Embracing an Integrated Model

Hospitals and cancer centers add proton therapy to their mix

In an effort to offer comprehensive oncology services, a growing number of hospitals are integrating proton centers with traditional cancer treatment facilities. Integrated facilities are outfit with proton therapy equipment as well as traditional photon therapy and other sophisticated radiotherapy devices used in the treatment of cancer. They play host to a multidisciplinary team of doctors, physicists, and dosimetrists who work together to coordinate both conventional radiation and proton therapy treatments.

Large hospitals are moving toward an integrated model because it creates new efficiencies, allowing medical centers to offer the entire continuum of cancer treatment options and to apply patient services across various types of care. Baptist Heath Cancer Institute, scheduled to open in 2016, will be among the first cancer centers to provide a fully integrated radiation oncology department. It will offer proton therapy in addition to standard radiation, tomotherapy and gamma knife stereotactic radiosurgery. The new facility will offer a spectrum of integrative medicine services and programs, including infusion chemotherapy, bone marrow transplants and diagnostic imaging. The success of such complex integrated oncology projects depends on careful coordination and thoughtful design. By assembling physicians, nurses, social workers, physical therapists, nutritionists, acupuncturists and counselors under one roof, Baptist Heath South Florida addresses the range of physical and emotional needs associated with all radiation therapies, as well as medical oncology.

SAH Global Oman Proton and Imaging Center

SAH Global Oman Proton and Imaging Center

Even new stand-alone proton centers are considering a mix of proton treatment rooms and traditional LINAC vaults. Beyond enhancing the patient experience, integrated proton centers can make sense from a business perspective. Doctors working across modalities of treatment can benefit from a consolidated administration and centralized clinic for consultations and follow-ups with patients. Typically, proton therapy center construction and vendor equipment installation is a lengthy process. By offering both modalities, centers can open in phases and begin treating patients through conventional channels while their proton facilities come on line. VOA’s proposed new design for the SAH Global Oman Proton and Imaging Center features 2 proton treatment rooms and 2 LINAC treatment rooms, allowing for shared nursing, imaging, clinical and administrative services, therefore minimizing duplication of those functions.

Site plan, SAH Global Oman Proton and Imaging Center

Site plan, SAH Global Oman Proton and Imaging Center

Another related and emerging trend is the design and construction of a proton therapy center adjacent to an existing radiation oncology department. This approach is not without its challenges. The need for specialized infrastructure makes integration with existing hospital architecture difficult. Proton therapy centers have unique structural requirements due to their large scale and weight—a typical cyclotron weighs 220 tons, as much as a 747 airliner, and a magnet weighing over 20,000 lbs. conveys the proton beams to the patient. Beyond the sheer magnitude of the materials involved, the equipment necessitates between 300 and 400 tons of water for cooling and between 1-2 Megawatts of power, enough energy to illuminate 16,000-33,000 60-watt light bulbs simultaneously. Such requirements are beyond the capacity of most hospital campuses.


Architects designing integrated proton therapy centers are faced with both practical and aesthetic challenges. Proton treatment facilities typically sit close to the ground with cooling towers and machinery consigned to the roof. This equipment can be unsightly to patients and staff with views from nearby medical towers. Safety is another major concern—evaporated coolant from the cyclotron’s quench vents and hazardous exhaust from the beamline must be safely discharged so as to avoid release back into the facility or neighboring infrastructure.

Despite these challenges, operational hospitals and cancer centers, as well as new stand-alone radiation oncology centers aren’t shying away from proton therapy technology. Increasingly, they’ll call on experienced design teams to help them add proton treatment rooms to their mix. When it comes to proton therapy, an integrated model is a natural fit.

Download the complete Design Quarterly Winter 2015 – Trends in Proton Therapy Center Design now.

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