As the Stanford Cancer Center celebrates its 10th anniversary of serving patients, many of those involved in its planning, construction and operation reflected on the milestone.
"Stanford already had an incredible multidisciplinary approach to cancer," recalled Charlotte Jacobs, MD, professor emerita of oncology, who led the effort from 1993 until 2001 to design and build the center. "But we needed a building to reflect the way we already practiced."
Indeed, when Stanford broke ground on the building on Sept. 4, 2001, Jacobs spoke of the achievement as being much more than a building. "It is the vision of our faculty and staff cast in bricks and mortar," she said. "It is an embodiment of our cancer faculty. It reflects their multidisciplinary approach to cancer, their zest for discovery, their superb clinical expertise and their dedication and concern for patients."
Patients had long come to Stanford for its expertise in oncology. But until 10 years ago, it could be a challenging experience: Patients would have to navigate across campus and the hospital to receive care in multiple locations. Waiting rooms on the ground floor of the hospital were crowded, often standing-room only. There were long waits for exam rooms. The infusion room for bone marrow transplant patients resembled a walk-in closet. And there was no natural light in the radiation oncology area. "It was a warren of dark rooms that did not address the inner needs and struggles of cancer patients," said Philip Pizzo, MD, professor of pediatrics and of microbiology and immunology, and former dean of the medical school.
Beverly Mitchell, MD, director of the Stanford Cancer Institute, recognizes the foresight and vision of those who came before her. "There was the recognition that cancer patients deserved a special environment, and that Stanford needed to deliver on that," said Mitchell, professor of oncology and of hematology, who came to Stanford in 2005. "It has really improved the atmosphere for cancer patients to have this light-filled building, with music in the lobby and dedicated clinic space. It has made a huge difference for our patients."
When the cancer center opened, Pizzo described it as having "gone a long way toward alleviating the fear, anxiety and discomfort associated with cancer care facilities."
"Indeed, this new facility serves as a model for Stanford and for our community," he said.
The building is the physical structure that initially brought together all the modality-based disciplines like medical, surgical and radiation oncology, said Douglas Blayney, MD, professor of oncology and medical director of the cancer center. "First and foremost, that was good for patients in terms of convenience," he said. "But it was also good for patients because there were multiple specialists collaborating both in time and in space on their particular cancer."
The center, by its design, allows professional interaction to occur between clinical faculty who share workrooms and office space. "This constant interaction between the physicians and the tremendous camaraderie that it fostered went beyond what any of us thought might happen," Jacobs said. "That accelerated the level of patient care to a level we could not have anticipated."
The team tasked with designing the Stanford Cancer Center recognized that cancer is not an individual disease, but a family affliction. "Giving space and time for the families to come together into one space that was designated for the treatment of their loved ones was a big, intangible benefit," said Sridhar Seshadri, vice president of the center, who led the process excellence work for the initial center design team.
"We wanted to make it patient-centered," Jacobs said. "We wanted to make it more comfortable for the patient." The team spent a lot of time determining how the space would function for patients and physicians. They wanted to create a warm atmosphere, with quiet, intimate areas, but they also wanted a wow factor, Jacobs said, with a grand piano in the lobby and a fountain out front.
Equally important was the desire to provide patients with ease of access, a one-stop shop. Patients can go from the clinics on the first floor to the infusion treatment area on the second floor to radiation oncology on the ground floor. They can have prescriptions filled at the onsite pharmacy, and grab a bite to eat at the café between appointments.
But getting the building designed and built was a tough, 10-year process. It started in 1994, when David Korn, MD, who was dean of the school at that time, asked Jacobs to coordinate the effort. She and Sarah Donaldson, MD, professor of radiation oncology, created a small working team that met regularly with clinicians in each cancer specialty, as well as with nurses, support staff and patients, and synthesized each group's priorities into the vision and blueprint for the building. Former hospital president and CEO Malinda Mitchell's expertise and leadership helped make the effort a success, Jacobs said.
In a show of unprecedented collaboration, the hospital administration and the School of Medicine faculty aligned around the belief that creating a defined place for cancer patients was critical. The project required City of Palo Alto review. After a thorough and, at times, challenging process with the city, the project moved forward with unanimous approval from the City Council.
The success of the cancer center and its programs over the past 10 years has led to it outgrow its space. "Because of our ability to give really excellent cancer care, we have increasing numbers of patients," said Beverly Mitchell, who is also the George E. Becker Professor in Medicine and who estimates current growth at 10-plus percent a year. Already, the center has expanded to the Blake Wilbur Building, with the Stanford Women's Cancer Center occupying the first floor, and the head and neck and cutaneous cancer specialties on the third floor. In January, Stanford opened a new infusion center in Redwood City, and will open a new cancer center in July 2015 in the South Bay. The Jill and John Freidenrich Center for Translational Research, which opened in 2012, also houses key components of the cancer program.
In addition to managing future projected growth, the cancer center's leadership team is turning its attention to transforming cancer care at Stanford. The Stanford Cancer Transformation sets out to "create a new cancer care model that is comprehensive, multidisciplinary, highly coordinated and structured around the unique needs of each patient," said Seshadri. Other goals include creating new diagnostics and therapeutics, increasing the number of clinical trials and hiring more physician-scientists.
Stanford aims to be a national model for efficient and effective cancer treatment by combining leading-edge science with smart, compassionate care, said Lloyd Minor, MD, dean of the School of Medicine.
"Too often cancer care is not coordinated, not patient-centered and not evidence-based," Minor said. "Our highly innovative model for cancer care delivery and research is going to change that by transforming the patient experience and bringing the best science to every patient."