Audrey Evans

Audrey Elizabeth Evans (6 March 1925 – 29 September 2022) was a British-born American pediatric oncologist who was known as the "Mother of Neuroblastoma". Evans worked at several hospitals before settling at the Children's Hospital of Philadelphia. She was one of the co-founders of the original Ronald McDonald House in Philadelphia as well as a co-founder of Philadelphia's St. James School.

Early life and education

Audrey Elizabeth Evans was born on 6 March 1925 in York, England. She was the youngest of three children born into a middle-class family. Her sister was six years older than her and her brother two years older. She attended a Quaker school before heading to a boarding school in Bristol, England where she stayed until the start of World War II. After the war began she went home and attended The Mount School in York, England. During her senior year she developed tuberculosis causing her to miss school.

Evans trained at the Royal College of Surgeons in Edinburgh in the early 1950s. She was the only female student in the medical school. She struggled during her first year of medical school and ended up failing. She attributes her failing to the fact that she learns by listening and not by reading. She did two years of residency at the Royal Infirmary where she was the only female in the program. After finishing her degree in 1953, she applied and received the Fulbright Fellowship at Boston Children's Hospital. She trained there for two years under Dr. Sidney Farber, who is known as the father of modern chemotherapy. She went to Johns Hopkins to finish her medical training in 1955.

Career

After she finished her medical training in the United States she returned to England to practice specialty pediatrics. She soon learned that this field was strictly for men and not women. So, she headed back to the United States to pick up her career in pediatric oncology. She worked at Boston Children's Hospital at first before she headed to the University of Chicago, in 1964, to work at their hematology and oncology unit. Here, Evans was recruited by former U.S Surgeon General and Surgeon Chief at the Children's Hospital of Philadelphia (CHOP), C. Everett Coop, to create the pediatric oncology unit there. She spent the rest of her career at CHOP. Throughout her career she took a total care approach towards her patients, meaning that she didn't just focus on her patients' physical needs but also their social, emotional, spiritual needs as well as supporting the families. In 1971, she created the Evans staging system for Neuroblastoma.

She served as chair of the Division of Oncology at the Children's Hospital of Philadelphia from 1969 to 1989 and was appointed a professor of pediatrics at the University of Pennsylvania School of Medicine in 1972.

Mother of Neuroblastoma

Evans was known as the "Mother of Neuroblastoma" because of all of the advances, research, and work that she did for this type of cancer. After years of treating this type of cancer she reduced the mortality rate caused by neuroblastoma by about fifty percent. Currently, the survival rate is above eighty five percent. Evans also instituted and chaired the early meetings for Advances in Neuroblastoma Research, which began on 30 May 1975, as a series of symposia held at Children's Hospital of Philadelphia. The conference is designed to promote the exchange of information among investigators studying Neuroblastoma biology, diagnosis, prognosis, and therapy. She created the Evans staging system in 1971 to determine neuroblastoma disease progression and to determine what treatments would be most effective.

Evans and Dr. D'Angio were the first to describe the phenomenon of spontaneous regression of widely spread neuroblastoma that they later dubbed "4S disease". This spontaneous regression usually occurs in infants younger than 6 months old.

Evans Staging System for Neuroblastoma

* Stage one: tumor is confined to organ of origin (completely excised)
* Stage two: tumor extends beyond organ of origin but does not cross midline; regional lymph nodes may be involved
* Stage three: tumor extends beyond midline to encroach on tissues on opposite side
* Stage four: distant metastasis (on skeletal, other tissues, or distant lymph nodes)
* Stage fourS: localized primary tumor that does not cross midline, with remote disease confined to liver, subcutaneous tissues, and bone marrow but without evidence of bone cortex involvement

Ronald McDonald House Charities

As CHOP's pediatric oncology department grew, people were coming from a wide range of places to be treated there. Evans realized that the families of the children that were being treated had no place to stay and would often get separated to different locations. Evans was introduced to The Philadelphia Eagles owner when the team had raised $100,000 for children with cancer in honor of one of the player's daughters who had leukemia. Evans accepted the money from Eagles owner, Jimmy Murray, and let him know that she needed $32,000 more in order to buy a house for the children and their families. A player for the Eagles had been advertising for McDonald's shamrock shakes and Murray asked regional manager, Ed Rensi, if he would donate money towards a house. Rensi agreed to use the proceeds from the shamrock shakes to pay for a house under the condition that it would be named the Ronald McDonald House. It started out as a place to stay and meet a person's basic needs; a place to sleep and eat. As the programs have grown they have adapted Evans' total care approach and created a place for family centered care. It's now considered a home away from home, free of charge. There are now more than 300 houses in 57 countries.

St. James School

After Evans retired in 2009 from her medical career she realized that she missed the kids too much. She decided that she wanted to get involved in a school. There was a city camp on a school campus that she started to be involved with but the campus would close once summer ended. They decided to open the campus as a school. The St. James School was opened on 11 September 2011. It was a tuition free school for kids in the Allegheny West, Philadelphia area. The school's goal is to break the cycle of poverty by having an extended school year.

Personal life and death

Evans married Dr. Giulio John D'Angio, in 2005, when both were over 80 years old. They met in 1953, while they were both working at Boston Children's Hospital. Their first interaction was when Dr. Evans was sitting at his desk going through his mail.

In 2005, after over 50 years of knowing each other they got married at seven o'clock in the morning so they were able to make it to work 90 minutes later.

Death

Dr. Giulio D'Angio died in 2018, aged 96. Dr. Evans died in Philadelphia on 29 September 2022, aged 97.

Awards and honors

* In 1976, she received The Janeway Award from the American Radium Society.
* In 1995, she received the Distinguished Career Award from the American Society of Pediatric Hematology/Oncology.
* In 1997, she received the William Osler Patient Oriented Research Award from the University of Pennsylvania.
* In 2000, she received the Lifetime Achievement Award from the Advances in Neuroblastoma Research Association.
* In 2008, she was selected as the honorary member of the American Society for Therapeutic Radiology and Oncology
* In 2018, she received an honorary degree of Doctor of Humane Letters from Holy Family University
* As of 2022, the film ''Audrey's Children'', about Evans' life and work, is in production, directed by Ami Canaan Mann and starring Natalie Dormer

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