Inside Duke Medicine

Rising population, demand for services drives creation of new Cancer Center facility

The robust demand for Duke’s world-class cancer care shows no signs of abating. On the contrary, all indications are that demand will continue to rise significantly as the number of cancer cases increases and as the state and local population continues to grow.

Duke University Hospital saw more than 50,000 patients with a diagnosis of cancer in 2010. Nearly 6,000 were new patients, from virtually every county in North Carolina and every state in the nation. More than 60 percent of the patients were referred to Duke for their initial treatment.

Meanwhile, clinics and treatment areas are operating on extended hours as more than 600 patients are seen every day in the cancer clinics, infusion center or to receive radiation therapy – facilities never designed to handle anything approaching the current volume of patients, let alone to continue to meet the exploding demand for services.

The current demand coincides with projections of significant future growth locally and statewide in the number of new cancer cases. A 16.5 percent statewide increase in the number of new cancer cases is anticipated over the next five years, with the greater Triangle region bearing much of that burden with a projected increase in new cases of 23.1 percent. In 2011 alone, Durham County is expected to see more than 1,200 new cases of cancer and Wake County nearly 4,000, among nearly 52,000 new cancer cases statewide.

At the same time, North Carolina’s population continues to rise, jumping 1.5 million between 2000 and 2010 and fast approaching the 10 million mark. The state now ranks as the 10th most populous in the nation.

Likewise the greater Triangle region, Duke’s primary service market and from which most referrals come, continues to see tremendous growth – particularly in the core counties of Durham and Wake. The region’s population is forecast at 2.41 million by 2015, up 11.5 percent from 2010. A recent study projects that the Raleigh area will be the nation’s fastest growing metropolitan region between 2010-2020, rising to 1.5 million inhabitants from 1.2 million.

All of the above factors, combined with the increase in the number of people living longer as cancer survivors, make clear the growing and specific need for Duke’s specialty cancer services and programs, even with the expansion of some other local and regional cancer facilities.

“The existing demand for cancer care at Duke, combined with significant future growth in the number of new cancer cases, creates a critical need to expand our ability to provide multidisciplinary, patient-centered care,” said Carolyn Carpenter, associate vice president of oncology services and interim administrator of the Duke Cancer Institute. “The Cancer Center facility will be the clinical cornerstone of the DCI, where we will bridge scientific discovery and clinical care to transform how patients and families experience cancer.”

When the new Cancer Center facility opens in just seven months, it will position Duke Medicine to accommodate existing and future demand for cancer care services. At the same time, it will optimize the total patient experience and work environment for clinical teams to further enable them to focus on patient care.

Thanks to the facility’s ample space, including 73 infusion stations and eight linear accelerators for radiation therapy, staff will be able to treat more patients at the same time, on a schedule more convenient for patients. That’s particularly helpful during the busy mid-day and afternoon, when most patients prefer to receive treatment.

“We’re seeing a lot more patients now than we did even a couple of years ago, in the same limited space, so we’re filling up faster,” said Jamie Garran, RN, BSN, a nurse in the treatment room who works with breast and gynecology cancer patients. “It’s a challenge for us as staff who want to provide our patients with comfort and privacy. The new facility is going to be wonderful. I’m excited about not having to scramble to find a chair to treat a patient.”

The cancer facility’s impact will be felt across the board in enhanced opportunities for collaboration and consultation among Duke Medicine’s outstanding cancer clinicians and scientific research faculty studying the mechanisms of cancer.

“With cancer care well-established as one of Duke Medicine’s hallmark services, the new building is critical to our mission,” said Christopher Willett, M.D., chair of Radiation Oncology and interim co-director of the DCI with Anthony Means, Ph.D., chair of the Department of Pharmacology and Cancer Biology, pending the Aug. 1 arrival of Michael B. Kastan, M.D., Ph.D., as executive director. “We simply must continue to anticipate, adapt and move forward in the changing landscape of cancer care.”

Read other articles from the special issue of Inside Duke Medicine on the Cancer Center facility.