Medicalizing malignancy: the uneasy origins of Ontario's cancer program, 1929-34

In the late 1020s, cancer was characterized as a public health problem for which urgent government attention was needed. Initially reluctant to become involved in cancer treatment, the government of Ontario was prompted by initiatives in other parts of Canada to establish a Royal Commission on the Use of X-Rays and Radium in 1931. The Commission recommended the purchase of radium and the establishment of a network of cancer clinics which became the framework of today's cancer system. This study explores the factors leading to the decision by the Ontario government to become involved in cancer and focuses on the role of the medical profession in shaping official response to the cancer problem. Despite the wish of the government to keep the Commission free from medical domination, the formulation of cancer policy became a struggle between two groups of doctors: specialists who believed in centralization and the organized medical profession which saw the state's involvement in cancer as a threat to its independence. This struggle resulted in a more fragmented and dispersed system than the comprehensive, centrally coordinated cancer system envisaged by the Commission.