Cancer Treatment

Dr. Gordon E. Richards – Canada’s Father of the Discipline of Radiation Therapy

One of the most important health care discoveries of the early 20th century was the potential of radiation therapy in treating patients with cancer. Very soon after the discovery of X-rays in 1895 and radium in 1898, practitioners began to hear, and spread, stories about the almost magical effect of “rays” on cancerous tumours. In Canada, the first report of X-rays being used to treat cancer surfaced in 1902. Others quickly followed, and in 1910 a doctor named William H. B. Aikins opened the Radium Institute of Toronto. By 1924, when he died, Aikins claimed to have treated more than 3,000 patients.

This was a time of excitement in health care. Radiotherapy held genuine promise for the treatment of a disease that until then had all too often confounded doctors. The fact was, though, that the health care community understood much more about the potential of radiation than they did about the practice itself, and there was certainly too little understanding of the dangers involved. There was no particular oversight or regulation with respect to radiation therapy. Treatments were given in less-thanstandard fashion by surgeons and general practitioners. Incredibly, some physicians were known to carry radium sources in their pockets.

The dawn of change

It was at this time that a man named Gordon E. Richards arrived on the scene. The son of a Presbyterian Minister, Dr. Richards was born in Lyn, Ontario. His father died when he was four, and he was raised in the home of his grandmother. Originally destined for the ministry, Richards opted instead for a medical career, working his way through the University of Toronto Medical School. He was a driven and highly successful student, who was President of the Undergraduate Medical Executive in his final year, and graduated as the top student with the gold medal in 1908.

It is unclear when or how Dr. Richards developed any interest or expertise in radiology, but shortly after graduating, he joined Vancouver’s St. Paul’s Hospital as a radiologist. In 1917, he moved back to Ontario to lead the new X-ray department at Toronto General Hospital. Until his arrival, diagnostic radiology was performed by non-MD radiographers, with physicians and surgeons interpreting the film. Over strenuous objections from clinicians, Dr. Richards directed that trained radiologists should be the ones making those interpretations, as well as final decisions as to treatment of cancer patients with radiation.

A more organized approach to radiation therapy

Over the following years, Dr. Richards’ department acquired higher voltage radiation machines and radium for the treatment of patients with cancer. These therapies were still being used by private practitioners outside formal institutions, but in Dr. Richards’ time and in large part because of his influence, these began to give way to a more organized and academic approach to radiation therapy. By the mid-1930s, Dr. Richards and his department had gained a national and international reputation for the treatment of patients with cancer.

Although there were no formal training programs in radiotherapy at that time, Dr. Richards trained apprentices, including two notable figures: Dr. Vera Peters, who became Canada’s best known and most honoured radiation oncologist through her work in Hodgkin’s disease and breast cancer, and Dr. Clifford Ash, who followed Dr. Richards as Chief of Radiotherapy and later became Director of Princess Margaret Hospital.

A more effective use of facilities

Dr. Richards’ contributions extended beyond radiation therapy to the broader issues surrounding cancer control, particularly in Ontario. He was one of the first to recognize that the treatment of cancer requires specialists working in specialized institutions. He was a strong proponent of centralizing radiation facilities, and he favoured linking these facilities to large hospitals “to make the most effective use of the facilities for frequent consultation with other specialty departments.”

The union of The Toronto Hospital (later renamed the University Health Network) and Princess Margaret Hospital in 1997, bringing together all cancer treatment modalities, truly realized Dr. Richards’ vision. Similarly, the more recent integration of Cancer Care Ontario’s cancer centres with their host hospitals would surely have met with his enthusiastic approval.

A significant role in all key aspects of cancer control

Dr. Richards’ influence in cancer control was not limited to Ontario. He helped form both the Canadian Cancer Society and the National Cancer Institute of Canada, serving as the latter’s president in 1947 and 1948. He was involved and played a key role in almost every significant national and provincial cancer control initiative that occurred in his lifetime.

Dr. Richards was known to have always been cordial with his patients, but it was said of him that he never learned how to play – rather, his life was directed wholly and completely to his work. That commitment probably played a part in ending his life. It is a sad irony that the man who did more than anyone to bring some order and regulation, not to mention safer practices, to radiation therapy in Canada died of a blood condition – almost certainly acute leukemia, and very likely the result of prolonged exposure to radiation. Dr. Richards was an extraordinary man, one who devoted his entire life to combating cancer.

Information from:

https://archive.cancercare.on.ca/about/ourhis/visionariespioneer/