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California Cancer and Research Institute

Cover Story

Issue: July 2009

By: Stacy Schwan

In October 2008 treatment options for patients with cancer in the East Bay improved dramatically when the doors opened to the California Cancer and Research Institute in Pleasant Hill. As the largest non hospital-affiliated freestanding cancer treatment facility in Contra Costa County, already the center has managed to provide what every cancer patient hopes for: the very best in leading-edge cancer treatment offered in an environment that feels welcoming and personal.

“The center evolved from all of us partners saying that we want to have more comprehensive services for cancer patients in our community,” says Dr. Matthew Sirott, President and CEO of Diablo Valley Oncology and Hematology Medical Group. “All of us came to this community from cancer centers in various parts of the country. We had great physicians, we had great supportive services, yet we had no cancer center.”

Soon after forming Diablo Valley Oncology in 2001, located in Walnut Creek, the partners began increasing the range of cancer services they could provide. They started by forming the Bay Area Cancer Research Group in 2002, which enables patients to participate in clinical trials. “Because we’re close to Genentech, we get a lot of their trials, which include very interesting new compounds that are not on the market,” Dr. Sirott says. “We also have access to national clinical trials, so it gives us a broad rand of clinical trial menu for patients who are interested.”

In 2003 the partners created the California Imaging and Treatment Center and equipped it with one of the first two PET-CTs in Northern California (Stanford acquired the other at about the same time). Then, in 2005, the partners decided the time had come to open a completely comprehensive cancer center. After two years of searching for property they located a three-story building in an ideal setting in Pleasant Hill and began construction in 2007. Eight months later the completed California Cancer and Research Institute opened for service. (Diablo Valley Oncology also maintains satellite offices in San Ramon, Brentwood, and Rossmore.)

The result is a contemporary and serene space where patients can come for everything from medical oncology appointments, radiation, chemotherapy treatments and diagnostic imaging, to clinical trials and supportive services such as nutrition counseling and patient education. Lush green trees surround the building’s exterior, so the view from every window and even from every chair in the chemotherapy suite is relaxing and peaceful. Also on the grounds stands a massive, 200-year-old oak tree, a peaceful giant offering patients and staff alike a place to reflect, regain perspective and renew hope.

The best cancer technology available under one roof

One of the center’s big “wow” factors is Elekta Synergy, a radiation treatment system that integrates a suite of advanced imaging tools with a digital accelerator to enable 3-D image guidance at the time of treatment. “What this community did not have previously was a modern radiation facility with state-of-the-art technology,” says Dr. Sirott. “IGRT (image-guided readiation therapy) is a new technology to this region.” He says they chose Elekta in particular because, instead of merely adapting their radiation machines as technology improved, “Elekta retooled their entire line, and the entire machine is one unit, one digital piece, operated from one screen. It’s just a very well coordinated piece of equipment.”

Dr. Sachin Kamath, Medical Director of Diablo Valley Oncology’s radiation oncology center, concurs. “Elekta was one of the first manufacturers to incorporate this image guidance capability into the machine. One of the technologies that they pioneered was arc therapy, which allows us to do a faster version of IMRT (intensity modulated radiation therapy). This technology allows us to focus the radiation better on our target, spare normal tissues, and deliver the radiation in less time than conventional radiation therapy.”

The center is also equipped with a “high definition” PET-CT imaging system, which integrates functional sensitivity of PET with the detail of diagnostic multislice CT. Manufactured by Siemens, the Biograph TruePoint 6 PET-CT detects smaller legions, provides faster scans, and requires lower doses than traditional PET-CTs.

Gathering state-of-the-art equipment and multiple specialties under one roof does not automatically guarantee better coordination of treatment, however. “The key for us is interconnectivity between the various departments,” says Dr. Sirott. For this, another vital piece of the technology puzzle was needed: the electronic medical record (EMR). The EMR they chose for the center is Impac Software, also by Elekta. Specific to oncology, the Impac EMR runs the radiation machines, stores imaging pictures and data, and performs numerous other functions such as calculating doses. Therefore, every test, scan, medication or other event that takes place in one department is automatically available to all the others. “It’s an interconnectivity that is typically only available at academic centers and very well coordinated community centers like ours,” explains Dr. Sirott.

Making things easier for both physicians and patients

All of this physical proximity and interconnectivity not only facilitates communication between physicians and reduces potential errors; it benefits patients through quicker and more convenient service.

“It really allows an ease of treatment that couldn’t be done before we were in one center,” Dr. Sirott says. “If I see a patient, order a PET-CT, evaluate it, and decide this person needs to see a radiation oncologist, they can do so in the same building, on the very same day. The radiation oncologist can then evaluate the PET-CT the same day, he can use the PET-CT to simulate the patient the same day, and we can treat the patients the same day, if necessary. You can’t do that if you are not all at the same site and working together.”

“Even the academic centers, which have all of these pieces, are still harder to utilize,” he adds. They’re cumbersome, complex systems. That’s the benefit of a community center; you don’t have to travel as far and we can get you through the system a whole lot easier.”

Dr. Kamath, who personally designs the treatment plans for every one of the patients, also appreciates the ease of having everything located under one roof. “One thing that makes us different is that we can easily coordinate the overall treatment with regards to incorporating chemotherapy and radiation therapy,” he says. “I’ve got the medical oncologist upstairs, an imaging center right next door, so communication between the doctors is much easier here and we coordinate treatment better.”

“Many patients today get radiation therapy and chemotherapy at the same time, so it’s great for them to come to our center for both and not have to do so much running around,” Dr. Kamath adds. “The thing I hear the most from patients is, ‘You’ve made this so much easier for me. I can see all my doctors here, I can get my treatment here, and not only are you communicating well with me, but I know that you guys are talking to each other.’”

Treating patients like family

“When someone is first told that they have cancer, they are shocked, they’re scared, and of course they want to get the best treatment they possibly can,” says Dr. Kamath. “I think this facility is very unique in that we don’t treat cancer, we treat patients with cancer.

“ What makes us different is that we use the most advanced proven technologies to deliver the same level of care as a Stanford or a UCSF, but we can also do it in a very personalized way,” he adds. “We take care of each of our patients as if they were a close family member.”

“An important message to primary care physicians (PCPs) is that we’re a partner with them,” says Lori Orr, COO of Diablo Valley Oncology. “Most of them have been with their patients for years. They’re part of the patient’s family. The PCPs are sending their patients to us, and we’re treating them as part of our family too.”

“My experience in working with our doctors is they really are in touch with what the community needs,” Orr adds. “Where the needs just aren’t there, or are not being met, they’ve come together to find the resources and the wherewithal to provide it. They have the understanding and the sensitivity specifically for cancer patients about how difficult their journey is. To have something like this cancer center is such a gift to this community.”

Big plans for the future

Only nine months after opening the center, and with an entire third floor yet to be utilized, Dr. Sirott is already busy dreaming up more big plans for the future. “I get excited about new ideas and I come up with them a lot,” he says.

As a physician caring for sick patients and the president of a comprehensive cancer center, Dr. Sirott doesn’t get much downtime to pause and reflect. However, every once in a while he’ll stop for a brief moment at the window to contemplate the old oak tree outside and enjoy the fruits of his labor. “It’s like a big puzzle, and it’s a challenge to get it to fit together. The vision is to fill this place with every possible cancer service that is within our means. The goal is for this center to be the top freestanding clinical facility in Northern California. But really the bottom line is, we know patients get better care than what we were able to do before, and better care than what most places can do on a routine basis.”

“I really love this place,” he says with genuine feeling. “You look at it and you say ‘this is what a cancer center should be.’”

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