The February opening of the Duke Cancer Center is a simultaneous testament to the future of cancer treatment and the historical evolution of patient care at Duke.
Since the Duke Hospital opened to patients in 1930, treating cancer has been integral to the mission of Duke Medicine, said Dr. Victor Dzau, chancellor for health affairs and president and CEO of the Duke University Health System. Seven years after its opening, Duke Hospital began one of the nation’s first brain tumor research and treatment programs. Since then, cancer research and clinical care have become a hallmark of Duke Medicine, which receives nearly $300 million annually in cancer research funding.
“We have a long history of success and have always ranked among the best cancer centers,” Dzau said. “Over the years, we have not been as well-adapted as we should have been.... When I looked at this I feel that this day we need to change and reorganize and create the cancer institute around the patients.”
In 2010, Duke Medicine launched the Duke Cancer Institute, which will be housed by the new Cancer Center and accompanying facilities. That year, Duke saw nearly 50,000 individuals diagnosed with cancer and conducted 869 oncology clinical trials with 5,979 patients enrolled, according to DCI’s 2011 annual report.
The establishment of the first brain tumor treatment program in 1937 was just the start in a cascade of improvements to Duke’s cancer programs, clinically and educationally. In 1947, Duke launched a training program teaching medical students how to treat cancer patients, according to a DCI presentation. One of the first doctors to use chemotherapy for brain tumors was Duke doctor Barnes Woodhall, who adopted the treatment in the 1950s.
And in another realm of firsts for the medical community, Duke was named as one of the country’s first 10 comprehensive cancer centers in 1973, said Dr. Joseph Moore, medical director of the Duke Raleigh Cancer Center, a part of DCI. The National Cancer Institute and National Institutes of Health designated the programs as the Duke Comprehensive Cancer Center.
Dzau said this title propelled the health system to bolster their fight against cancer. Duke’s long history of success with cancer treatment correlated with former President Richard Nixon, Law ’37, signing the National Cancer Act of 1971, which encouraged patients to seek treatment at the named comprehensive cancer centers.
“Nixon declared war on cancer, and with that [the NCI] started appointing specific places in the country to be areas of cancer treatment,” he said. “Duke was one of the first.”
And in subsequent years, the resources available to researchers and patients have expanded even physically, culminating in the Cancer Center facility that will open to patients Feb. 27.
When he was a fellow in 1975, Moore said the cancer center was a combination of oncology and hematology departments squeezed onto the second floor of the Purple Zone in Duke Hospital North.
“There were four examining rooms and a very small area where labs and examining rooms were,” Moore said. “Treatments were all done in the same area, and it was quite small.”
In 1978, Moore and other staff members moved into the $6.5 million Edwin A. Morris Clinical Research Building—now known as the Morris Cancer Clinic and adjacent to the Duke Cancer Center—providing them with more room to perform examinations.
“We expanded quite a bit—we had around 20 examining rooms,” Moore said. “We were in the basement level, so there were no windows in the examining rooms, and we gradually outgrew this.”
When the cancer divisions moved from the basement to their current area in the front of the Morris Cancer Clinic, the cancer program truly evolved, Moore said. The comprehensive center began with just three divisions of specialized cancer treatment—oncology, hematology and cell therapy. The more feasible space within the Morris Cancer Clinic allowed Duke’s cancer program to expand to 40 divisions.
The Cancer Center will allow for even further development, he added.
“The building is a manifestation of growth of the whole program and an improvement in the sophistication of treatment and research,” Moore said.
The Cancer Center facility will eliminate some of the limitations of the Morris Center, said Tina Piccirilli, director of the Duke Center for Cancer Survivorship. One major limitation of the space was its inability to provide certain amenities—such as a resource center and garden—that give the Duke Cancer Center such a welcoming feeling.
“When you see these elements that have been incorporated into the building you immediately get a sense that you’re in a comforting place and that you’re going to be cared for,” Piccirilli said. “That first impression translates into integrated care—the warm and comforting environment sets the tone for the kind of care you’ll receive.”
Although the building will be a huge asset in treating cancer, it is still only one important step to a long road ahead in planning for improved cancer treatment, which will include recruiting more physicians and researchers, Dzau said.
“Our work is not done, but it’s a major step,” he said. “We have other plans going forward, but it is a very big step [that is] symbolic of the cancer institute and our vision.”
DCI Executive Director Dr. Michael Kastan was out of town and could not comment for this story.
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