Dec. 4, 2002 – Greatly adding to the stress level of a new cancer patient in the Virgin Islands often is the necessity of going off island for radiation treatment following diagnosis and surgery. In most cases, that means leaving family and incurring living expenses in another, perhaps totally unknown, community for six weeks or more.
No one who listened Wednesday to the top administrators of Roy L. Schneider Hospital can doubt that they will achieve what they plan — a world-class cancer care center in the Virgin Islands which will alleviate the need to leave the territory in order to get comprehensive, state-of-the-art cancer care, including radiation treatment.
The project has been under discussion and intense pre-planning for four years, and a dream in some V.I. hearts for many years before that. But Rodney E. Miller Sr., Schneider Hospital chief executive officer, and Amos Carty Jr., chief operating officer and second in command, make it clear that this project is going to happen. And their firm schedule is to have the facility a reality by 2004.
"Failure is not an option," Miller said emphatically, and cost overruns or other obstacles will not stall or halt the project.
With $5.8 million from the territory's tobacco settlement proceeds, $2 million from Partners for Health fund raising and $1.7 appropriated by the V.I. Legislature to assist with personnel recruitment, Carty said, the project is "close to the start point." All officials present at the Wednesday press conference agreed and emphasized, however, that fund raising will be perpetual.
Dr. Bert Petersen Jr., lead medical planner for the project, noted that new scientific discoveries, treatments and equipment are constantly emerging. He said these developments will need to be incorporated into the center's offerings.
The hope is that fund raising and demand for the facility that will be created through patient successes and marketing will mesh to require expansion. Architect Kimberly Stanley of the Atlanta firm of Stanley Beaman & Sears said the facility to be erected in the immediate phase is being planned to accommodate potential expansion.
"We are going to have a new, powerful weapon in the war on cancer right here in the Virgin Islands," Miller said. "The quality of treatment will equal that of Memorial Sloan-Kettering." He said the press conference was the start in keeping the community informed of progress all along the way.
Miller and Carty said the cancer care center will be an operating reality by 2004, and Stanley said that is the architects' target.
Virgin Islands special needs
Petersen, a Virgin Islander who is a nationally known cancer specialist, cited statistics indicating that one problem locally is the lack of early detection of cancers. The territory's doctors see more late-stage new patients than the U.S. average, he said, and African-Americans in general have a 30 percent higher late-detection average.
So an early mission of the center will be educating the community and the physician community to the need for screening — and particularly screening of "at-risk" patients, those with family history or risk factors implying a higher likelihood of developing cancer.
The Virgin Islands cancer registry tallies 400 to 500 new patients per year. While there are no firm statistics on totals, the U.S. average is calculated as eight times the number of new patients. That would mean there are some 3,200 to 4,000 V.I. residents living with and fighting cancer.
There are existing Caribbean cancer-care centers, Petersen said, but some local people balk at going to Puerto Rico because of language difficulties, and a facility in Barbados has had problems keeping specialized staff. The expectation is that the St. Thomas cancer center will attract patients from throughout the Caribbean. Carty said many Eastern Caribbean residents are now treated at RLS Hospital.
What will be gained, Petersen said, is that "patient care will all be coordinated." There's a need for comprehensive services to patients and help with ancillary services, he said, and particularly for patient follow-through..
He used the term "patient navigator" to describe a person who will be with a patient throughout the process from diagnosis to post-care, someone who will keeping checking to see that the patient keeps all appointments and receives all needed support. Such a "navigator," he said, might be pastor, surgeon, family member, friend, social worker, psychiatric worker or American Cancer Society support group volunteer. Again, he said, this is a community-education need.

Professional assistance at hand
Professional firms have been lined up to advise and assist with the project.
Kelley Simpson, Oncology Solutions vice president, outlined steps her firm will take in consulting on management and securing professional connections, analysis and marketing.
The center will be marketed to the U.S. mainland as well as the Caribbean, as part of the effort to become self-sustaining. "Where else could a patient go for world-class cancer care and be in such a beautiful setting?" Petersen said. With marketing, fund raising and access to federal grants because of the troubling V.I. statistics, there will be no problem with the center becoming self-sustaining, he said.
He stressed the need for collaboration with outstanding medical institutions, which is one of the mandates of Oncology Solutions, so that patients will have access to all possible treatments.
Julie Lux of Cancer CarePoint laid out the steps that company will take in recruiting specialists, which she said is "starting immediately." First to be chosen are two hematology/ oncology specialists who oversee chemotherapy. Early next year a radiation oncologist will be recruited, followed by nursing and technical staff to meet the expected 2004 opening.
The Atlanta architects, whose firm specializes in health-care facilities, explained their role in the project. "We reinvent what a hospital is," Stanley said, observing that patients often view a hospital as a place to be sick rather than a place to get better. The firm's aim is to create buildings that heal. The firm designed a "History of Music" exhibit for the rooftop garden of the new Brenner Children's Hospital at Wake Forest University in Winston-Salem, North Carolina.
Stanley, Beaman & Sears has just won a health-care environment award from the Center for Health Design for The AFLAC Cancer Center at Egleston Children's Hospital, Emory University, in Atlanta – a 240,000 square-foot facility. The firm will work with local architects and groups of users, cancer survivors and community members to create the V.I. center that will initially occupy some 12,000 square feet.
Its first task is site evaluation and determination for the center. Miller, however, was firm on Wednesday that the facility will be built on "this hospital's property, definitely." The decision will probably be announced in March or April, Stanley said.
For more information about the assisting firms, visit the Oncology Solutions, Cancer CarePoint and Stanley, Beaman & Sears Web sites.

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