OBITUARY ODILE SCHWEISGUTH

 Pioneer of cancer treatment for children -  born March 1913, Remisemont, Vosges,  she died on March 26th 2002 aged 89

Before the second world war childhood cancer was not a major problem. It did exist but virtually all who had it diagnosed died rapidly. Infections were much more important. The discovery of antibiotics at the start of the war, and immunisation against common infectious diseases has virtually wiped out infections as a cause of death in young people. Cancer has therefore become a priority and indeed in spite of the fact that 75% of children can now be cured it remains the commonest reason, after accidents, why someone will die between the ages of one and forty years. Childhood cancer which affects one in 600 before the age of 15 is different from that which one in 4 adults will eventually get. Leukaemia and tumours of the kidney, brain and lymph nodes make up the majority. In the early part of the 20th century a few children could be cured by surgery. The harnessing of the magical powers of radiation discovered by Marie Curie improved survival only slightly. Ironically it was an accident during the second world war when a ship full of mustard gas was sunk which led to the discovery of anticancer chemotherapy. Pioneering efforts in the late 40’s in Boston and New York led to the discovery that many childhood cancers seemed to be particularly responsive to these new drugs.

 It is perhaps fitting that the European developments were centred on Paris, the city where Marie Curie had discovered radium. It was the Institute Gustav Roussy at Villejuif which Odile Schweisguth was to make the mecca for young enthusiastic doctors from all over Europe, and which remains a major world centre of excellence.

 Odile Schweisguth was born in 1913 and was the fifth child of a French army officer. She spent much of her early childhood in Mainz, Germany where her father was part of the occupying forces. She achieved her baccalaureate at the age of 17 and then spent 2 years learning needlework and studying the piano for up to four hours each day. Always determined to study medicine she enrolled in the medical school in Nancy but transferred to Paris where she qualified as a doctor in 1946. Odile never married but her four siblings produced 29 children and it was this which gave her a love of young people. It was whilst working as a junior doctor at the Hôpital Enfants Malodes that she received a call from Villejuif to say that they needed a paediatrician to look after children with cancer. She started in 1948 with a once weekly visit but by 1952 was there at least half time having being made Chief of Paediatrics in 1951. One of her main attributes was an assured assertiveness and she determined to get the best facilities for children who were then housed at the end of an adult ward. She demanded and achieved a separate children’s ward of 16 beds, 8 for boys and 8 for girls divided by a brick wall. There was an additional room for babies with up to 5 cots but it had no running water and all of the staff, doctors and nurses shared one tiny office. In spite of the facilities Odile remembered the tremendously happy atmosphere with the staff and patients being like a family.

 In the early days most patients continued to die and the ward was seen from the outside as a very sad place and this made great difficulty in her recruiting an assistant. At the end of 1959 she visited Sidney Farber in Boston where she met the other pioneers who were to go on to dominate the field over the next 40 years. During this trip she also went to Memorial Sloan Kettering Hospital in New York and to San Francisco. She returned to Paris inspired and began the introduction of anticancer drugs and this brought a new mood of optimism. She was able to recruit Jean LeMerle to join her in l966. One of the first successes was with Wilms’ tumour of the kidney, the commonest solid tumour in young children. Occasional patients had been cured in the past by often heroic surgery but the introduction of the drugs vincristine and actinomycin dramatically improved things. Villejuif was the only hospital in France specialising in childhood cancer and many patients were sent there from all over the country. There was great excitement when many of the children returned home cured of their fatal disease. Consequently doctors asked to come and spend time in Paris and between 1966 and 1970 she had many “assistants” initially from France but then from all over Europe.

Odile’s growing band of followers began to meet on a regular basis at an annual summer school in Paris but there was a need for a more formal structure to bring the young specialists together. In 1969 the first meeting of what was to become the Societe International Oncologie Pediatrique (SIOP) was held in Barcelona with 30 attendees. Odile was elected as president and remained its inspiration and driving force for many years. It has now grown to an organisation of over 1200 members world-wide from over 60 different countries. At first the annual congresses were bilingual in French and English but Odile herself recognised that English was becoming the international medical language and insisted on a change to a single voice. She was always very tolerant of those whose first language was not English but she had had great difficulty with rapid speaking Americans. On many occasions she would leap to her feet, from her usual place at the front of the auditorium and shout “speak slowly and in Eenglish”.

She wrote a text book for care of children with cancer and this was translated into English by Ann Barratt, now Professor of Oncology at the new Medical School in Norwich. She retired in 1978 and SIOP honoured her by the introduction of the Schweisguth Prize to be given to the best young doctor training in paediatric oncology. This prestigious award has now been won by most of those who are leading the continuing revolution in cancer care for children. Several of them have been British and how now playing a leading role in the further developments of treatment.

She retired to Colombe a village in south east France, where she continued to keep in touch with many of the patients whom she had treated over the years. This along with her enormous personal family of great nieces and nephews kept her busy.

 She greatly upset the French prime minister by refusing the Legion d’honneur. “Why do I need medals” was her response. There is no doubt that Odile Schweisguth was the pioneer who laid the foundations which enable us to now offer real hope of cure to the 1400 children each year in the UK who are unfortunate enough to be given the diagnosis of cancer. Indeed one in 900 20 year olds is now a survivor of this disease. The organisation which she founded SIOP, is now truly global and beginning to bring hope to many children throughout the developing world.

A.W. Craft
Former President of SIOP