Sunday, June 29, 2008

Cancer Center

Cancer centers, as the name implies are focused on the treatment of cancer. Once a cancer diagnoses is made, the size, type and location of the cancer will determine the treatment regimen. (Other factors, such as the patients age and health will also weigh heavily on the treatment options.)

Most treatment plans offer a combination of surgery and one or more treatment options. (For purposes of this post, I will focus on the treatments that occur outside of the OR. A future post on Operating Rooms will cover the design implications in the modern OR.)

Categories of Cancer Treatment options include:
Radiation treatment involves the use of radioactive energy beams, implantable "seeds", and other sources of direct delivery of radiation to the location of the tumor.

Chemotherapy is a pharmacological treatment method, using a "cocktail" of medications to eradicate the cancer cells or stifle its growth.

The most common radiation treatment device is a linear accelerator or "Linac". The linear accelerator generates a high energy x-ray beam. This treatment method seeks to bombard the tumor with radiation in an effort to kill the cancer cells. The room housing the linac must keep the radiation contained, preventing any exposure to surrounding areas. The room is typically called a "vault" or "maze". The term vault comes from the similarity of its construction to a bank vault. Thick walls of concrete, lead and/or boron are used to prevent the radiation from escaping. The design is maze like in an effort to keep the scatter radiation from having a direct path to the vault door.

Here are two videos of a linac, one is animated and the other shows the range of motion of an actual unit. In the second video, note that the gantry (table) would normally have the patient positioned at the axis of the rotation.








The patient is in the room alone during treatment. The massive door is shut and the technician will maintain communication with an intercom and a video feed into the room. All radiation dissipates immediately after the device is shut off and the staff can enter the room.

In contrast the the environment of the Linac, chemotherapy is typically delivered in a communal area, such are a room of recliner chairs. The patients are free to interact if they wish during their treatment. Chemotherapy is delivered intravenously. An IV bag and/or infusion pump will deliver the chemo chemicals into the bloodstream. Here is a video describing cancer and chemotherapy.



In future posts, we will explore the varieties of radiation treatment (Brachytherapy, Gamma Knife, Cyber Knife, and seed therapy).

Sunday, June 22, 2008

Outpatient Focus for the Summer

My editorial calendar changes each season and Summer is time to focus on outpatient areas. This offers a broad range of topics to discuss, so I expect my volume of posts will increase. Summer break was the time of year when elective surgeries seemed to increase among my family and friends. Once school was out there was more flexibility in the schedule. It also meant that there were fewer school related activities to get in the way of rehab and follow-up appointments.

A new poll is posted, so please feel free to suggest areas of emphasis - Surgery, physical therapy, oncology, etc. This blog is a chance to share the types of information you need most, so please suggest the best areas to focus upon.