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Boston isn’t the only city slated for a new cancer center. Far from it.
There’s little appetite to build general acute-care hospitals, especially as their financial outlook dims and more services move outpatient. So on its face, Dana-Farber Cancer Institute’s plan to build a new cancer hospital with Beth Israel Deaconess seems peculiar.
Cancer centers, though, are having their own sort of renaissance. This year alone, at least six prominent cancer centers have announced plans to build new hospitals in cities like New York and Chicago. Experts say it’s largely driven by the advent of targeted precision therapies like CAR-T, which are still mostly delivered in hospitals.
“We are seeing a pretty significant investment from the top-tier cancer centers when it comes to building additional inpatient beds and creating a dedicated inpatient environment for cancer patients,” said Mike Brown, a director at the consulting firm Chartis and co-leader of its oncology solutions practice.
In fact, all of this year’s newly announced hospitals have one thing in common: They’re among the country’s 72 National Cancer Institute-designated centers, meaning they’re considered the best in research and patient care.
In Boston, leaders with NCI-designated Dana-Farber and Beth Israel Deaconess acknowledged a lot of cancer care is moving into outpatient settings, but said there still aren’t enough beds to care for all the cancer patients who need care, especially given the rising incidence of cancer.
Exciting developments like CAR-T, where a patient’s own T cells are removed, trained to recognize cancer and then re-administered back to the patient, are curing patients’ cancer, but they also carry significant risk, said Karen Knudsen, CEO of the American Cancer Society and former oncology head at Jefferson Health’s Sidney Kimmel Cancer Center.
“The safety of doing that in an outpatient setting is really uncertain,” Knudsen said. “It is possible that could become a norm in the future, but right now, it needs to happen inpatient.”
This is happening even as technological advances and patient demand drive more cancer treatment — and treatment of all kinds, for that matter — into more convenient, cheaper outpatient settings. Today, there are more Food and Drug Administration-approved oral oncology treatments, and patients can use infusion pumps instead of going to infusion centers.
And while some cancers can be treated at smaller community hospitals, newer advances like CAR-T therapy, which requires expertise similar to delivering stem cell transplants, are being delivered in advanced cancer centers.
“In community settings, they’re probably not getting as much pressure on the inpatient side of things,” Brown said. “Organizations like Dana-Farber are in a very different world.”
CAR-T therapy has FDA clearance to treat blood cancers, including leukemia, lymphoma, and myeloma. Those cancers currently take up a disproportionate amount of inpatient beds relative to their total prevalence because they often need stem cell transplants and are hospitalized for weeks, Brown said.
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