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Cancer taking lead role at IU: New hospital aims to boost reputation, research

July 21, 2008

To glimpse the priority list of the honchos running the Indiana University medical complex, drive west along Michigan Street and look north toward the IU Hospital.

The 38-year-old facility is now nearly totally eclipsed from view by a sparkling, $150 million addition to the IU Simon Cancer Center, which stretches steel, glass and stone across an entire block between University Boulevard and Barnhill Drive.

By bulking up its cancer care and research, IU leaders hope to improve the prestige of the entire downtown hospital campus, which is run jointly by the IU School of Medicine and the Clarian Health hospital system.

"Our strategy has been to move up in recognition overall with cancer as the lead," Dr. Craig Brater, dean of the IU School of Medicine, wrote in an e-mail while on a visit to IU's AIDS-treatment project in Kenya.

The IU Cancer Center is one of only 55 in the nation recognized by the National Cancer Institute for a combination of high-level care and research. But not until this year did IU and Clarian crack the top 50 hospitals for cancer treatment and research, according to rankings by U.S. News & World Report.

Raising its reputation could help the IU Cancer Center recruit and retain larger numbers of top-notch cancer clinicians and researchers, who could attract more grant money and clinical trials to the center.

IU has a lot of money to work with. In 2006, the Simon family of shopping mall developers donated $50 million to the cen- ter. It was renamed the IU Melvin and Bren Simon Cancer Center.

But IU has plenty of company, too. Many university-based cancer centers are adding buildings to expand both research and patient care, said Dr. Linda Weiss, chief of cancer centers at the National Cancer Institute in Maryland.

"It's very helpful for recruiting," Weiss said, also noting the importance of many other factors. She added, "If you're trying to recruit clinician-scientists, there's a fairly limited pool of those people."

Yet, there's a big need for their skills. While cancer treatment has progressed rapidly in recent years, the disease is by no means cured. At the same time, rates of cancer keep rising as Americans' unhealthy habits persist, as the 70 million baby boomers age, and even because medical advances have lengthened life spans, making it more likely for a person to eventually contract cancer.

"Between now and five or 10 years from now, it's staggering-the [expected] incidence of cancer," said Dr. Stephen Williams, director of the IU Simon Cancer Center, reclining behind his desk on the fourth floor of the Indiana Cancer Pavilion.

More room needed

The pavilion, opened in 1996, is already over capacity, Williams said. He walked through the pavilion's busy third-floor chemotherapy infusion center and out into its crowded waiting room. For the last three years, patients sitting there have looked across an atrium and an outdoor garden to see the new cancer building going up.

That building is now nearly complete. IU and Clarian officials will conduct public "sneak peak" tours July 25-26. The first inpatient will arrive Aug. 27. And the first outpatients will come Sept. 2.

The 405,000-square-foot cancer hospital, designed by Indianapolis-based Maregatti Interiors, is meant both to sooth and to impress. On every floor, light streams in from floor-to-ceiling windows that look out onto Michigan Street.

At the main entrance, a line of 75 bamboo trees shoots out of a rock-lined garden and extends above a second-story walkway. Plants also sit outside the private registration area and curve along the café dining area, which also looks out to a garden.

The hospital has an Asian flair, with light wood paneling and balsa-wood light shades throughout. Marble-like tile covers the ground floor. Lights-designed to evoke the shifting colors of the sky throughout the day-play off opaque surfaces hanging from the ceiling in the entry.

"It's trying to keep people entertained while they're in the building," said Debbie Evans, a marketing project leader for the IU and Clarian cancer programs.

IU and Clarian won't fill the new building all at once. But over the next 18 to 24 months, Evans said, outpatient departments from the Indiana Cancer Pavilion and inpatient departments from the IU hospital will move into it.

At full capacity, the building will allow IU to double the number of cancer patients it treats. It had 4,200 inpatient visits last year and 38,000 outpatient visits.

IU and Clarian will need that space because the World Health Organization and some U.S. health insurers predict cancer rates could double by 2030.

There are currently 1.4 million Americans with cancer, according to the U.S. Centers for Disease Control and Prevention. As of 2004, the latest data available, Indiana had more than 28,000 cancer cases.

One of those was Fort Wayne resident Heidi Floyd. She was diagnosed with breast cancer in October 2004-two months after becoming pregnant with her fourth child.

Floyd's doctors in Fort Wayne gave her the standard advice-have an abortion. That's because she couldn't receive typical chemotherapy while pregnant. But she refused, saying, "If it was a choice between me and the baby, it was definitely going to be the baby."

Floyd's boss-in the sales department of Fort Wayne-based Vera Bradley Designs -told her to check out the IU Cancer Center. She went to Dr. George Sledge, coleader of IU's breast cancer program, who had already treated two dozen pregnant women with cancer.

"He's so heavily invested in research. They know how to handle tricky situations like this," said Floyd, who now tells her story nationally to help raise money for the Vera Bradley Foundation for Breast Cancer. The foundation gives all its money to the IU center.

Floyd had her baby, Noah, in April 2005. She credits Dr. Sledge with saving both their lives.

"Were it not for him, I would not be here," she said, "nor would my baby."

Boosting research

If IU and Clarian attract more cancer patients, it should help them do more research. That's because rising numbers of patients should lead to rising numbers of clinical trial participants.

In fact, IU and Clarian are counting on it.

Half of a new 250,000-square-foot building, two blocks behind the IU Cancer Center, will be devoted to cancer research. It will open next spring.

The medical staff of the IU Simon Cancer Center offers every patient an opportunity to be in a clinical trial, which is a regimented study of experimental drugs, devices and methods of treatment. Nearly 17 percent of patients do so, about 700 each year.

Dan Evans, CEO of Clarian Health, said researchers are attracted to hospitals where lots of patients participate in clinical trials.

"A huge help is the clinical volume," Evans said, while ticking off other factors that are crucial to attracting researchers: the reputation of IU faculty members, the center's $76 million in research dollars, among others.

"The dean of the medical school and CEO of Clarian are in a contest with every other academic medical center in the country, to attract researchers and their resources," Evans added.

Cancer researcher Linda Malkas came, in large part, so she could work along doctors trying to find better ways to treat patients. She was a full professor at the University of Maryland in 2001 when IU called.

"I didn't need to leave," said Malkas, who is now the Vera Bradley Endowed Chair of Oncology at the IU medical school. "But I said, 'Gee, there's an opportunity that maybe some of the things that we're doing may actually make the jump from the lab to the clinic.' And it worked."

Brater, the dean of the IU medical school, said the biggest opportunity the new hospital opens up for IU is "to recruit and retain the best and brightest." He hopes it works.
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