The Ontario Cancer Institute: Successes and Reverses at Sherbourne Street (review)

Hospital histories are plentiful and range from commemorative, photoladen publications to extensively researched, scholarly studies. All have their place, appealing to different audiences. This history of the Ontario Cancer Institute (OCI) will appeal to many readers owing to its focus on a disease-specific medical centre as well as its authorship by an OCI research pioneer.

In this book, OCI researcher-physician Ernest A. McCulloch describes the growth of the Ontario Cancer Institute from a small cancer hospital to a large cancer treatment and research centre during its thirty-seven years on Sherbourne Street in Toronto. Officially named the Ontario Cancer Institute and Princess Margaret Hospital (OCI/PMH) upon its opening in 1958, the OCI was Canada's first dedicated cancer hospital. Its focus was cancer treatment, research, and education. Cancer patients traveled to the Princess Margaret Hospital for various forms of radiation therapy, which included the standard therapy machines, isotope machines using cobalt 60 or Cesium 137, and a 24 Mev betatron machine, as well as radium implant treatments. At the Ontario Cancer Institute, clinicians and scientists conducted research towards better treating and understanding cancer.

Two main research areas were radiation therapy and cancer biology. Clinicians sought to improve treatment modalities while scientists investigated cancer cell mechanisms. At the OCI, collaboration among clinicians and scientists occurred often, and a significant amount of research success resulted. According to McCulloch, this was due to the 'unity and confidence' of those clinicians and scientists working at the OCI over the years. He highlights the early cancer research of Harold Johns, inventor of the cobalt bomb for radiation treatment; Arthur Ham, professor of histology at the University of Toronto; Gordon Whitmore, Jim Till, John Hunt, and Robert Bruce, who all studied the biological effects of radiation; Lou Siminovitch, who conducted DNA replication studies in animal cells; Allan Howatson, an electron microscopist; and Ernest McCulloch, a physician with a hematology interest. Later research contributors included Peter Ottensmeyer, UV photochemistry researcher; Ray Bush, a practising radiation oncologist; Tak Mak, T-cell receptor researcher; and others.

Of particular note is the chapter on normal and malignant stem cells, in which McCulloch describes his own important research work. In the early 1960s, McCulloch and Till developed the first quantitative assay (or clonal method) for the identification of stem cells. Their method established the existence of stem cells and how they might be studied experimentally. Interestingly, this innovation was developed unintentionally; they were conducting experiments on the radiation sensitivity of normal marrow cells. McCulloch and Till continued to study blood cell development, pursuing research on hematopoietic cells found in bone marrow.

Research innovation, according to McCulloch, was related to the strong leadership of the OCI. The author describes the organization's growth and challenges, such as its various directors, personnel changes, and university affiliations, but only briefly alludes to any personality conflicts, generational differences, or institutional clashes. In several places the context of cancer research internationally or the culture of the research lab might have been helpful to the reader. For example, Hardi Cinader 'had a European concept of research organization,' suggesting questions about the nature of research collaboration or the uniqueness of the OCI? The quarrel between Alan Bernstein and Tak Mak was 'a rough spot,' which did not apparently interfere with either of their successful careers, but the nature and short-term impact of this quarrel is not clearly explained. As well, the continuities and changes in cancer patient care at the Princess Margaret Hospital (or elsewhere in Canada) are not covered in any depth in this book. Yet McCulloch touches upon several interesting issues, such as the problem of staff recruitment in the 1980s and the long waiting-list crisis for cancer treatment.

These last remarks reflect this reader's interest in wanting to know more about the OCI/PMH. Academic historians will be frustrated by the lack of proper citations to the OCI/PMH annual reports, the OCI and OCTRF Role...