For Children with Cancer, Cure Is Not Enough

Authority in pediatric radiation oncology receives 2012 Hewlett Award

Sarah S. Donaldson, MD, loves coming to work in the morning.  It’s one thing that hasn’t changed throughout her more than forty years at Stanford. As Professor of Radiation Oncology, Donaldson has significantly improved life for children with cancer. When she was a resident, pediatric oncology was not a defined discipline, and most children with cancer died. With a combination of chemotherapy, radiotherapy, and oftentimes surgery, five-year survival rates for children with malignant disease have risen to 80 percent. Quality of life is also better, thanks to Donaldson, the recipient of this year’s Hewlett Award, an annual tribute to Walter Albion Hewlett, MD, who led the Department of Medicine from 1916-1925. Hewlett was an extraordinary and compassionate physician, much like Sarah Donaldson.

A member of the faculty since 1973, Donaldson became chief of the radiation oncology service at Lucile Packard Children’s Hospital in 1991.  Over the past 40 years, she has pioneered treatments for children with malignant disease, including developing innovative therapies for pediatric Hodgkin’s disease and other childhood cancers.  She is an international leader in pediatric radiation oncology, and recognized for her work evaluating the quality of treatment and quality of life, related to the side effects of radiotherapy.

“Today, cure is not enough, we want cure with a wonderful quality of life,” said Donaldson. “It’s taken a while and we’ve learned a great deal along the way, but children are now being cured without the same side effects we saw 30 years ago.”

“Managing children with cancer is the one of the most difficult areas of clinical medicine and she does this for patients and their families with sensitivity, expertise, calmness, and authority,” said Ross McDougall, MD, MB, PhD, and Professor Emeritus of Radiology and Medicine, who has worked with Donaldson for 30 years.

Mentorship Matters

Born and raised in Portland Oregon, Donaldson began her medical career as a nurse, working alongside her mentor, surgical oncologist, William Fletcher, MD, at the University of Oregon. It was Fletcher who, despite her apprehension, convinced her she could go to medical school. She attended Dartmouth Medical School as 1 of only 6 women in a class of 48 students, and graduated from Harvard in 1968. When it came time to choose a specialty, she once again turned to Fletcher for guidance.

“I didn’t know much about radiation therapy and there was no as specialty of medical or pediatric oncology at the time, but I did want to be involved with cancer patients,” recalled Donaldson. Dr. Fletcher advised her that radiation therapy needed surgically oriented clinicians and being in the field meant she could take care of cancer patients, and be on the ground floor of an emerging and expanding discipline. The perfect opportunity arose, when he sent her to Stanford to meet Malcolm Bagshaw, MD, who succeeded Henry Kaplan as chairman of the Department of Radiology, and Head of the Division of Radiation Therapy; Bagshaw welcomed her into the department.

“I was lucky because Dr. Fletcher opened a door for me.  When I couldn’t figure out where to go and what to do, he guided me,” said Donaldson, who loves being surrounded by medical students, residents, and fellows. “They are so bright and ask questions that stimulate you to go home and read to find the answers.”

Throughout her years at Stanford, Donaldson has published more than 200 peer-reviewed articles in leading journals. She is a recipient of Gold Medals from the American Society of Therapeutic Radiology and Oncology in 2000, the American College of Radiology in 2007, and was recently awarded the Dean’s Medal from the School of Medicine in 2012.

Her most significant gratification, however, comes from seeing her patients grow to be healthy and productive adults. “Taking care of a child through cancer diagnosis and treatment, seeing this youngster graduate from high school, go to college, have children and even grandchildren is true continuity of care. It’s the big picture that is most important, and nothing is more gratifying than contributing to this journey through life.”

Sarah Donaldson, MD, Professor of Radiation Oncology and 2012 Hewlett Award Recipient