Eleanor Josephine Macdonald (born 1906) has been a pioneer in the field of cancer epidemiology. Over the course of forty years, she made several significant contributions to the understanding of cancer and was a strong advocate for early treatment of cancer symptoms.
Macdonald was the first cancer epidemiologist; previously, epidemiologists had only researched communicable diseases. While working at the Massachusetts Department of Public Health, she was the first to precisely determine incidence rates for cancer. In Connecticut, Macdonald developed the first population-based cancer registry. Later, she proved that there is a connection between sunlight and malignant melanoma of the skin. Many of the cancer programs in existence today are due to her efforts, or are patterned after programs she developed.
Macdonald, the third of six children, was born on March 4, 1906, in West Somerville, Massachusetts, to Angus Alexander, an engineer of Scottish descent who worked for the American Telephone and Telegraph Company, and Catharine Boland Macdonald, a concert pianist of Anglo-Irish descent. She was educated at Radcliffe College and graduated with a degree in music and history of literature and English. She performed as a professional cellist for two years after graduation. Around this time, a physician friend of her father's requested her help writing a research paper; this work inspired her to become an epidemiologist.
Macdonald took a job with the Massachusetts Department of Public Health, beginning a series of studies on cancer, a subject which would become the focus of her lifetime's work. At the Massachusetts agency, the first cancer program in the country was set up. Here Macdonald studied the incidence of cancer and other chronic diseases occurring in people older than age 40. For a period of five years, she and her colleagues went house-to-house in Massachusetts seeking information on the residents' health. When she presented her results, the medical community hailed it as the first accurate calibration of cancer incidence in the country. Macdonald felt that although cancer was a pervasive problem, with early detection people would fare better. She collaborated with a group of physicians who went out to everyone of the 355 communities in Massachusetts to raise people's awareness of cancer. The physicians provided outpatient diagnostic clinics and encouraged individuals to see a doctor when the symptoms of cancer first appeared. The physicians also explained cancer symptoms to community physicians who were unlikely to have seen many cancer patients. Coming to a doctor sooner enabled many people to have their cancer treated while it was still in an early stage and helped more people recover or live longer. Macdonald's approach to the problem of cancer made her the first epidemiologist in the cancer research field. She also approached the issue on another level, speaking about public health and cancer awareness on a radio program that aired every week for a number of years. During this time, Massachusetts became the first state to have a cancer awareness week.
From 1940 to 1948, Macdonald worked for the Connecticut State Health Department. There she created a population-based cancer record registry and follow-up program for the state of Connecticut, the first such program in the world. Over a six-year period, she and a volunteer checked all hospital records for patients with cancer. They then traced each case to find what had become of the patients. They found 1,800 were still alive, although physicians who had treated them earlier had assumed they had died. "This was the beginning of follow-up for cancer patients," Macdonald commented in an interview for NTCS. Cancer registries that have been created since have used this system as a model. This aspect of her career was only a part of her work at the time. For about 10 years, Macdonald worked weekends to set up and run the statistical department at Memorial Sloane Kettering in New York, a hospital that specializes in cancer. In addition, she served as a consultant to the National Advisory Cancer Council in Washington, D.C.
Macdonald's next major opportunity to further her work arose when she was asked to set up and run the cancer epidemiology program at the University of Texas M. D. Anderson Hospital in Houston. Macdonald was made a full professor of epidemiology in 1948, a position she held for 45 years. In her years with the University of Texas, Macdonald created a pilot cancer registry and follow-up program in El Paso with data compiled from 1944 onward. This pioneering program was very comprehensive and included data from hospitals, clinics, laboratories, nursing homes, private group practices, and dermatologists' offices—places where cancer patients would have been seen. The study included follow-up in 56 counties for 23 years. This survey yielded the first cancer incidence data for Hispanics, which turned out to be lower than in whites. From her research, Macdonald determined that intense exposure to sunlight was linked directly to a rise in the occurrence of skin cancer, including melanoma. Part of her evidence was the fact that individuals who live closer to the equator have a higher incidence of skin cancer than those who live farther away.
Macdonald's work resulted in clinical trials to check the effectiveness of cancer treatments. She also helped to organize the first southwestern chemotherapy trials for leukemia patients. She stepped down from her position as professor in 1974, but has remained on call for the University of Texas M. D. Anderson Hospital. "It has been marvelous to be a pioneer. Everyone encouraged me in my work, and I did not feel that they discriminated against me because I was female," Macdonald stated in her interview. Macdonald was awarded the Myron Gordon award in 1973 for research into pigment cell growth in melanoma. That year she also won several other awards, including an Outstanding Service Award from the American Cancer Society. During her career, she was a member of the American Association for the Advancement of Science and the American Public Health Association; in 1946 she was elected a member of the American Association for Cancer Research. Now retired and living in Texas, she remains active by taking classes and pursuing her hobbies of playing the cello and writing.
Macdonald, Eleanor J., Interview with Barbara Proujan, conducted on January 13, 1994.