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The Sarah Cannon Cancer Center, headquartered on TriStar’s Centennial Medical Center campus, is in the middle of a multi-year construction process that encompasses the addition of new equipment and facilities along with major renovation to existing spaces in order to maximize diagnosis and treatment options for patients in their large network.

In the December issue of Nashville Medical News, it was noted Centennial Medical Center was embarking on a $143 million construction project primarily focused on enhancing cardiovascular and oncology services. Approximately half of the expenditure is being committed to oncology care. The facility received CON (certificate of need) approval to proceed with this next phase on January 23, 2008.

Centennial Medical Center has already invested millions in renovations and new equipment purchases for the Sarah Cannon Cancer Center. Rocky Billups, RN, MS, director of oncology services for TriStar, was brought in from an HCA facility in Denver two-and-a-half years ago to oversee the growth of cancer services in the Sarah Cannon network.

Billups, who has a clinical background in bone marrow transplantation (BMT) in addition to administrative experience, was intrigued by the opportunity to help launch and oversee a BMT program and major expansion project that would consolidate services to create a comprehensive cancer hospital.

The construction plan creates a dedicated Cancer Center integrating into one area inpatient and outpatient services, radiation oncology, lab services, a comprehensive cancer imaging center, medical and surgical oncology, operating rooms, BMT and hematological services and the addition of Middle Tennessee’s first Cyberknife.

“Cancer is increasing in prevalence, and it’s also now becoming more of a chronic disease … so patients are living longer with it, which is a great thing, but we need to make sure we’ve got the resources to take care of those patients,” Billups said of the reason behind the multi-million-dollar expansion and renovation.

Park View, the original building on the medical campus, has already embarked on a ground-up renovation project. To date, the third and fourth floors have been overhauled to function as the BMT unit, medical oncology and patient rooms.

For just over a year, Centennial has offered patients autologous bone marrow transplants. By the middle of this month, plans are to begin accepting patients for allogeneic BMT.

“The BMT unit now is 11 beds, and the oncology unit is 14,” said Billups. “What we did, because of planning for growth, is that whole 25-bed area is set up where the BMT unit can be the entire floor,” he continued, noting the plan does ultimately call for the third floor to be entirely dedicated to BMT and hematological malignancies.

Renovation was completed with a strict eye toward minimizing infection. The floor was heat sealed so there would be no room for dust, and the ceilings are non-porous to eliminate moisture buildup. Bathrooms were completely redone, and special drywall was used to cut down on fungal risks.

“For bone marrow transplant patients, infection is a big issue,” Billups pointed out. Despite the attention to safety, he noted that special effort was made to use hotel finishes to create a homelike atmosphere. “These patients could be here for 30, 60 days so you want them to feel like they are in a nice place, and you don’t want it to appear sterile and cold.”

Currently, construction is being finished on an adjacent wing that will become a 20-bed medical oncology unit. The fourth floor has also been renovated. Right now, it’s being used as a general medical-surgical unit, but it will become a dedicated oncology unit by the time the construction project is completed. The second floor will also be available for patient rooms.

The first floor, Billups continued, “will be an imaging center for outpatient and inpatient. We have SPECT-CT, PET-CT, MRI and routine radiology for diagnostics. And then we will have four operating rooms on the first floor.” He added the build out allows for the option of adding two more ORs, pending future need and CON approval.

The main floor will also house ancillary services, including a blood bank and pharmacy. Billups also plans to include kiosks from which local non-profit organizations such as the American Cancer Society and Gilda’s Club can offer information.

“We really want to make sure it’s very patient-friendly and that all the resources the patients need are right there,” he said.

The basement, which is already set up for radiation oncology, has three vaults. The new $2.4 million Trilogy system is housed here.

Billups explained that Trilogy is “able to do image-guided radiation therapy (IGRT). There’s only one other in the city, at Vanderbilt.” He continued, “The standard of care for radiation therapy is IMRT (intensity modulated radiation therapy). IGRT goes to the next level.”

The versatile system is able to combine both imaging and treatment technologies to deliver a wide range of external beam radiotherapies including IMRT, stereotactic radiosurgery, fractionated stereotactic radiation therapy, three-dimensional conformal radiotherapy and intensity-modulated radiosurgery.
Additionally, there is a dedicated vault for high-dose-rate brachytherapy, and the third vault houses a traditional linear accelerator used for IMRT.

In the new medical office building, which is ground-up construction adjacent to the Park View building, the Sarah Cannon Cancer Center will feature an Accuray CyberKnife® — the first in Middle Tennessee.

Used for highly conformal radiosurgery anywhere in the body, the CyberKnife has sub-millimeter accuracy and the ability to continuously track, detect and adjust for tumor and patient movement.

“It took us two-and-a-half years to decide which piece of technology we wanted to purchase,” he said of the thought that went into choosing CyberKnife over Gamma Knife. “From a market standpoint within Nashville, we wanted to make sure we had the best piece of technology that could be used by all our physicians. The Gamma Knife can only treat patients intracranially, whereas the CyberKnife can do both intracranial and extracranial,” he explained.

The versatility of the CyberKnife means it can be used by neurosurgeons for brain tumors, urologists to fight prostate cancer or thoracic surgeons for lung cancer, among other uses.

In addition to housing the $4.5 million piece of new equipment, the new building will have three floors, with the capability to expand in the future. The goal is to consolidate the offices of medical and surgical oncologists under one roof. Also in the new building will be administrative offices and support services such as patient navigators and a cancer concierge, who is available to help patients and their families with questions about the city. The hope is to also include a boutique with wigs and other items designed for cancer patients.
Billups said for physicians and staff, the consolidation of oncology services into one area is expected to increase both efficiency and satisfaction.

“For our patients, it’s going to allow them to have access to cancer care in one place,” he said, adding that a cancer diagnosis is stressful enough without having to worry about finding the way around a large campus.

Local architecture firm, Earl Swenson Associates, Inc., has been awarded the project. Completion of the entire expansion and renovation is scheduled for the end of 2010.



March 2008

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