Three essential questions when considering a new proton therapy center

March 13, 2017
Rad Oncology Proton Therapy
From the March 2017 issue of HealthCare Business News magazine

As medical planners and architects, this information informs even the most basic design decision: the building footprint. With the data above provided, we can derive the volume of patients throughout the day, which, in turn, informs the number of rooms needed to treat the population.

How much space do I need?
Each proton therapy center is unique. Their areas of excellence, their throughput expectations, their case mix — all must be fully vetted. Consider that each tumor type requires patients to spend an average amount of time in the treatment room. Three prostate cancer patients can be treated in one hour, while a child being treated for a brain tumor will require far more time due to the need to sedate the patient, accommodate family and move into a post-treatment recovery room. The tumor type tells us, in general, how many treatments the patient will need over time, and how long they will be in the room for each visit. Although we never lose sight of the fact that these patients are being treated for life-altering illnesses, the formula that drives the decision around the size of the center, and hence, budget, is actually quite simple.

Unlike other types of construction, proton therapy centers are not scalable. Whether the plan calls for one treatment room, or three, the cost per square foot remains relatively constant, and significant, due to the highly specialized nature of the construction, and system, and the equipment installation and commissioning. Over the years, we’ve coached clients through the questions, often working with consultants such as Linda Mischel for feasibility studies, and Leonard Arzt, former executive director of the National Center for Proton Therapy. Each proton center design is finalized through dialogue between the design team and the owner, but the range of sizes appears to be consistent among the many studies we have completed. The surface listed is for the bunker and all clinical spaces:

• One-room proton: 20,000 to 25,000 square feet.
• Two-room proton: 45,000 to 50,000 square feet.
• Three-room proton: 60,000 to 70,000 square feet.

The cost for an average large-size proton therapy center, the size of a football field, can be between $120 million and $200 million, with equipment. These centers typically house four to five treatment rooms, and are able to treat around 1,500 patients a year. A compact one-room proton therapy center, able to treat 200 to 300 patients per year, will cost approximately $30 million, with equipment.

Most of our clients are interested in scaling up over time. In every such case, we recommend building that additional room now and equipping it later. It is far more cost-effective to prepare for additions with the original construction than to add on later. With the essential questions answered and the size of the proton therapy center determined, the rest of the now fully informed design scenario can be developed.

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