Cancer will soon have one more enemy on the Kenai Peninsula.
Central Peninsula Hospital in Soldotna is in the process or renovating space in its main building that will house a visiting medical oncologist's clinic to treat cancer patients here on the Peninsula.
It's the first step in a long-term plan that CPH has set out on to give cancer patients living here more treatment options closer to home.
CPH chief Ryan Smith said the hospital has recognized the need for an on-site cancer treatment center for some time.
"We do these community health needs assessments every year and the community course was telling us every year that the issues the community would like to see us address were oncology and cardiology," he said.
Smith said that right now when a central Peninsula resident is diagnosed with cancer, typically they'll see a family practitioner, internal medicine physician or a surgeon who will likely refer them to a medical oncologist in Anchorage.
The patient will see the oncologist, and if they need chemotherapy then, Smith said, in many cases they'll do the first treatment with the medical oncologist in Anchorage.
Sometimes they're able to then transfer the care to the outpatient infusion center at CPH, but they may choose to continue to receive treatment in Anchorage or elsewhere.
If a patient needs radiation therapy, however, they will only be able to get that in Anchorage or Outside.
Additionally, if a patient also needs surgery as part of their treatment they'll be referred to Anchorage or Outside, he said.
"So what happens now is if you need radiation treatment you've got to find a way to fly up (to Anchorage) every day or live with somebody or someplace," Smith said. "So we've thought all along, how can we let patients who live on the Peninsula stay on the Peninsula for that type of care?"
Step one is nearly complete, Smith said. CPH is in the final stages of negotiating an agreement with Anchorage-based Katmai Oncology Group, and expects them to be able to start seeing patients in early 2011.
"They'll be coming one or two days a week and be able to see patients here in the hospital instead of those patients having to travel to Anchorage," he said.
Step two, building an onsite cancer treatment center, will take a lot more work and time.
He explained that establishing such a facility will require countless hours of discussion, collaboration, handshakes, pen strokes and votes before any picks and shovels hit the ground.
"In a political environment there's internal politics and external politics that impact whether we build a cancer treatment center," Smith said. "And because of the dollars that are involved it's not something that we can just do with our plant replacement and expansion fund. It's a bond type of issue that would need to be put out to voters."
Smith said the hospital would most likely start by trying to form a partnership.
"It's not just as simple as throwing in a machine or something," Smith said. "When you start doing things like radiation therapy you need a radiation oncologist, a physicist, a dosimetrist. It's a program."
Additionally, Smith said there are a number of other sub-specialists needed to establish a cancer treatment center, and many are hard to come by.
By partnering, the hospital could avoid having to do all the recruitment on its own.
He estimated that the facility would require about 10,000 square feet of space, space that would likely be located in either an addition to the main hospital or in an off-site building on the campus.
In gross terms of costs, he guessed a center would run $10-12 million to build and purchase the necessary equipment.
If work on the center started tomorrow, Smith said it would probably be three years before anyone would receive treatment.
Smith said a good analogy might be to compare building a center with putting together a puzzle that doesn't come with all the pieces in the box.
Complicating that is the hospital's political nature.
"Anytime you have to go make commitments to individuals in order to get them to partner with you and you're ultimately subject to that political arena of getting approval," Smith said, "you have to make sure that you have a plan that's going to be fool proof to sell to the community because you would hate to make commitments to other individuals and ultimately have it denied at the voter level.
"It's not just something you throw together and take to the assembly for approval."
Smith also wasn't shy about noting the eventual construction of a cancer treatment center was included as part a recommendation made by the Central Peninsula Hospital Inc. board -- the nonprofit company that governs the hospital -- earlier this summer to form a joint venture partnership with a for-profit company.
A Sept. 7 decision by the borough assembly, however, curtailed the discussion on the deal.
"One of the things that was very appealing about the market process was that we were guaranteed to get these things in very short order," Smith said. "All of the proposers were all willing to build cancer treatment centers."
He said however, that just because the governance discussion is presently off the table, that doesn't meant the cancer treatment center is, as well.
"Just because we didn't proceed with that doesn't mean we shouldn't continue to pursue this," he said. "But I would say it's going take us a little longer and it's another piece of the puzzle that needs to be put together in a more structured fashion."
Smith acknowledged that while community assessments show support for the construction of a treatment center, not everyone necessarily thinks having that level of care in a small community necessary or economically sensible.
"We think a cancer treatment center is something we can provide with a good quality," he said "And then financially it has to make sense. Through the models we've developed and through the models the proposers have developed they obviously all thought it made sense."
That being said, he noted that in the end such a project's fate lies in the hands of the people.
"When it goes to a vote of the people, it's the ultimate test of whether they'll be willing to be on the hook for those bond payments," he said.
He guessed however, that most would support it.
"If you've ever talked to someone who has (had cancer) and who has had to go for radiation therapy treatment, you'll have a hard time finding people who have actually been through that experience that would say, 'We should just do that in Anchorage, that's fine,'" Smith said.
Dante Petri can be reached at firstname.lastname@example.org.
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