Dialogue

A Cornerstone and Catalyst for Hope

Jun. 25, 2018

Building hopeEven on the gloomiest days, light streams through the wall of windows in the lobby of the Wilmot Cancer Center. It fills the patient rooms on the building’s upper floors, and it brightens areas on the ground floor that would traditionally lack natural light.

It is one of the building’s most distinctive features and among its most intentional. The light inspires energy and hope, and it encourages those inside to connect and collaborate.

When it opened in 2008, Wilmot Cancer Center was conceived as a state-of-the-art facility that would foster growth and excellence in cancer care, research and community service. Since then, the building has exceeded those expectations, solidifying Wilmot Cancer Institute’s reputation as a leading cancer center in upstate New York. It has enabled growth not just on the campus of the University of Rochester Medical Center, but across the Finger Lakes region. Through novel therapies and new technologies, it has also changed the lives of thousands of people who have faced cancer over the last decade.

“This building is a testament to the power of bringing people together,” says Jonathan W. Friedberg, M.D., M.M.Sc., director of Wilmot Cancer Institute. “It was step one toward our goal of becoming one of the nation’s top 50 cancer centers and our pursuit of National Cancer Institute designation. Now, we are poised for the next decade, which no doubt will bring important advances in cancer diagnosis and treatment.”

Designed to inspire, connect

Nurses meet on WCC7The building opened with four floors and 164,000 square feet of space for outpatient care and research labs. Its outpatient clinics on the first floor created an area where the primary disciplines that treat cancer — medical oncology, radiation oncology and surgery — could physically come together, enabling patients to see their team all at once.

“With this building, we solidified our commitment to combined modality treatment,” says Yuhchyau Chen, M.D., Ph.D., Chair and the Richard T. Bell Endowed Professor of Radiation Oncology at Wilmot. “Patients can see their medical oncologist, radiation oncologist and surgical oncologist at the same time and place. Cancer patients benefit tremendously from multi-disciplinary tumor board discussions of each case among oncologists, pathologists, radiologists, and other cancer care specialists. This is made possible by the state-of-the-art audiovisual equipment we have for reviewing imaging studies, tumor pathology, and also allowing remote access.”

Bringing the teams together in the same clinic has allowed the clinicians to implement a truly multidisciplinary approach to care at a time when there are more options for combining surgery, radiation, chemotherapy and other treatments than ever before. And with radiation oncology just steps from medical oncology and a quick elevator ride from Wilmot’s inpatient units, communication and care became much more efficient.

The addition of the inpatient floors, which began in 2010, created a comprehensive cancer hospital that offers a seamless, full continuum of care. The 86 patient rooms are all private and nearly double the size of those on existing units elsewhere at Strong Memorial Hospital.

Nurses meet on WCC7“Having the inpatient units here has transformed the patient experience,” Friedberg says. “They’re certainly the nicest, most comfortable hospital beds in the city, and our patients are deserving of that.”

The units — surgical oncology on WCC5, the Samuel E. Durand Blood and Marrow Transplant Program on WCC6, and hematology/oncology on WCC7 — were also designed to facilitate nursing care. In contrast to traditional inpatient units that have a central nursing station, Wilmot’s units have nursing work areas throughout, allowing the nurses to be closer to the patients. This change requires the nurses to find new ways to stay in closer communication.

“They have spot huddles in the hallway to touch base and share issues that are going on and to ensure continuity when new staff come on,” says Dwight Hettler, RN, MS, OCN, NE-BC, Wilmot’s associate director of clinical operations. “They make a concerted effort to keep everyone feeling included and clued in.”

Communication has also played a key role in Wilmot’s expanding clinical trials infrastructure. For both medical and radiation oncology, having research coordinators closer to clinical investigators and patients has helped build stronger relationships and allowed Wilmot to open more trials and recruit more participants.

Growing toward the future

Oncologists and therapists plan treatmentThroughout the cancer center, the need for more space and more staff came very quickly as growth in new patients has averaged between 15 and 20 percent annually since 2008. To meet the need, Wilmot’s teams have grown substantially. Today, there are about 120 physicians and more than 200 nurses and nurse practitioners who provide care to patients.

“When we moved in, there were empty offices and rooms, but we’re full now,” Friedberg says. “We’ve filled the building and are looking to expand.”

Advances in technology have also boosted the need for staff. The move to the Wilmot Cancer Center came as advances in technology — particularly the shift from film to digital imaging — began to revolutionize the field of radiation oncology.

“Everything is completely different now,” Chen says, citing developments in treatment-planning technology, intensity-modulated radiation therapy, image-guided radiotherapy, organ-motion management radiotherapy, radiosurgery to ablate hard-to-reach tumors, and stereotactic body radiation therapy. “These developments mean we can deliver radiation with greater precision and fewer side effects, and our patients have a very different experience than before.”

Chair of Radiation Oncology Yuhchyau Chen and her teamHer team of physicians has nearly tripled since 2008, and she expects her staff to continue to grow as linear accelerators and other radiation technology become more complex. Chen says her department is committed to staying at the cutting edge of cancer treatment — following closely the development of proton beam therapy and other advances, such as the role of radiotherapy in enhancing immunotherapy and ablative radiotherapy for refractory cardiac arrhythmia.

Even for Wilmot’s volunteers, the building has meant growth.

“When I started, there were only two of us,” says Pat Zampi, who began volunteering for Wilmot in 2000. She helps distribute coffee, tea and snacks to patients in the infusion center. She remembers how cramped the old infusion center was, and with limited storage for supplies, volunteers could offer only juices and pretzels.

Today, they have a small kitchen where they can brew coffee, heat water for tea or soup, and keep a variety of snacks refrigerated.

“Having that kitchen and a separate storage room is phenomenal,” Zampi says. “We can serve patient needs better.”

Pat Zampi in the Infusion CenterTo Zampi, that means engaging patients in conversations if they’re willing and helping them learn about resources and services.

“Our space allows more of this,” says Zampi, who is now herself undergoing a round of treatment for lymphoma.

The Wilmot Cancer Center now has more than 50 volunteers, who help with everything from filling the new-patient binders to rounding on the inpatient floors with books, knit hats and other materials. They also serve on Wilmot’s Patient and Family Advisory Council, or PFAC. During construction, this committee played a key role in selecting the pull-out sofas in the patient rooms and the chairs in the infusion center, and today, they continue to provide insight and advice to Wilmot’s leadership.

More than a building

The construction of the Wilmot Cancer Center created not just a physical space, but also a shared identity for all of the cancer care and research at the University of Rochester. In 2014, the cancer center announced its reorganization as the Wilmot Cancer Institute to reflect better its structure and burgeoning programs, including its growing network of locations throughout the Finger Lakes region.

Now the largest cancer center in upstate New York, Wilmot serves more than 17,000 patients each year.

The stereotactic body radiation teamIts clinical programs are only half the story, though. With more than 100 scientists, Wilmot’s research programs focus on understanding the biology of cancer, how cancers thrive in the body and strategies for overcoming treatment resistance. They are also leading national research on treatment toxicity and side effects, the late effects of cancer and ways to help patients live better.

Although cancer research is done throughout URMC, Wilmot Cancer Center’s third floor is filled with cancer-specific investigators, their labs, and a conference space for meeting and collaboration.

Wilmot’s scientists and clinicians are working together to translate their findings from the laboratory into the clinic. For example, radiation oncologists and immunologists are collaborating to study how radiation can enhance the effectiveness of immunotherapies. Surgeons and medical oncologists are working with exercise physiologists to study how physical activity can improve short-term and long-term outcomes for patients. Clinicians and scientists from a range of fields are studying the role of aging in cancer and how to improve care for older adults.

“Our building has more than fulfilled its promise of improved research and care here in Rochester,” Friedberg says. “Our aspirations now have grown to become a top 50 Cancer Center in the United States. Given the progress in our understanding of cancer, further emphasizing our research mission positions us to make substantial contributions favorably impacting outcomes in these diseases.”