Vera Peters

Mildred Vera Lobb (née Peters), OC, physician, radiation oncologist, researcher (born 28 April 1911 in Thistletown, ON; died 1 October 1993 in Toronto, ON). Known professionally as Dr. Vera Peters, she conducted groundbreaking research on Hodgkin’s disease, now known as Hodgkin’s lymphoma, and breast cancer, which led to changes in the way these diseases are treated. (See also Cancer; Breast Cancer Research in Canada.) Peters was also a pioneer of patient-centered care, which prioritizes patients in the decision-making process for medical treatment, and which is now the standard model in health care.

Early Life and Education

Mildred Vera Peters was born in Thistletown, Ontario in 1911. Her mother, Rebecca Mair, was a teacher and her father, Charles, was a dairy farmer. Her parents valued academics and supported all of their children in their education. At the age of 11, her father died, and Peters grew up with her mother and six siblings. An exceptional student, she was educated in a one-room schoolhouse in Thistletown and graduated from high school at the age of 16.

At age 17, Peters attended the University of Toronto where she began her studies in physics and mathematics. Her six siblings helped to pay for her tuition. After a year of study, Peters joined the university’s Faculty of Medicine (see Medical Education). As a student, she played women’s hockey.

During her medical studies, Peters met Dr. Gordon Richards, the director of the Department of Radiology at Toronto General Hospital, who was treating Peter’s mother for breast cancer (see Cancer). Richards was a pioneer in radiation therapy in Canada and, over time, became an important medical mentor for Peters. In 1933, Peters’ mother died from metastatic breast cancer. The loss of her mother deeply impacted her and inspired her later work in the field of radiation oncology. In 1934, Peters received her medical degree from the University of Toronto Medical School. Out of 115 new graduating doctors, only 10 were women. At this time, women in medicine continued to face challenges because of their gender.

Early Career

Following her graduation, Vera Peters continued her medical training by completing a surgical residency at St. John’s Hospital in Toronto, Ontario. During this time, she studied cancer and surgical anatomy. Peters began working as an apprentice to Gordon Richards at the Ontario Radiotherapy Institute, Toronto General Hospital in 1935. In 1937, Peters began working at Toronto General Hospital as a junior assistant radiotherapist. Although there was no official training available in the new field of radiation oncology at the time, Peters worked alongside Richards and developed her skills in radiation therapy. Over time, she began to treat many cancer patients, including many with Hodgkin’s disease.

Hodgkin’s Disease

Hodgkin’s disease, now known as Hodgkin’s lymphoma, is a type of cancer that starts in the white blood cells and affects the lymphatic system. In the 1940s, Hodgkin’s disease was still considered to be a fatal and an incurable form of cancer. However, Vera Peters and Gordon Richards saw patients who were cured. In 1947, after 10 years at Toronto General Hospital, Peters began to review the files of patients with Hodgkin’s disease in order to evaluate their treatment methods. Upon Richards’ advice, Peters painstakingly analyzed the records of 113 Hodgkin’s patients who had received radiation treatment. Peters published the results of her study in 1950, making several important contributions to the field. First, she introduced a three-stage classification system which helped to assess the severity of the disease and provided a basis for treatment planning. This classification system paved the way for today’s four-stage system. Second, she found that the length of survival time increased greatly for patients who received radiation treatment in the earlier stages of the disease. Third, she found that high-dose radiation treatment of the affected lymph nodes, as well as of neighbouring lymph nodes, increased survival rates for patients with stage 1 Hodgkin’s disease. Peters’ optimistic findings challenged the prevailing beliefs of the time and her 1950 study was largely ignored by the medical community.

Despite the doubt of the medical community, Peters persisted and presented a second, updated study in 1956, which attracted the notice of the medical community. By examining 291 cases of Hodgkin’s disease amongst patients, she found that high-dose radiation treatment was highly effective in treating Hodgkin’s disease, particularly in the early stages. Peters demonstrated that patients could, in fact, be cured with proper intervention in the early stages of the disease. The medical community did not accept these findings immediately. It took confirmation by other research studies to convince them. By the 1970s, doctors began to believe in the curability of Hodgkin’s disease. As a result, oncologists began to change their treatment protocols, increasing the amount of radiation to treat early-stage Hodgkin’s disease. Peters continued to publish studies on Hodgkin’s disease throughout her career. Today, Hodgkin’s lymphoma is considered to be a highly treatable form of cancer when caught in its early stages.

In 1958, Peters began working at the newly named Princess Margaret Hospital in Toronto (originally the Ontario Cancer Institute). All of the patients from the Ontario Radiotherapy Institute were transferred to Princess Margaret Hospital.

Breast Cancer and Lumpectomy

Vera Peters’ research also changed the face of breast cancer treatment. Deeply affected by her mother’s death from breast cancer, Peters was committed to studying its treatment throughout her career. (See also Breast Cancer Research in Canada.) Radical mastectomy, or the removal of the entire breast and chest muscles, was the leading form of breast cancer treatment until the 1970s. Peters was concerned about the negative psychological and emotional effects radical mastectomy had on patients. Always observant and curious, Peters once again studied patient case files to investigate the impact of different treatments on breast cancer survival rates. From these files, she published numerous studies that eventually helped change the course of breast cancer treatment. In her first study on breast cancer published in 1967, Peters advocated for lumpectomy, which involves preserving the breast while removing any cancerous tissue, followed by radiation therapy. Peters found that this less invasive treatment was just as effective as mastectomy. Her findings were first met with skepticism from the medical community. However, other studies from Europe and the United States also demonstrated that conservative lumpectomy was just as effective as radical mastectomy.

Over time, Peters’ preferred treatment method slowly gained acceptance. In 1969, Peters was invited to speak at M.D. Anderson Hospital in Houston, Texas on the topic of conservative approaches to breast cancer treatment. As a result, the hospital began performing conservative lumpectomies followed by radiation. However, the general skepticism of medical professionals continued throughout the 1970s. Using approximately 8,000 patient case files, Peters completed the first controlled study comparing stage 1 breast cancer patients who received mastectomy and radiation with those who received lumpectomy and radiation. Her study confirmed that there was no difference in outcome. In 1975, she presented the results of her study to the Royal College of Physicians and Surgeons of Canada. Peters’ work finally received recognition and acceptance. Today, radiation after a lumpectomy is recommended to treat early-stage breast cancer and reduce the risk of breast cancer recurring or spreading.

Impact on Health Care

Vera Peters’ work on Hodgkin’s lymphoma and breast cancer changed the way these diseases were treated (See also Cancer; Breast Cancer Research in Canada.). Hodgkin’s lymphoma is now considered curable in its early stages and, since the 1990s, lumpectomy followed by radiation has become the standard treatment for early-stage breast cancer. In addition to her groundbreaking research, Peters was also known for her compassionate and gentle treatment of cancer patients. She actively listened to their concerns and acknowledged their emotional needs. She was a champion of compassionate practices that put the patient at the centre of their treatment; she is recognized as a pioneer of patient-centered care, a treatment method that is now the standard in Canadian medicine. She is also remembered as a supportive mentor to new doctors.

Personal Life

Known as Mrs. Lobb in her personal life, Vera Peters successfully balanced work and family throughout her career. She was married to Kenneth Lobb, a high school physical education teacher, and together they had two children, Sandy and Jenny. When Peters retired from Princess Margaret Hospital in 1976, she opened a private practice in Oakville, Ontario. Peters was diagnosed with breast cancer in 1984 and she died from metastatic cancer (cancer that spreads from its point of origin to another location in the body) in 1993 at Princess Margaret Hospital.

Legacy

Peters was posthumously inducted into the Canadian Medical Hall of Fame in 2010 and the Canadian Science and Engineering Hall of Fame in 2013. In 2020, Peters was featured on a commemorative stamp released by Canada Post. Charles Hayter, Canadian playwright and radiation oncologist, wrote a 2014 play celebrating the life and work of Dr. Vera Peters entitled Radical.