Interview
Text: Émilie Mathys
Photo: Eric Déroze

“I’d like to show that diversity is not a threat”

Solange Peters On the front line in the European campaign against cancer, Solange Peters is head of medical oncology at Lausanne University Hospital. She has also long fought gender stereotypes in hospitals. In Vivo met with her for an interview.

A leading figure in the fight against cancer, Solange Peters was elected President of the European Society of Medical Oncology (ESMO) in 2020. This organisation’s core mission is to improve the quality of cancer care and promote equal access to treatment for all patients. As her term at ESMO draws to a close, In Vivo spoke to the expert who ranks among the top 1% of highly cited researchers in the world. Solange Peters talks about her relationship with her career, with death – which is inevitably intertwined with her work – and her plans for the future.

in vivo / Cancer can be the result of poor lifestyle choices, or caused by genetic factors. But mostly, it is just bad luck. Is it important to relieve people of the guilt they feel?

SOLANGE PETERS / Yes, bad luck is one of the bases of my involvement in medicine, and especially oncology.

In my opinion, we should obviously do everything we can to counteract what happens to people in an untimely, unexpected, sudden and painful manner.

iv / “Fighting cancer.” “Beating cancer.” War metaphors are often used in talking about the disease. Can this terminology impact patients?

SP / I never thought about it... I don’t usually use that kind of language. I talk about “success”, “hope”, “relief”. But maybe patients use it to motivate them more? We want to keep some control over our misfortunes. It’s risky to think that you are the only one with any power over it – because you also become the only one guilty in case of failure – but it’s never the case. Ultimately, each person must use the vocabulary that is specific to the what they’re going through.

iv / What challenges will oncology, and patient care in general, face in the years to come?

SP / We have to rethink our whole healthcare system. Managing health system finances and its sustainability are now central issues. Although on a decline, only academic research remains a sustainable model, and we spend millions at the CHUV on these innovations. If the issues of fair costs, reimbursement models and more rigorous practice of our profession are not prioritised, no society will be able to continue financing optimised care, not even our own. Innovation is sustainable when we personalise it.

Science must learn to define what each patient specifically needs.

For example, with immunotherapy, patients today can already live significantly longer with cancer, enjoying a lifestyle over a long period that sometimes resembles that of the normal population. I’m not convinced that we can cure all cancers, but we can turn them into chronic diseases.

iv / And what personal challenges do you face?

SP / I love my job, I love treating people, and I couldn’t live without it. I frequently receive offers to work in the pharmaceutical industry or large international professional organisations, but I’m not ready to leave patients. I have a lot of experience in international healthcare, and I would certainly like to be work with the WHO. I’ll also take on the position of president of the Swiss Cancer League. Apart from that, in the right conditions, I can see myself returning to politics (ed. note: Solange Peters was a member of the Communal Council of Lausanne in 1996 and then elected leader of the Socialist party and to the National Council), possibly at national level. If I run, I have to get involved ahead of time, go to the markets on Saturday morning and work hard. I don’t want people to think that I take advantage of my privileges or my reputation.

iv / Your term as president of the European Society of Medical Oncology (ESMO) is coming to an end. What takeaways have you drawn from this office?

SP / I was elected after years of international scientific and educational work at the ESMO. Covid-19 soon came along with tremendous uncertainty for public health. In a few weeks, we drew up about 30 guidelines for cancer treatment during the Covid-19 pandemic that was used by professionals across Europe. ESMO members asked me to stay on for another year as president, and I was able to make a real difference. Today, ESMO’s governing bodies are made up of 50% women, with many young, committed and visionary colleagues from all countries. Diversity quotas have been introduced and fees for members from low-income countries have been permanently eliminated We also created the International Cancer Foundation, which I chair, and which aims to support humanitarian projects to fight cancer.

iv / You work in a very competitive, male-dominated environment. Has pressure always been a driving force?

SP / Yes, as a student I was already president of the Federation of Student Associations. At the age of 20, I was on the Communal Council of Lausanne. I always had in mind this commitment to equality, equity and diversity. I was brought up in a family of left-wing politicians. We always welcomed people in need at home. One of the things that makes me the most angry is when I feel that a woman is not by definition the main contact. This happens in small ways, and in repetitive behaviours that I unfortunately see every day. The way they respond to our action, our emails or when our managers prefer to consult a male colleague for an opinion, when he is neither the expert nor the guarantor. These everyday stereotypes that women have to overcome throughout their career make it a steep course. That’s why three-quarters of them give up.

iv / At what point in your career did you decide to go into oncology?

SP / I am both a biologist and a doctor. As a doctoral student, I worked on HIV. When AIDS hit, I watched many of my friends die. I knew then that I would specialise in infectious diseases. When I started my dissertation on the mechanisms of resistance to treatments for the AIDS virus, people were dying within a year from the advancement of the disease, in very painful conditions. By the time I was done, they could have children. The disease became chronic. Then I went back to field work in medicine and discovered oncology. There was a lot of crossover with HIV infection, including the cancer cell resistance and immunity. At the time, this was a ground-breaking area: people were dying of cancer without any hope of effective treatment, and research had no solution. After six months, I knew it was for me and have never regretted my choice.

iv / You say that there is no field that brings you closer to people than medicine.

SP / Oncology is unique. When a diagnosis is made, no matter how early, what comes to mind first? Death. Every time. People go straight back to their founding values, to what their priorities are now. The close relationship with patients is unique and precious, even if we don’t always understand their choices. This closeness can also be rough, because failure and grief are realities. Cancer kills more than half of them.

iv / Your career is far from over. At this point, what would you like us to remember about to remember about Solange Peters?

SP / It’s hard to say. I’d like to show that diversity is not a threat but instead a wealth. Unfortunately, gender discrimination is still very present at the CHUV, despite efforts from General Management. We need to work on the real aspects of change, which are necessary, so that diversity is no longer an exception but the obvious way. /



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Biography

Born in Lausanne in 1972, Solange Peters grew up in a family of pharmacology professors and committed to the socialist cause. Their children inherited this political commitment. Solange Peters is a trained biologist and physician. Since 2016 she has been head of the CHUV’s Service of Medical Oncology.