Central Valley cancer patients no longer need to travel across the state to receive optimal care. In fact, according to Community Medical Centers’ Chief of Medical Physics, Dr. Kenneth Forster, the quality care offered at the highly anticipated $68 million Community Medical Cancer Institute, set to open Aug. 1, is superior to any currently offered in California, rivaling even prestigious cancer treatment facilities on the East Coast.
On Friday, July 13, The Roundup had an opportunity to tour the cancer institute and learn of all the high-tech and patient-centric upgrades that make the new facility so remarkable.
One of the center’s claims to fame is its imaging center, which boasts a PET/CT scanner that can detect cancer lesions four times smaller than a typical PET/CT scan, and an MRI machine that not only detects lesions just as accurately, but also enhances the patient experience by incorporating technology to make the claustrophobic patient feel like they are in a wide-open space and by using noise canceling headphones that also allow the patient to relax.
“We wanted to get the best state-of-the-art equipment and it all had to be patient centric, which to me means fewer visits, less time in an uncomfortable position and also doing whatever we can to make them more comfortable while they are there,” Forster said.
The PET/CT scan machine appears similar to a standard PET/CT machine, but Forster explained it is very different. The way a PET scan works, he said, is the patient is placed on a low carbohydrate and high protein diet prior to the scan and once there, they are given a special radioactive sugar. Since cancer cells feed on sugar, they instantly go for this sugar substance, which includes fluorine, and this radioactive sugar gets stuck when the cancer cells attempt to digest it, making the cancer cells easier to detect on the PET. Where the Clovis Community Cancer Institute’s PET differs is in the detection. Rather than uses a regular crystal-like detector to detect and signal cancer cells, this PET uses an acrylic block that uses 64 detectors.
“It is a game changer because we can see lesions four times smaller,” Forster said. “The old is basically analogue and this is digital, like going from an old black and white TV to a 4K flat screen. But that’s not all, we can use less radioactive sugar and we can still image faster so normally a PET scan takes 30 to 40 minutes and here we can actually easily do it in 15 minutes, with images acquired in as little as two minutes. This means we can catch it earlier, but the other thing is if there is something to worry about you might think about, ‘Oh we have a lung lesion over here.’ But then we do a PET scan and we see something on the other side, so then you may need to talk to chemotherapy as well and medical oncology instead of just having a surgeon or radiation for it, so we can change the therapy up front. Plus, when you come for a follow-up and we don’t see anything it means a lot more because we will see the smallest things.”
There are only 18 such PET/CT scanners throughout the United States, with the nearest one up to this point located at UCSF in San Francisco—the only other one in California. There are only three in the Western United States, the one in San Francisco, one in Portland and now the one in Clovis.
The high-tech MRI machine is even more rare. There are only six total throughout the United States—one in New York, one in Michigan, one at the University of Arizona, one at the University of Nebraska, one at the University of Arkansas, and now the only one on the West Coast here in Clovis. The Clovis machine, Forster said, is also the only one with the digital magnet and lighting system to create the therapeutic atmosphere that makes the patient feel at ease during the MRI.
“What are the big problems you have when you have an MRI? Well two things most people complain about are claustrophobia and noise. So, this has incredible noise canceling headphones where you can bring your own music and we can play it from our stereo here or the patient can quietly listen to something soothing, and we can change the lighting and effects so the patient feels like they are not in a small confined space,” Forster said. “There is a mirror in front of the patient’s face so when they are lying there they can see what is behind them so they get the mood lighting and it feels like they are in something open.”
The patient can choose from a variety of calming colors and themes. One is an ocean blue where patients can view enchanting digitized sea life, featuring everything from dolphins to stingrays, swimming so it feels as if the patient is at an aquarium.
Not only is this imaging better than anything else available in the state, the radiology department also features the latest and greatest technological equipment.
Both the Cyberknife and the Varian TrueBeam use radiology to target and eliminate cancer cells within patients without surgery. With radiology treatment, however, its important to target these cells without damaging the surrounding normal tissues in the body. This is where the superb accuracy of these two machines comes into play. Both include crossing pathological X-ray machines that repeatedly scan the patient to ensure accuracy. These X-ray communicate with the robotic couch that is able to move the patient into the precise location. The radiology machine itself, either the Cyberknife of the Varian TrueBeam, can circle the patient, coming in at over 100 different angles to precisely target the tumor or cluster of cancer cells. These machines are so advanced, Forster said, that they can even follow tumors that move, such as lung lesions that tend to move as the patient breathes. And if the patient moves, the Varian TrueBeam has a response time of .01 seconds to turn off. The accuracy of the machine is so good, Forster said, that the worst beam offender he measured was off by 40 microns, which is .04 millimeters.
“This allows us to treat very precisely and also allows us to treat small tumors,” Forster said. “It is the same local control, meaning the cancer is not going to come back in the same place, as if a surgeon had opened up your chest and pull out one lump of lung, but our patients don’t feel as many side effects [as recovering from surgery]. A lot of patients will come in and want a morning appointment because they want to go into work later, so they can come here and get their lung cancer treated and go off to work … The idea is we want to make it as comfortable and convenient for the patient as possible because they have enough trauma in their lives.”
The imaging and radiology departments are located on the first floor of the three-story cancer institute, along with a lab that is convenient for patients who ordinarily have to have lab work done off site.
On the second floor is the medical oncology clinic which will be home to nine medical oncologists and radiation oncologists. There is plenty of room for more physicians, Vice President of Cancer Services John Strubert said, but there will only be nine to start. Off-site oncologists and surgeons will also be welcome to use the facility. The second floor will also house oncology support services, which is comprised on social workers, geneticists, financial counselors, speech language pathologists, dieticians, and nurse navigators which will be assigned to ever patient to help with scheduling of all appointments and coordinating care.
The top floor will house the clinical research department where Community Medical Centers staff in partnership with UCSF will be researching new clinical trials.
“UCSF has been doing this for a long time. We want to capitalize on their experience and their expertise to bring what they already have available to our patients and bring them the most up-to-date or cutting-edge treatment opportunities that we just haven’t had in Central California before,” Strubert said.
The infusion center, where patients will receive chemotherapy treatments, is also on the third floor. On a clear day, patients here can see a beautiful view of the Sierra, along with a view of the institute’s desert landscaping on an outdoor balcony. Rather than watch reruns of cable network shows on a shared television screen, each patient receiving chemotherapy will also have access to an iPad they can use while there to watch their favorite show or browse the Internet.
“No on wants to have cancer and no one wants to go through chemo but the layout, the beautiful landscaping and everything up there is trying to make it very much patient centric,” Strubert said.
There are over 12,000 patients in the Central Valley who are diagnosed with cancer each year, Strubert said. Currently, Community Medical Centers sees 25 to 30 percent of those patients, and there is a huge gap, he said, in between the number of patients and where they are able to go.
Now that the Clovis Community Cancer Institute is complete, these patients will not just have another option, but access to some of the best cancer services in the nation.
“What we’re doing is providing a great facility,” Strubert said. “We have the best technology already, the best physicians and the best staff, so why not come here?”