Inside Duke Medicine

New Cancer Center: Personalized care and pursuit of research

Personalized care and pursuit of research advances characterize new center

Cancer care patients at heart of new center

Duke Medicine’s new comprehensive Cancer Center will not only help address projections of steep increases in cancer incidence – both locally and regionally – in coming years, but it will also soon facilitate a never-before-seen synergy among one of the most talented oncology faculties in the country.

“Almost any hospital or medical center would say that they treat cancer, but there is a quality and sophistication of cancer care that can only be provided by specialists and subspecialists who have received specific training and focus all of their time – 24/7, every day – on continually refining clinical practice based on the latest in clinical research,” said Victor J. Dzau, M.D., Chancellor for Health Affairs. “Providing this kind of highly specialized cancer care –ultimately in a facility that will optimize the patient experience – is just another way the Duke Medicine is serving our local, regional and statewide communities.”

As for meeting the current and projected patient demands, the construction of this center cannot go quickly enough.

Last year, Duke faculty and staff provided cancer treatment for many thousands of inpatient encounters, and hundreds of thousands of outpatient encounters. Many days now, more than 100 patients cycle through the Morris Cancer Clinic to receive chemotherapy treatments.

At the same time, thousands of patients participate in the more than 700 research studies being conducted at Duke to explore therapeutic improvements in cancer care or to seek better understandings of a host of non-treatment-related cancer issues.

As if this wasn’t enough, the latest projections from the North Carolina Department of Health predict a 14 percent growth in new cancer cases in the state between 2006 and 2011, and a 21 percent increase in new cancer cases in the Triangle during this same time period.

"When you consider the rates at which various cancers continue to plague our society, we are compelled to create a space in which we can optimize the ability of our faculty and staff to fight these diseases,” said William J. Fulkerson Jr., M.D., senior vice president for clinical affairs.

“Projections for large increases in cancer cases in North Carolina over the next several years suggest our plans – as well as those by the University of North Carolina – will just meet the demand,” said Dzau. “I believe the clinical and research collaborations between UNC and Duke have the potential to turn the Triangle into one of the country’s epicenters for advancements in cancer care.”

In addition to facilitating innovative research and providing important learning experiences for residents and fellows, the Cancer Center has been designed to improve the way patients experience their treatment of cancer, as well as address the emotional well being of patients and their families.

“The new facility is all about improving the patient experience as well as improving faculty and staff efforts to understand, treat and fight cancer,” said Kevin Sowers, MSN, RN, FAAN, Duke University Hospital CEO. “Our aim in designing the new Cancer Center was to create a healing environment that would benefit not only the patients coming here for treatment, but our employees, too.”

Once completed in 2012, the new center will consolidate in one location all of Duke’s outpatient clinical cancer services, eliminating the current need for patients to move from one clinic to another depending on their treatment needs. Moreover, patients and their families will enjoy more space and accessibility, convenience and attention to their special needs.

Marcia Williams knows what it’s like to need that attention. A Durham mother of four and grandmother to 14, she was first treated for breast cancer at Duke in 2005, and later underwent surgery, chemotherapy, radiation and breast reconstruction.

It wasn't easy, she said. “But my doctor really challenged me to fight for my life. Ultimately, I feel it was God who healed me, but I also feel that it was the knowledge of the doctors and the caliber of people at Duke who saved my life.”

Patients like Williams and Duke Medicine staff were polled and then followed to learn how patients move through the existing cancer clinics. Those suggestions were incorporated into the new design in order to maximize efficiency and minimize patient wait times, provide support for patients and their caregivers, and produce a comfortable atmosphere for staff and patients alike.

“It’s truly been a group effort by patients, staff and physicians to come up with ways to make the treatment experience for patients optimally convenient and pleasant,” said Sowers.

Currently available patient services will be expanded in the new center and new additions will include a cancer patient boutique, a retail pharmacy, a cafe and a patient resource center with educational materials for families, caregivers and patients.

Recognizing that patients and families are often required to spend many hours in the oncology clinics for treatment, architects have incorporated new features into the design to enhance the patient experience.

“The outdoors will be brought in, taking advantage of the healing properties of the environment,” said Mark Greenspan, project manager for the expansion. “This includes large expanses of windows that allow sunlight in, as well as an outdoor rooftop garden terrace where chemotherapy patients can go while receiving their infusions. The center will also contain quiet healing spaces where people can go to meditate and reflect.”

Clinical areas have been designed to ensure that exam rooms, pharmacy and CT, MRI, and PET imaging technologies will be located near each other, minimizing the need for patient transport during their visits, and improving the coordination of care.

“The multidisciplinary team spaces and embedding of patient support resources will go a long way to improving the way we provide care,” said Tracy Gosselin, RN, associate chief nursing officer of oncology services.

The Cancer Center will be connected via a new pedestrian concourse to the Duke Medicine Pavilion at Duke University Hospital. That nearby facility, expected to be completed in 2013, has been designed in such a way as to allow easy and seamless transport of patients requiring surgical and inpatient care services. The creation of the new operating suites in that DUH expansion is important, said Sowers, because many cancer patients require a surgical procedure before they enter into the outpatient environment.

Similarly, Duke cancer researchers believe, the new Cancer Center will improve their ability to talk with patients about clinical trials and answer any questions they might have related to their participation.

“Delivering cancer care in the 21st century requires state-of-art, multidisciplinary care with access to cutting-edge clinical research. To accomplish this, today’s cancer center must have everything you need in one location, where specialists and clinical researchers can work together to address patient needs,” said Jeffrey Crawford, M.D., associate director of clinical research in the Duke Comprehensive Cancer Center.

With Duke’s increasingly connected system for patient electronic medical records, health system physicians who refer their patients to the Cancer Center will be able to closely follow their treatments. And those patients will be encouraged to become active participants in their care by utilizing the Duke HealthView portal to interact with their own real-time medical records, lab results and integrated scheduling.

“The completion of this Cancer Center is critical for people throughout the state and the region,” said Fulkerson. “Unfortunately, everything points to cancer becoming an even greater healthcare challenge for many years to come, and our ability to continue to lead the charge in innovative treatments and research discoveries will be strengthened by this project.”