The underestimated role of pioneering women in radiation oncology: lessons from the past for today's practice.

purposeThe early history of radiation and radiation oncology is imprinted by innovative pioneers both in physics and clinical application. Despite the remarkable example of Marie Curie, the contributions of female physicians, physicists, and radiation therapists in the first years of radiation practice are often forgotten or neglected. This analysis aims at a comprehensive review of pivotal female pioneers in the field of radiation oncology and summarizes current and future challenges with regard to gender equality in the radiation oncology workforce.

methodsThe History and Women in Radiation Oncology working groups of the German Society for Radiation Oncology (DEGRO) conducted a selective literature research on Marie Kundt, Marietta Blau, Elisabeth Fleischmann, and Anna Hamann, who were chosen as representative examples of female pioneers. Medical and sociological analyses were selected to illustrate the present situation and point out future challenges.

resultsThe review illustrates that women in radiation oncology in the late 19th/early 20th century were hindered in enrolling in educational institutions and in pursuing an equal (and recognized) professional career; they were also subject to discrimination. Thus, great dedication and personal sacrifices were needed to succeed. Despite this, significant contributions were made by women, and the four discussed colleagues contributed to or even enabled the formation of critical aspects of modern radiation oncology, such as X‑ray imaging, radiation physics, different treatment techniques, and the profession of radiation technicians. Lacking adequate radiation protection at the time, their inspirational spirit came at a significant cost, and three of the four presented pioneers (MB, EF, and AH) succumbed to irradiation-induced cancers. Today, modern analyses still show that female professionals tend to drop out during their career before professorship or head of department positions and are therefore underrepresented in these career stages.

conclusionThe history of women in radiation oncology is marked by discrimination and great personal and professional sacrifices. Despite these challenges, female pioneers contributed to the development of modern radiation oncology in a significant way. Today, gender disparities in the workforce persist and constitute challenges which need to be addressed to enable equal access to leading positions.