On Christmas Eve in 1851, a young surgeon, William Marsden, was driving home when he saw a young woman crouched in a doorway. She was obviously mortally ill. He carried her into his carriage and went directly to St. Bartholomew's Hospital, where he had recently joined the staff. Since he now had admitting privileges, he wished to admit this young woman so that she could receive some medical attention. However, the Admitting Office refused her admission because clearly she was suffering from cancer, which was, at that time considered, a venereal disease and such patients were not accommodated at St. Bartholomew's Hospital. He returned her to his carriage and took her home where he and his wife, who also had medical training, nursed her until she died within the next week. The Marsdens extended their home and hospitality to other unfortunate patients who could not receive medical care in a London hospital at that time. They purchased a house next door, which they converted it into an infirmary so that they could accommodate a larger number of patients. This was the beginning of what became the Royal Cancer Free Hospital in London. In 1951, on the 100th Anniversary of the initial event, the name of the hospital was changed to the Royal Marsden Hospital to honor this courageous surgeon and humanitarian.

In the United States, there was a similar attitude concerning cancer, particularly cancer in women. The most frequently diagnosed cancers were cervix and breast. In the public's and Professor's minds these were somehow connected with venereal disease. In New York City, the Women's Infirmary was founded by an eminent gynecologist, Marion Sims, for women of means who needed hospital care. Again, the issue of the disease cancer segregated these women into yet a new hospital that was supported by many of the first families of New York City. This was Memorial Hospital, founded in 1888. Here men and women could be cared for when they developed cancer. In 1938 Memorial Hospital moved to a site on the East Side of Manhattan (donated by the Rockefeller family) and was renamed “Memorial Hospital for Cancer and Allied Diseases.” This allowed a degree of denial for the patients and their families. Cancer carried a stigma in the public's mind. Cancer as a cause of death was never mentioned in the obituaries of the NEW YORK TIMES or the LONDON TIMES. It wasn't until the 1980s that the name of the hospital was changed to Memorial Sloan-Kettering Cancer Center.

In the 1950s, cancer of the cervix was the most frequent cause of death from cancer in women, exceeding breast cancer or colon cancer. Lung cancer was infrequent. Dr. George Papanicolaou, a pathologist at New York Hospital, developed a technique to identify abnormal cells that could be seen on vaginal smear. By performing this test on a regular basis, women could be screened for early detection of cervical cancer, which could be effectively treated. In the 1960s, Denmark undertook a national screening program and clearly demonstrated that the death rate from cervical cancer could be diminished by regular Pap smears. This has now become universally accepted.

In the United States at this time, cervical cancer is no longer a major cause of cancer deaths in women. Pre-invasive cancer of the cervix can be identified and treated without major surgery or radiation. The newest development is the identification of Human Papilloma Viruses as the major causal agent of cervical cancer. It is found in over 90% of cervical cancer and is sexually transmitted. Thus, we have now come full circle. Within the last year, a vaccine has been prepared, which appears to prevent cervical cancer. This is in clinical trials in Europe and in the United States and we can look forward to the eradication of this form of cancer all together, an achievement that would have astounded (and delighted) Victorian English physicians and generations of American gynecologists.

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