Duke plans cancer center

Tower could accommodate 300

Duke University Medical Center wants to spend hundreds of millions of dollars to build a cancer center and a tower with patient rooms on its flagship Durham campus.

The additions will replace aging facilities with state-of-the-art buildings that better meet patient needs, Victor Dzau, Duke University Health System CEO, said Thursday.

"We have to do it," he said. "It's not just what we have today. We have to build for tomorrow."

Duke's plans could put in motion broader changes for the hospital complex.

As the medical center considers features it must incorporate into the new buildings, it must examine the current facility too, said Kevin Sowers, chief operating officer for Duke University Hospital.

Some of Duke's patient rooms are 25 years old and 200 square feet too small, Duke says. Operating rooms are one-third the size of those built today. Neither can easily accommodate modern medical equipment.

The proposed tower would accommodate up to 300 patients. It probably would house other medical operations such as a heart center, as well.

Competitive field

Duke's ambitions reflect the competitive medical landscape. The hospital vies with other medical centers to attract not only patients, but the most talented doctors.

While Duke cancer patients must traverse hospital grounds for treatment, Rex Healthcare in Raleigh pulls the services together in a freestanding cancer center. So does UNC Hospitals, which has broken ground on a $207 million expansion of its cancer center in Chapel Hill. And most of Duke's peer medical centers nationally have consolidated their cancer programs.

"If you came to Duke and you said, 'Point me towards the cancer center,' you can't find it," said Molly O'Neill, chief strategic planning officer for the Duke University Health System.

The Triangle's growing and aging population demands a response from hospitals, said Mary Beck, senior vice president of planning and program development at UNC Health Care.

"Just as we're expanding and enhancing our offerings for patients with cancer, Duke needs to do the same thing to stay with the market," she said.

Duke still must convince state regulators that the project is justified. The state must grant a certificate of need before hospitals can expand. Plans are still in the earliest stages and few details are available. The hospital has no specific plans for renovations to existing patient rooms, which would require separate state approval.

Duke hopes to break ground on the cancer center and tower in 18 months, but it could be 2011 or 2012 before the new buildings are open. Duke will fund the construction with cash reserves as well as by selling bonds and through fundraising, Dzau said.

In the meantime, Duke is using Duke Raleigh Hospital, formerly Raleigh Community Hospital, to test its cancer center concept. Duke Raleigh Hospital's freestanding center, organized around 11 types of cancers, is the system's fastest-growing service in Wake County, O'Neill said.

Likewise, the new cancer center will be a one-stop shop for patients, Dzau said, with enough space for outpatients to see several specialists during the same visit. It also will house chemotherapy and radiation treatment centers, radiology services and patient support programs.

Duke's expansion must serve the its needs for two decades, said Bill Fulkerson, CEO of Duke University Hospital. As a result, planners will try to develop facilities that are flexible enough to accommodate unanticipated demands.

"Our desire is really to think about what the hospital needs to think about in the future," he said. "That's kind of a daunting task."