Cancer institute: a look inside


A long-anticipated cancer treatment center is continuing to take shape outside Avera Marshall Regional Medical Center. And as participants in a recent hard-hat tour of the construction learned, things are taking shape on the inside as well.

This summer, construction crews have been working to complete everything from radiation and chemotherapy facilities, to more public areas of the Avera Cancer Institute Marshall.

About 16,500 square feet of space is being added or remodeled at Avera Marshall to build the cancer institute and other improvements, said Avera Marshall Environmental Services Director Kevin Schroeder. From the outside, the most visible parts of the construction include brickwork and construction on a large, open area near the hospital’s current main entrance.

The overall design of the cancer institute is planned to blend with Avera Marshall’s Bruce Street clinic building, with some added touches like Kasota limestone accents.

Schroeder said the open area near the main hospital entrance will become part of a new entryway and lobby area for both the hospital and the cancer institute. The space will feature large windows to let in natural light, a seating area and a fireplace. The area will also feature a “Heritage Wall,” with a mural display showing the timeline of the Marshall hospital’s history.

When the new lobby area is built, the Avera Marshall Auxiliary’s gift shop will also have space to expand, Schroeder said.

One of the central features of the cancer institute, and one of the earliest parts of the project to begin construction, is the concrete vault where radiation therapy treatments will take place. While the vault will be finished into a patient-friendly treatment room, it’s still a bit bare at the moment. Schroeder said 75 tons of rebar and 10,000 yards of concrete went into the construction of the vault. The walls are six feet thick, and portions of the interior walls are also lined with lead bricks, each weighing more than 60 pounds.

The concrete and lead act as a shield, to help safely contain any radiation.

An indentation in the vault floor marks the future location of part of the linear accelerator, the machine that provides the radiation for cancer treatment.

A linear accelerator works by producing a beam of powerful X-rays, said Steven Black, vice president of The Oncology Group. The Oncology Group is working with Avera Marshall on the cancer institute project. The beam of X-rays can then be positioned over part of a person’s body, while he or she lies still on an adjustable table, Black said.

“When the switch is on, the beam is there to treat the patient,” he said. When the accelerator isn’t in use, there’s no radioactivity.

Schroeder and Black said the cancer center will make use of IMRT, or intensity-modulated radiation therapy. With IMRT technology, Black said, the linear accelerator equipment will be able to adjust the shape, intensity and direction of the X-ray beam. IMRT allows the radiation to be focused on tumors while helping to protect the rest of a patient’s body. In radiation therapy 30 or 40 years ago, the same job had to be done by making lead patterns that were loaded onto the equipment for each new patient, Black said.

“It’s really remarkable,” Schroeder said of the new technology.

It will take several weeks to ship the particle accelerator to Marshall.

“It’s scheduled to be here the week of September 8th,” Schroeder said. The accelerator is big and heavy enough that it will also need to be brought into the vault in pieces and assembled there, he said. After that, there will be a 19-week period where the accelerator is calibrated and tested by a team of physicists.

In addition to the vault, the cancer center includes space for chemotherapy treatment. During a recent hard-hat tour of the construction, metal support frameworks marked the location of hallways, exam rooms and waiting areas, as well as chemotherapy bays. There will be four chemotherapy bays at the cancer center, as well as two more private chemotherapy rooms, Schroeder and Black said.

Schroeder said consultation with cancer patients “was really a vital part” of forming the cancer institute’s design. For example, feedback from patients helped determine the number and location of restrooms and changing rooms. Having flexible design elements like sliding door panels allow patients more privacy if they want, or gives patients a chance to meet each other and lend each other support. Schroeder said community artwork and photography submissions, combined with stories from people who have been affected by cancer, will help add to the decor.

Gordon Crow, Avera Marshall Foundation executive director, said community connections are a strong influence on the cancer institute, in more ways than one. People from around the region have contributed to make the institute possible, including around 1,400 individual donors to the cancer institute’s fundraising campaign, he said.

“It speaks well of the communities (in southwest Minnesota),” Crow said.

Crow and Schroeder said the cancer institute should be occupied and offering chemotherapy by early November. The first radiation therapy treatments should begin in January or February.