History of the Southern Alberta Children's Cancer Program: The story of kids' cancer care in Calgary and Southern Alberta over the past 60 years

By Dr. D. H. Ross Truscott

Research efforts to discover cancer therapies for kids dates back to the end of World War II after many experiments with mustard gas and nitrogen mustards. In 1947, Dr. Sydney Farber's group published a paper on the effects of a folic acid antagonist, inducing remission in children with leukemia. Reception of this report in the medical community was unenthusiastic! Most malignant tumours and leukemia were uniformly fatal at that time. Research scientists were not discouraged, however, and with perseverance, successful therapies followed.

Our story traces back to the early days in the organization of cancer services for children in Alberta. This includes the contributions of the many medical nursing and paramedical personnel involved in developing the program for children's cancer services for Calgary and Southern Alberta.

Our pediatric oncology clinic is a success story and is improving the survival rates and quality of life for patients. I regret the fact many of the pioneers who helped us in the early years have passed on. They were so helpful in maintaining the continuity of care and the establishment of ongoing progress in improving results in those early years.

• Language: English
• Publisher: Tellwell Talent
• Release date: Feb 10, 2022
• ISBN: 9780228847472

Dr. D. H. Ross Truscott

Ross Truscott is a retired pediatrician who practiced in Calgary, Alberta, from 1962 to 1995, and part time after that until 2011. He has a long-standing interest in pediatric oncology and worked to establish a children's cancer program for Calgary and Southern Alberta.He grew up on a family farm near Alameda, Saskatchewan, and attended the University of Saskatchewan for pre-medical studies and his first two years of medicine. He graduated with his MD from the University of Alberta in 1955. He completed his pediatric training at Vancouver General and the Hospital for Sick Kids, Toronto, and pediatric pathology training at Columbia-Presbyterian Medical Center in New York. He and his wife, Marilyn, raised a family of five children—two sons and three daughters—and they were blessed with eight grandchildren. Marilyn passed away from cancer in 2011.

Book preview

History

of the

Southern Alberta

Children’s

Cancer Program

The story of kids’ cancer care in Calgary and Southern Alberta over the past 60 years

Dr. D. H. Ross Truscott

History of the Southern Alberta Children’s Cancer Program

Copyright © 2022 by Dr. D. H. Ross Truscott

All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author, except in the case of brief quotations embodied in critical reviews and certain other non-commercial uses permitted by copyright law.

Tellwell Talent

www.tellwell.ca

ISBN

978-0-2288-4748-9 (Paperback)

978-0-2288-4747-2 (eBook)

Dedication Plaque

The Child Health Care Centre is dedicated

to Alberta’s most precious resource

– our children –

Here, care extends to the spirit, as well as to the body;

the prevention of illness

is fundamental; the regard for

the family and the involvement of

the community are foremost.

This commemorative plaque was

dedicated at the opening of the

Child Health Centre

September 10, 1981

Dedication

This book is dedicated to the supporters of the

Southern Alberta Children’s Cancer Program. This includes the Kids’ Cancer Care Foundation, the Alberta Children’s Hospital Foundation, and the other support groups. Finally, this book is also in recognition of all kids with cancer, their families, and cancer caregivers everywhere.

Table of Contents

Foreword

Preface

Introduction

Chapter 1 - Pediatrics and Oncology in the 1950s and 1960s in Calgary, Alberta

Chapter 2 - The 1970s and Dr. June Whaun and the Birth of the Children’s Oncology Clinic

Chapter 3 - Alberta Children’s Hospital Development

Chapter 4 - Alberta Medical Association—Childhood Cancer Audit Subcommittee

Chapter 5 - Nursing and Support Personnel of the Children’s Oncology Programs in the Early Years

Chapter 6 - Dr. Ron Pilkington

Chapter 7 - The 1980s and Dr. Zipf

Chapter 8 - Dr. Ron Grant

Chapter 9 - Dr. Tom Bowen and the Introduction of Bone Marrow Transplantation

Chapter 10 - Nancy Marshall

Chapter 11 - Dr. Max Coppes and Clinic Expansion

Chapter 12 - Dr. Ron Anderson and His Long-term Commitment

Chapter 13 - The Pediatric Neuro-oncology Program

Chapter 14 - The Bone Marrow Transplant Program

Chapter 15 - The Southern Alberta Children’s Oncology Program—Present Day

Chapter 16 - Pediatric Oncology Research

Chapter 17 - Pediatric Oncology Support Consultants

Chapter 18 - Support Systems and Pediatric Oncology

Clinic Fundraisers

Chapter 19 - The Long Term Survivor Clinic

Chapter 20 - Summary and Reflections

Acknowledgements

Appendix A: Original letters

Timelines

Abbreviations

Sources

Photo Credits

About the Author

Foreword

I am pleased and honoured that Dr. Ross Truscott asked me to contribute some introductory comments regarding his recent book: A History of Children’s Cancer Care in Calgary and Southern Alberta.

I have been blessed to know Dr. Ross Truscott since I relocated to Calgary from Seattle in 1980, now some 40 years ago. Indeed, I have known and worked with Ross as a colleague and friend and he was pediatrician for my children.

In Dr. Truscott’s book, he carefully chronicles the history of children’s cancer care in Calgary and Southern Alberta. He has had an interest in pediatric oncology since his pediatric residency in 1958, with a career in pediatrics and pediatric cancer care spanning sixty-two years. He shares his observations of children’s cancer care from a time when this diagnosis, while he was doing pathology training, was one of a terminal illness with no hope of cure, and through the growing pains of developing chemotherapies and radiotherapeutic approaches and on through hematopoietic stem cell rescues, allowing even further intensification of chemo/radiotherapies. He shares his intimate involvement with the struggles to establish pediatrics as a specialty in Calgary and the subspecialty of pediatric hematology/oncology in Calgary and with Edmonton, Alberta as a whole. Unlike some of us who burned out and moved on, he persevered through all of the turmoil to ensure the patients always had the most up-to-date care and continuity of care. Battling local and provincial health systems, he always presented the case for developing a children’s cancer program locally and provincially. Giving poignant descriptions of the succession of clinic directors (seven, I believe, including Drs. June Whaun, Ron Pilkington, Ted Zipf, Ron Grant, Max Coppes, Doug Strother, and Victor Lewis) with whom he shared his vision for cancer care, he is able to present a history of the Calgary and Southern Alberta Cancer program and the evolution of the University of Calgary and its Department of Medicine, and then its Medical School that no other person could provide. However, Dr. Truscott really was the first spark and gentleman driving force, the real first clinic seed that created the today’s reality of the Children’s Cancer Care Program in Calgary and Southern Alberta, and the corollary programs of Pediatric Hematology Program and the Pediatric Hematopoietic Stem Cell Transplant Program.

Ross chronicles the successive contributions of the clinic directors and many of the team members, but sometimes ignores his critical role in binding the team together, which allowed the team to survive and eventually flourish. He never seemed to be flustered, nor daunted, nor discouraged, as he always had a focus—how to achieve the best cancer care program for the children of Alberta. Ross was a physician pioneer and his many cancer patients his co-pioneers. The current success of the Southern Alberta Children’s Cancer Program is forever indebted to Ross, the physician pioneer, and to the many children and their family warriors who went to battle against the various cancers—and who can now look back on the many victories.

Dr. Ron Grant was one of the first to see the importance of the long-term follow-up clinic to ask the questions: Are we doing this right? Is the outcome worth it? Can we re-tweak the protocols so we have similar or better survival with less toxicity, pain, and suffering? Dr. Grant recognized Dr. Truscott’s incredible overview of, and vision for, children’s cancer care and could find no one better qualified nor suited to share and take on the challenges of the long-term follow-up clinic. Without database registries and international diagnostic, treatment, and management consortia for rare disorders like children’s cancer, we would be much slower to make progress and likely miss answering the question of how can we do better.

Ross, you championed cancer care when we had little to offer but prayer and supportive care; then helped obtain early treatments when they were in their infancy and scarce; then supported belonging to international treatment groups like the Pediatric Oncology Group; and then pioneered the approach of pausing and asking the patients and their families: How are you doing? Was it worth it? What would you do differently? What are the regimen related toxicities that our protocols created? These child warriors and their families have battled, and many have, post-traumatic stress disorders. Ross, you have been instrumental in reminding us, now that we are curing cancer, can’t we do a better job to improve the lives of our patients and their families? Many of us only hope so and strive for the answer, but one thing is clear: No one could have done a better job than you and the many warriors and warrior families that you have helped over the years.

Congratulations on a job well done and for such a wonderful effort in chronicling the story over sixty-two years. All programs need a conscience and none are better than the one you and your long-term survival clinic have provided. Marilyn, I am sure you are looking down and smiling as you and your family’s support of Ross were the support for the entire children’s cancer team of Southern Alberta. From me, but one small and brief member of the enormous team Ross spawned, thanks to all the Truscott family!

Dr. Tom Bowen MD FRCP

Preface

It was May 1997 and the Alberta Children’s Hospital celebrated the seventy-fifth anniversary of the establishment of the first children’s hospital in Calgary. The history of the development of the children’s hospitals in Calgary has been chronicled by Arty Coppes-Zantinga and Dr. Ian Mitchell in their publication The Child in the Centre. That was a major milestone in recording the story of child healthcare here in southern Alberta up to that time. In recent years, I have been encouraged by many of my medical colleagues to undertake the recording of the history of children’s cancer care for Calgary and southern Alberta.

My interest in children’s cancer began during my pediatric residency training at the Hospital for Sick Children in Toronto in 1958 with Dr. Bernie Laski and his leukemia patients, and with a pediatric pathology residency at Babies Hospital in Columbia-Presbyterian Medical Center in New York City from 1959 to 1960. There I studied with Dr. Dorothy Andersen, Dr. James Wolff, and Dr. William Blanc. Dr. Wolff was a hematologist interested in treatment of leukemia and pediatric solid tumors and he had collaborated with Dr. Sidney Farber in the 1948 study published in the New England Journal of Medicine showing the effectiveness of the methotrexate precursor aminopterin in the treatment of leukemia. In that study of sixteen children, ten of them showed favourable responses and transient remissions. Indeed, that was a landmark study, but it had a limited acceptance in the medical world at that time. After training there, we returned to Regina to join a community pediatric practice with my former mentor Dr. Barrie Duncan. Dr. Michael Heimbach was a fellow pediatrician at this clinic and was a very helpful and supportive colleague there. There was a difficult political climate in Regina at that time related to the implementation of Medicare. After working in emergency services during the famous doctor’s strike and the advent of Saskatchewan Medicare, Dr. Heimbach and I relocated to Calgary in August 1962. The concept of socialized medicine was sound, but the implementation seemed to be anti-physician at the time and the social turmoil was very stressful for physicians and their families, whereas Calgary was a calm and welcoming environment. During our first years of practice in Calgary, Dr. Heimbach and I recognized difficulties in managing cases of cancer in children. We had many discussions on this problem, and we recognized that the Calgary medical community would benefit from the development of a medical school with its attendant teaching outreach and the promotion of research.

Many health professionals have been involved in developing and providing those services for the Children’s Cancer Program of