancer Institute (NCI) breast cancer study of 1,700 women at multiple medical centers questioned the efficacy of the radical mastectomy vs lumpectomy. However, the NCI study was only a few years old, so long term survival was unknown and surgeon-dominated medical groups easily dismissed these results, while continuing to extol the radical approach.

Peters never confronted her critics publicly. Instead she responded with numerous published papers that demonstrated equivalent survival years when lumpectomy and radiation was compared with mastectomy. Regardless, the surgical community reacted with defiance and sarcasm. The American Cancer Society (ACS) replied negatively to lumpectomy, saying, “The American public should not be stampeded into accepting less proven methods.” ACS medical director Arthur Holleb bluntly criticised lumpectomy as an “almost useless procedure”, and renowned Stanford surgeon Lawrence Crowley suggested that mastectomy’s good results were too reliable to risk “…migrating too rapidly to new methods of therapy [lumpectomy] based upon evolving but yet unproved theoretical concepts.”

Peters knew that her approach was anathema to the surgery community, “I was refuted and shunned by most of the outstanding surgeons in the States, except for Dr George Crile.” As the founder of the Cleveland Clinic, Crile learned about minimalist surgery in thyroidectomy procedures. Using that experience, and Peters’ work, he applied lumpectomy to breast cancer treatment beginning in 1955. In spite of ridicule from fellow surgeons, Crile later published The Breast Cancer Controversy, a guidebook for women dealing with breast cancer. He cited Peters’ data showing that lumpectomy-radiation results were equivalent to mastectomy.

The media also played a part in promoting alternatives to mastectomy. In 1972, Time ran an article that included Peters’ lumpectomy approach to early stage breast cancer. She received letters from physicians in remote corners of the world requesting protocol details, and women everywhere learnt about treatment alternatives and lumpectomy.

Many women considered breast cancer to be a female plague, an issue that required secrecy. When famous women began to publicly discuss breast cancer, a dark curtain partially lifted. The advent of mammography in the 1960s vastly increased the ability to diagnose and effectively treat early stage breast cancer. The first celebrity breast cancer patient was the child movie star Shirley Temple Black. In 1972, her mammogram revealed a small mass. Black chose to undergo a biopsy and then reviewed all options before choosing a modified mastectomy. Two years later, Betty Ford, wife of the US President, Gerald Ford, was diagnosed with breast cancer and underwent a radical mastectomy. With her public openness and interviews, Ford helped cast light on the hidden breast cancer world. However, some came to the conclusion that the President’s wife would surely have had the best procedure available and, as a result, radical mastectomy continued to be the first line treatment for many women, regardless of their breast cancer stage.

Years later, a major advocate for Peters arose. Bernard Fisher, a University of Pittsburgh surgeon, studied hundreds of breast cancer cases and survival statistics and supported Peters in his 1990 presentation, Biological and Clinical Justification for Relegating Radical Breast Cancer Operations to the Archives of Surgical History.

The male surgical world spent scores of years doing more excessive surgery than necessary and ignoring or decrying Peters’ approach. Her work was re-enforced over time, and by a grateful cadre of female patients. In 2013, an online article in Cancer demonstrated that lumpectomy-radiation provided longer survival times than mastectomy. In spite of excellent data on lumpectomy for early stage breast cancer, many women still debate mastectomy vs lumpectomy when confronted with breast cancer.

Feminist leader

When Peters was cited in popular newspapers and magazines, women began to examine their medical options and rebel against the Halsted approach of paternalistic male surgeons. Peters had an impact on both breast cancer activism and a woman’s right to choose her treatment. Small patient information groups morphed into networks and advocacy, questioning surgical breast cancer decisions, and giving women a new power to determine other health choices. From the work of Vera Peters and others, a new set of feminist voices arose.

Women began flexing their prerogative muscle and moving into male professions like science, mathematics and medicine. Until the late 20th century, few women entered medical school and their specialty areas focused on pediatrics and obstetrics-gynecology. Now women were claiming equality based on justice and ability. Peters became an exemplar for female medical students who recognised radiation therapy as an excellent specialty. Gillian Thomas, a young colleague, declared, “Vera was modest and driven by an inherent curiosity. She left her footprints in the snow for us to follow.”

Peters’ tranquil approach to life and work was a medical model for decades. Never argumentative, her data demonstrated her points. She talked with patients and fought at the medical barricades so that women could examine facts with their physicians and together review treatment options.

Family life

During medical school, Peters worked summers as a waitress on the ship SS Cayuga that cruised the shores of Lake Ontario. Among the young wait staff was a charming physical education teacher, Ken Lobb. Vera fell in love with him. They married in 1937 while she was training under Gordon Richards. Their enchanting outdoor wedding photo shows a beaming bride and groom both dressed in sparkling white attire. Her smart suit and perfect hat completed a stunning ensemble. Ken also represented a haberdasher’s dream in his quintessential white suit. He bore a striking resemblance to young Ernest Hemingway, while lovely Vera mirrored a silver screen starlet. Photos of the handsome couple might have been the centerfold in a 1930s Hollywood magazine.

The honeymoon was a long trip through Canada and the US. They loved the outdoors and fishing was enthusiastically pursued. In later years, golf and bridge also occupied important recreational pursuits. Both Vera and Ken were inveterate smokers, an activity considered rather cool at the time.

Vera was one of the early women who successfully juggled the roles of doctor, wife, and mother: Sandy was born in 1942 and Jenny seven years later. Just as she softly presented scientific data and refused to argue, she adopted that ‘keep the peace’ manner at home. Sandy remembers that her mother made more money than her father, but always let him lead the family, except for a name change. When she debated becoming Vera Lobb, she asked Gordon Richards’ advice and followed his proposal to retain her birth name. Sandy and Jenny were acutely aware that phone calls for Dr. Peters came from the hospital while non-medical callers requested Mrs Lobb.

“Mom had a fabulous sense of humor, yet in public Dad was the outgoing one and she let him lead. It was a wonderful relationship. Every morning, Dad brought Mom coffee in bed, before she even put her feet on the ground,” Sandy reminisced.

Ken was the pillar who sustained the family, the supportive husband in an era when men were expected to dominate and be served. He even urged Vera to go to England for six months when she was offered a sabbatical. Jenny was barely nine years old when Vera left. Ken managed his daughters, work, the ever-changing housekeepers, the household, and almost daily letters to Vera. At the end of her sabbatical leave, Ken and the girls joined Vera for a grand European vacation. Other men would have felt dominated by an accomplished physician-wife but Ken gave her full support to quietly confront the male medical world.

As a physical education teacher, Ken was also the football coach. He had a number of winning teams and a devoted following among the boys. Occasionally, a boy from an alcoholic abusive family related his home problem to Ken. The boy would spend major time at the Lobb house, and occasionally moved in. A thankful troop of children (now adults) can attest to Ken’s caring nature.

A housekeeper always had a role in the Lobb family. Supper was family time and if Vera saw a late patient, the meal was held. Dinner was an occasion to share and be together. After supper, Ken would work on projects while the girls did school assignments. After seeing 40 patients during the day, Vera brought home medical charts to analyse survival rates and treatment. The girls enjoyed testing her concentration by making outrageous comments followed by, “Oh Mom will never hear that because she doesn’t hear anything.”

Accompanied by coffee and cigarettes, Peters analyzed data well into the night. One morning the girls came down for breakfast, and found Vera still at the table working.

“Mom, you must have stayed up late and got very little sleep because you’re back at it.”

“Actually, I forgot to go to bed. I got so interested in what I was doing that when I looked up, it was daylight.”

Peters had such extreme dedication that she often fixated on the next activity. One morning, her thoughts focused on a patient as she settled into her car. She then proceeded to toss the car keys out the window and placed her lit cigarette in the ignition.

Summers were spent at a cottage in the resort area of Sundridge, a few hours north of Toronto. Their simple cabin was located on lovely Lake Bernard, a mecca for all water activities. Here the family had a true paradise complete with berry picking, jam cooking, swimming and fishing. For Peters, that summer month was a time to completely focus on family.

While Vera was in England, Ken was diagnosed with diabetes mellitus, a problem he hid from Vera, not wanting to interrupt her sabbatical. Six years later, a more serious malady occurred as Ken was playing golf. He developed some chest pain and was diagnosed with a heart condition. Jenny remembers him waking at night, gasping for breath. Vera had Ken placed under the care of a Toronto cardiologist who prescribed barbiturates.

Ken might have been aware of President Eisenhower’s 1955 heart attack: The President’s physician was Paul Dudley White, considered to be the founder of modern cardiology, who developed a unique cardiac prevention strategy that involved diet, exercise and weight control. Ken adopted some of the White strategy. He ceased smoking and successfully restricted his diet to lose 40 plus pounds. Jenny remembered, “Dad invested in great suits for his new shape. He even came home from work earlier and had a snooze. He was a different man.”

In 1967, Ken Lobb was counselling a student when he stopped talking and his head dropped. An ambulance rushed him to hospital but this heart attack was fatal. Vera continued alone with her daughters, medicine, and devoted friends. Now a young widow at 56, she sold the family house and moved elsewhere. “I don’t know what I would have done without my work,” she told her daughters.

Hodgkin’s Disease and Henry Kaplan

In 1956, Vera Peters gave her first major presentation at the International Congress of Radiology. The Mexico City audience was replete with medical experts anxious to hear from this Canadian female who had the temerity to cure Hodgkin’s disease. In the audience was the brilliant, young Chairman of the radiology department at Stanford University. Henry Kaplan had done definitive work in cancer radiation using a mouse model system before being recruited by Stanford. Hearing Peters’ talk, he felt inadequate. She documented her Hodgkin’s disease protocol with radiation dosages, treatment of adjacent lymph nodes, and a classification system for disease stages. Her quiet manner belied the fact that she was already one of the world’s preeminent radiation therapists.

Kaplan had a brilliant mind and a commanding presence. He also had the ability to control meetings and issues. His interrogative questioning of Peters in Mexico City set the stage for his entry and later dominance in Hodgkin’s disease. He returned to Stanford and, following Peters’ system, began a 30-year review of Stanford patient records. Kaplan had a talented partner, an equally intelligent but gentler medical oncologist, Saul Rosenberg. Over the next decade, a number of multi-disciplinary meetings were held regarding Hodgkin’s disease and the most appropriate classification system. Rosenberg had great admiration for Peters and during these many conferences he always included Peters and even invited her to the Stanford social gatherings.

Peters quickly learned that whatever Kaplan believed as truth, he dictated to others. In the first Hodgkin’s collaborative study among multiple centers, Kaplan was determined to utilise a staging laparotomy procedure, surgically opening the abdomen to determine the extent of disease. Vera refused to do unnecessary surgery so Kaplan initially excluded Toronto from the study. Rosenberg often intervened between Kaplan and Peters. She once commented, “Saul and I nearly always agreed. We should have worked together.”

Over the next years, a number of multi-disciplinary symposia were held to reach agreement on a classification system for Hodgkin’s disease stages. Kaplan obtained grants and organised a number of these meetings. In 1965, the group met in Ann Arbor and Peters was invited as keynote speaker, since she was the first to introduce a classification system. Each speaker was allotted 20 minutes but as she was giving the keynote, Peters had 40 minutes. As usual, she was nervous, but proceeded to clearly explain her classification system. The conference chairman, however, never received the extended time memo and at 20 minutes, halfway into her presentation, he cut her off. Unbelievably, Peters never protested and quietly sat down.

As the group broke for lunch, Kaplan approached and said, “Vera, you’ll never get me to use your classification in Hodgkin’s disease, never.” As the conference ended, the chairman chose a classification committee and Vera Peters was omitted. Years later she commented, ”I thought it was the worst slap in the face that I ever had.” She still continued her work and published scientific papers that described appropriate classification.

At a Paris meeting, Kaplan and his wife asked Peters to join them for dinner. Halfway through this gourmet repast, he turned to her and said, “Vera, I think you should stop writing about Hodgkin’s disease and concentrate on cancer of the breast.” She did not respond but thought, “I feel sorry for him.”

In treatment protocols, Kaplan was always more aggressive than Peters. He opted for higher doses of radiation while Peters believed in less damaging lower dosages. In the early years of chemotherapy, clinical battles revolved around which combination of drugs worked best and whether or not radiation treatments were also involved. Both Rosenberg and Peters agreed on combining radiation therapy with chemotherapy and thereby decreasing the amount of radiation. At first Kaplan continued with radiation alone but finally agreed on the combination.

Henry Kaplan and Gordon Richards shared a number of traits. Both men were beloved by patients. Richards made Toronto a mecca for radiation therapy while Kaplan did the same for Stanford. Unlike Richards however, Kaplan was intolerant and often verbally abusive with colleagues and those he considered enemies. However, for rising stars in the Stanford orbit he was a tower of encouragement. Sara Donaldson, a Kaplan trainee, is recognised as one of the foremost pediatric radiation oncologists, and once declared, “We thought Henry Kaplan was a god and later learned that Vera Peters had done the early innovations that Kaplan built on.”

Over the years Peters recognised Kaplan’s brilliance, but so disliked his attitude, saying, “I discovered that he was dictatorial and wanted the limelight at all times. He belittled some of the things that I did or said that proved to be true.”

She always credited both Kaplan and Rosenberg with improved treatment approaches including utilization of Stanford’s linear accelerator.

“Henry did a lot of good work and you just can’t ignore good work, even if you hate the man,” she told an interviewer years later. Kaplan did once acknowledge her achievements; as a featured speaker at a Toronto symposium, he praised the now-retired Peters, who was no longer a competitor.

Vera Peters received a multitude of awards and honorary degrees. Among all her accolades, she had two favourites and both occurred after retirement. The 1977 Antoine Béclère Award was presented to her in Paris by the Radiological Society of France. Béclère was the father of radiation therapy in France and Peters was the first woman to receive that commendation.

Two years later she received the gold medal from the American Society for Therapeutic Radiologists (ASTR). Both Jenny and Sandy accompanied her to New Orleans where the award was presented. Chairman of the ASTR Board, Philip Rubin, delivered the opening remarks: “Vera Peters is a very special person who loves to study the natural history of malignant disease. She has a sixth sense about when and when not to intervene. Her contributions to the management of Hodgkin’s disease and breast cancer are pioneering efforts and her insights were clearly ahead of her time. In Hodgkin’s disease the concept of extended field irradiation for uninvolved nodes and in breast cancer, lumpectomy and irradiation are now essential parts of our clinical practice.” Once the medal was placed around her neck, Vera returned to her table where the dessert awaited. As she sat down, the medal dropped into her ice cream. She calmly retrieved it and laughed along with the entire table.

Life after retirement

At age 65, Peters retired. She could have extended her career by another five years, but one issue broke her spirit. Her Toronto hospital committed to join a randomised breast cancer clinical trial in which appropriately matched early stage breast cancer cases were divided into two groups: mastectomy vs. lumpectomy. Yet, the proposal meant that some women with early stage breast cancer would be arbitrarily chosen to undergo unnecessary mastectomy. Peters had shown in numerous retrospective studies that these early stages could be successfully treated with lumpectomy. Maintaining non-confrontational behavior, she never disclosed the real reason for her departure. Later, the hospital abandoned the trial, but by then she had left.

Jenny, a medical resident and her husband Alan, a lawyer, led busy lives in London, Ontario when their son David was born. Their baby-sitter left abruptly and Jenny phoned the best baby-sitter she knew.

“Mom, our sitter has left and we desperately need you to come and take care of David. How soon can you get here?” The perfect timing of that request must have coincided with Peters’ need for a change. She moved to London and became the doting grandmother.

When Jenny and her family moved to Oakville, so did Peters. Jenny opened her geriatric practice and Vera occupied a small section in the office as a consulting cancer physician. Remembering those two years, Jenny said, “One of the most heart–warming pieces of my career was when Mom joined me in the office and took patients on referral. “

In that era, retired physicians lost hospital privileges, so Peters referred her patients to radiation therapists like Mary Gospadarowicz, a colleague who recalled how Peters was idolised by all her patients, “Vera told us that we always had to come here for our follow-up.” And so they did.

Peters continued to write papers, lecture, and enjoy her growing family and friends. Yet during this time her health deteriorated. A positive side effect from her hip replacement was that she stopped smoking. Later she was diagnosed with both breast cancer and lung cancer. She now returned to Princess Margaret Hospital in Toronto, where she’d spent so much of her medical career, as a patient. Simon Sutcliff, a radiation therapist and CEO at the hospital, procured a room for her, and her daughters brought many desired items including an easy chair, a photo wall, a kettle, microwaves, her pink silk jogging suit, creating a space where all visitors were welcome. Anyone who knocked on the door was greeted with a friendly, “Come in!” Hospital staff brought residents to learn from this gracious physician who had the gifts of curiosity and compassion.

At the end of each day, Sutcliff went to her room and the two friends socialised over crystal glasses of sherry with shared tales of life, philosophy, and the future. He said, later, “I wanted to know Vera, she was someone I respected as a major contributor.”

When Peters died, Gospadarowicz and colleagues wrote a moving obituary tribute, which acknowledged Peters’ impact on two cancers while quietly overcoming male prejudice.

“Dr Peters was the ultimate caregiver. Her insight into the disease, wealth of experience, and scientific approach to cancer treatment were combined with a deep empathy and care for each patient. Indeed, many patients admit that once having Vera as their doctor, every other physician seemed second best.”

Further reading

Reinhardt-Reiss, J; Donaldson, S, (2015) “Homage to M. Vera Peters, MD”, Intl. J. Of Radiation Oncology, 92(1) pp. 5-8.

DeCroes Jacob, C, (2010) Henry Kaplan and the Story of Hodgkin’s Disease, Stanford University Press.

Knepper, K. and Donaldson, S, (1996) “Women in Radiation Oncology and Radiation Physics”, A History of the Radiological Sciences: Radiation Oncology, ed. Gagliari, R.A., Radiology Centennial Inc.: Reeston, VA.

Cowan, D.H., (2008) “Vera Peters and the Curability of Hodgkin’s Disease”, Current Oncology (15, No.5) 5-9.

About the author

Joan Reinhardt-Reiss’ renaissance background includes science training, public interest advocacy for environment and health. For a decade she has worked with Breast Cancer Fund to legislatively eliminate toxics in our environment. Additional vitae: ultra-marathon champion, National Public Radio commentator, and grandmother. Travelogues, writing, a published NYTimes letter, and NPR commentaries, can be found onher website.


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