ABOVE: Ronald McDonald House Charities

Legendary pediatric oncologist Audrey Evans died on September 29 at her home. She made groundbreaking discoveries in chemotherapy but also saw the bigger picture of disease, taking steps to ease the burden on families pursuing treatment and earning a reputation for making her young cancer patients more comfortable through unconventional means. In 1974, she cofounded the Ronald McDonald House Charities, providing lodging and other resources for families during treatment.

Audrey Evans was born in York, England, on March 6, 1925. Her father worked in paper manufacturing and her mother was a homemaker. Though there weren’t many women in medicine while she was growing up, her parents supported Evans’ desire to become a doctor. She earned her medical degree from the Royal College of Surgeons in 1953 before heading to Boston Children’s Hospital to work under Sidney Farber, the famed pediatric oncologist who made great strides in leukemia treatments, The New York Times reports.

There, in the late 1950s, Evans and her colleague Giulio D’Angio tested new approaches to treating cancer, such as using chemotherapy in concert with other techniques. Their results hinted, for the first time, that chemo could work on solid tumors. 

She briefly worked as an instructor at Harvard University before moving to the University of Chicago Clinics, eventually becoming head of its hematology-oncology division in 1964. Evans joined the Children’s Hospital of Philadelphia in 1968 and held many leadership positions over the years, including chief of pediatric oncology. 

Evans once said that because the world of pediatric oncology made administrators uncomfortable, they rarely visited. Therefore, she was able to bend hospital rules, allowing her patients to keep small pets with them in their rooms to bring comfort and happiness. According to Legacy, she also had her own small flock of finches that lived at the hospital. Today, keeping animals around would conflict with the neutropenic precautions that hospitals take to avoid the spread of infections, but in that era, cancer cases were almost always fatal due to a lack of effective treatments, so palliative care—enhancing patients’ and their families’ quality of life—was a high priority. 

In 1971, Evans developed the diagnostic tool called the Evans Staging System for Neuroblastoma, a disease that at that time had a survival rate of only 10 percent. The system looks at the location of the tumor and assesses whether it has metastasized, allowing doctors to prescribe an appropriate course of treatment based on the severity of disease, thus not over-medicating children with milder cases. Evans is also widely credited for the fact that today, even the highest-risk group of neuroblastoma patients has a survival rate of 50 percent, according to The Washington Post. Children in the lowest-risk group have a 95 percent survival rate.

In the early 1970s, Evans became more acutely aware of how children’s cancer treatment could put a burden on families. Often, they traveled from far away to go to the hospital, taking time off of work and paying a small fortune for lodging. She wanted to create a place that would make it easier for families to get their children the treatment they needed, one that would be affordable while providing food and moral support from other families who were facing similar circumstances. This idea culminated in the Ronald McDonald House Charities, and what started as one location in Philadelphia in the mid-1970s has since expanded into more than 380 facilities around the world.

Evans partially retired from the Children’s Hospital of Philadelphia in 1989, but couldn’t walk away completely. She performed research for 20 more years, finally retiring in 2009 at the age of 83. Her philanthropic work never stopped, and she was integral to the reopening of an abandoned historical church as a tuition-free school in Philadelphia for children who have struggled with their education due to a lack of resources. The doors to St. James School opened in 2011. 

Earlier this year, Natalie Dormer signed on to portray Evans in the film Audrey’s Children. The project is currently in production. 

Evans married Giulio D’Angio in 2005 after collaborating professionally for fifty years. They were married first thing in the morning, stopped for tea and pastries, and then went back to work, according to a tribute from Ronald McDonald House Charities. D’Angio died in 2018. Evans is survived by her two stepsons, grandchildren, and great-grandchildren.