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Personal Perspective with Dr. Peter Schwartz of Yale Cancer Center
Dr. Peter Schwartz
Since being recruited in 1975 to start a Division of Gynecologic Oncology at Yale University, Dr. Peter Schwartz, the John Slade Ely Professor of Obstetrics, Gynecology & Reproductive Sciences, and Vice Chair of Gynecology at Yale, has dedicated his efforts to provide the highest quality of care to his patients. The Division of Gynecologic Oncology was created in 1978 when subspecialty training in gynecologic oncology was still new. Dr. Schwartz introduced modern surgery and chemotherapy for the treatment of gynecologic cancer patients at Yale.
Dr. Schwartz grew up believing that all successful men were engineers, doctors, or lawyers. Having gone to a technical high school, he found himself uninterested in pursuing a career as an engineer, and the thought of facing a jury was not appealing. After a conversation with his family doctor, Dr. Schwartz decided to pursue a career in medicine and attended Union College as a pre-medical student. Coming from a technical high school, he had never taken a biology course, but in college soon became fascinated with science; especially when it related to humans.
While in medical school at Albert Einstein College of Medicine of Yeshiva University, Dr. Schwartz found himself somewhat unenthusiastic about his studies until he began a summer job working in a surgical research lab with Dr. Robert H. Goetz, a vascular surgeon. Previously, his summer job had been as a mechanic at an automated bakery. Once he entered the surgical research laboratory he knew that medical school was the right place for him.
Dr. Schwartz did his surgical internship at the University of Kentucky Health Science Center. Gynecologic surgery provided Dr. Schwartz the best opportunity to be a surgeon and still spend time with his wife, Arlene. During his residency at Yale-New Haven Hospital, his mentor, Dr. John McLean Morris, was a gynecologic surgeon focused on the treatment of cancer and Dr. Schwartz decided to enter the same field. Following a two year stint at Travis Air Force Base in California, he was sent to the MD Anderson Cancer Center in Houston, Texas for radical cancer surgery training. During the time of his training, Houston was the international hub for gynecologic oncology, and he learned about the role of chemotherapy and radiation in gynecologic cancers, the former being a new focus in this developing field.
Since returning to Yale in 1975, Dr. Schwartz has seen much advancement in modern chemotherapy and supportive care. His favorite aspect of his work is treating patients and building relationships with them that last a lifetime. Robotics is now being used in surgery for gynecologic cancers, which has been a pleasure for Dr. Schwartz to see. Robotics allows for smaller incisions that greatly reduce the risk of infection in obese patients receiving surgery, often a problem when larger incisions are needed. However, the most dramatic advancement that Dr. Schwartz has witnessed is the development of the HPV vaccine for the prevention of cervical cancer. The idea that there is a vaccine that can prevent cervical cancer from ever occurring is amazing to him.
The major challenges of Dr. Schwartz’s career are the prevention and earlier detection of ovarian cancer. In 1990, he began the Yale Early Detection Program for Ovarian Cancer, one of the first such programs in the United States. This program incorporates state of the art diagnostic imaging along with research markers developed at Yale, to attempt to diagnosis ovarian cancer in women at high risk for this disease based on their personal and family health histories at an early stage when it is highly curable.
Working at an academic center like Yale, Dr. Schwartz is able to not only care for his patients, but work alongside basic research scientists to find better ways to treat his patients. The opportunity to develop advances in diagnoses and treatment for women everywhere is part of what keeps him at Yale, where new research is always being done.
Dr. Schwartz has been providing neoadjuvant chemotherapy for ovarian cancer since 1979 and developed this treatment approach at Yale. For decades oncologists debated whether or not this was an effective treatment strategy for women with advanced ovarian cancer. Recently, the European Organization for the Research and Treatment of Cancer (EORTC) reported the results from the first prospective randomized trial, confirming that providing chemotherapy before surgery (neoadjuvant) is an appropriate alternative to aggressive surgery followed by the same chemotherapy. When chemotherapy is administered before surgery, there is less morbidity, the surgery is shorter, and the stay in the Intensive Care Unit is reduced. Dr. Schwartz believes neoadjuvant therapy will soon become a standard of care in the United States, and is a big step toward individualized patient care, which he feels is greatly needed when treating ovarian cancer.
While a Fellow in Houston, Dr. Schwartz worked as part of a team that pioneered the use of selective arteriography and embolization techniques for controlling massive hemorrhage in gynecologic cancer patients. Upon his return to Yale, he applied these techniques, for the first time, to control massive hemorrhage in the postpartum patient. He is recognized internationally for his work in treating women with ovarian germ cell tumors with modern chemotherapy. These cancers previously were associated with a very high mortality, a great tragedy as most patients develop these tumors as teenagers, or in their early 20’s. His work showed that not only could they be cured, but fertility could be preserved.
Dr. Schwartz has a long interest in hormonal therapy of gynecologic cancers. Working with a team of investigators from Yale, they reported the first series of patients with ovarian cancer whose surgical specimens were evaluated for estrogen and progestin receptors. He reported that based on these findings, the use of tamoxifen, an estrogen agonist/antagonist, could be used in treating women with recurrent ovarian cancer and performed the first prospective randomized trial using platinum-based chemotherapy with or without tamoxifen as the initial treatment of advanced stage ovarian cancer.
When Dr. Schwartz isn’t providing quality care to his patients, conducting research, or working with the Discovery to Cure Program, a program he developed in order to achieve accurate detection of ovarian and other reproductive cancers at their earliest stages, he enjoys downhill skiing. Arlene and he have been skiing in Utah and the Canadian Rockies. They have three wonderful sons and daughter-in-laws. He loves playing baseball with his two grandchildren.
Having served as Section Chief of Gynecologic Oncology for 30 years, Dr. Schwartz has seen numerous advancements. He has served as the president of the New England Association of Gynecologic Oncologists, the Felix Rutledge Society, and the Society of Gynecologic Oncologists, an international society promoting excellence in the quality and integrity of
clinical and basic scientific research in the field of gynecologic malignancies. During this time, his commitment and dedication to his patients has never wavered. First and foremost, his goal is to help women with gynecological cancers live fuller and better lives.