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The Cobalt process: radiation cancer therapy developed in Saskatchewan

Sylvia Fedoruk considers herself a lucky person to have participated in one of Saskatchewan’s historic triumphs in the treatment of cancer.
Fedork
Sylvia Fedoruk is shown at a University of Saskatchewan gymnasium in Saskatoon. Fedoruk was a member of the team that pioneered the world’s first cobalt unit. Among her other accomplishments are championships in basketball

SASKATOON — Sylvia Fedoruk considers herself a lucky person to have participated in one of Saskatchewan’s historic triumphs in the treatment of cancer.

Fedoruk was a member of the team which pioneered the world’s first cobalt unit, an innovative step that used radioactive cobalt to attack tumours that were located deep within the bodies of patients.

The original Cobalt-60 Beam Therapy Unit, and others like it, have saved the lives of millions of cancer patients around the world, and are still in use in Third World countries.

The 60th anniversary of the first treatment with the cobalt unit is being celebrated with the opening of an exhibit at the Western Development Museum on Sunday, Dec. 4.

“I was among the graduate students working with Dr. Harold Johns and, following graduation from the University of Saskatchewan, I became his assistant at the Saskatoon Cancer Clinic in 1951,” says Fedoruk.

“It was an exciting time in the world of medical physics. High-energy accelerators, such as the betatron, were being used to treat cancer. Cobalt units were just beginning to be tested clinically. Scintallation crystals and photomultiplier tubes were more readily available to university laboratories. Radiopharmaceuticals were beginning to appear on the market.”

Johns, who had come west from McMaster University and then to Saskatoon from the University of Alberta, was hired specifically by the University of Saskatchewan to develop cobalt-60 as a radiation source in teletherapy equipment.

Fedoruk is a Saskatchewan girl from Canora. During the Second World War, her parents moved to Ontario to work in the war factories.

Three pieces of advice from women had an impact on Fedoruk’s pursuit of a career.

“Because I hadn’t taken French in my first year of high school in Saskatchewan, the school officials in Windsor weren’t going to let me take French there. My mother, Anne, marched down to the principal’s office, changed his mind, and I took both Grade 9 and 10 French in one year. French was necessary to my future university studies,” says Fedoruk.

“I had an English teacher, Ruth McLaren, who liked what I did with English, but urged me to think about concentrating on math or science. I did. And then when Dr. Johns came to Saskatoon, his wife, Cybill, told me that her husband was very impressed with my work and that I had a chance to do very well in the profession.”

Fedoruk, Doug Cormack, Lloyd Bates and Ed Epp were the graduate students working closely together, and Fedoruk admits “we were on the cutting edge of the profession.”

Because Canada was a leading producer of cobalt, it had a heads-up on potential rivals, including the United States.

The Saskatoon unit was designed by Johns and Bates, and it was built by Johnny Mackay of Acme Machine & Electric for the Saskatoon Cancer Commission and installed at the University Hospital.

The unit consisted of a steel-encased cylinder suspended from an overhead carriage. The source was mounted on the circumference of a wheel near the centre of the head so that by rotating the wheel, the source could be brought opposite an opening through which the radiation could emerge.

“We had been treating patients with cancer, some with a low-energy machine which could be used on skin problems, and some with a medium energy machine, which you might use on the arms, for instance. The cobalt unit allowed the rays to be controlled through a small hole in the lead container, and gave us a chance to penetrate into deeper areas of the body without damaging the skin tissues.”

Fedoruk did the calculations on the first woman, Molly Birtch, to be tested. She was a 43-year-old mother of four who was being treated for cervical cancer. She lived another 47 years, dying in Victoria in 1998.

Ruth Bittner, an employee at the Western Development Museum, tells the story of her mother, Anne Appleby, who was treated in 1962 and lived until this year. “I would have lost my mother when I was 11 years old if it hadn’t been for the Cobalt unit,” says Bittner.

Saskatoon’s cobalt machine treated 6,728 patients until it was replaced in 1972, first by another cobalt radiotherapy machine and later by a linear accelerator.

“The best part of it,” says Fedoruk, “is that it was a true Saskatchewan story, involving Dr. Johns, and we four graduate students, and three authors from the National Research Council. Scientific publications came quickly. So often, many of our good ideas are exported and someone else picks up the glory. Ours was a story where, as Canadians, we exploited the original work.”

Johns left Saskatoon in 1962 to move to Toronto. Fedoruk was tempted by offers from Toronto and Montreal. She was happy to succeed Johns as director of physics services and she spent 35 years with the Saskatoon Cancer Clinic. She later stayed as a consultant.

One of her great thrills happened in 1989, when in her role as Saskatchewan’s lieutenant-governor, she was called upon to open the new Saskatoon clinic.

Seldom has a Saskatchewan woman been asked to climb so many mountains, and Fedoruk conquered them all.

She was an athlete par excellence. At the university between 1947 and 1951, she played on five basketball teams, three volleyball teams, two track and field teams and two golf teams, all of which were Western champions.

She played on Saskatchewan and Western Canadian softball championship teams with the Saskatoon Ramblers. She played third for Joyce McKee when they won Canadian curling championships in 1960 and 1962. The team has been inducted into the Canadian Curling Hall of Fame.

She became the first woman to be appointed chancellor of the University of Saskatchewan, holding the role from 1986 until 1988 when she was appointed lieutenant-governor.

She was the Saskatchewan host for the Duke and Duchess of York in 1989 and had a private audience with the Queen in 1992, at which time the Queen, who obviously did her homework, was especially curious about Fedoruk’s role in cancer research.

She is also an officer of the Order of Canada.