In the Miami Cancer Institute, part of Baptist Health South Florida, is a victory bell. A rope hangs from it, waiting for its moment. The only people allowed to ring it in celebration are cancer patients who have completed their treatments, defeating the disease.
Separately, by the pediatrics oncology wing is a victory gong, rather than a bell. It is enshrined in glass and flanked by two mallets. These quirky, victory percussion instruments represent the spirit of MCI.
But MCI is at over-capacity. First opened in January 2017, it was meant to host 800-1,000 daily visits. Now, the building sees an average of 1,200-1,500.
For decades, the global cancer rate has slightly risen while mortality has lowered. Improved early detection and aging populations means more to treat, as cancer probability rises with age. About 18% of deaths globally are caused by cancer, around 28,000 lives every day. But innovation and determination lets medical specialists battle the disease with ever better solutions, including empathetic care.
“Not even six months of me being here, my mother was diagnosed with breast cancer,” said Erika Marin, a spokesperson at Baptist Health. Her experience as both worker and caregiver let her bear witness to “this horrible disease. I was able to see why we are who we are. You know, it’s incredible the work that we do.”
Among the radiation oncology facilities at MCI are the vaults, sealed by doors that “weigh about 35,000 pounds,” said Marin. These vaults are shielded by thick concrete walls, while radiation levels are measured. The Cyber Knife specializes in targeting moving tumors, locking its aim to kill malignant cells while sparing healthy tissue. One such case is lung cancer, the third most common cancer in the U.S. and the deadliest by total number of annual deaths. When patients breathe, their lungs move, complicating radiation aim. Technology like Cyber Knife helps guard against that obstacle.
Another type of radiation oncology at MCI is proton therapy, which targets tumors with high energy protons. The gantry head, which emits the protons, can rotate around the patient bed by 360°. The bed is also adjustable, allowing any targeting angle.
“Proton (therapy) can be used on multiple different cancers,” said Justin Morales, a radiation therapist. These technicians target cancerous cells with millimeters of accuracy. This power to spare surrounding tissue means that proton treatment is prioritized for children.
The therapy “is going to give them the best chances to not have any effects growing up,” said Morales.
The room is designed to soothe patients; with rounded corners, colored lights and music speakers. Even the radiation-shielding masks — one is painted like the Spiderman character — become fun.
“You build a bond,” said Morales. “You build a connection with other people, and it’s incredible.”
The masks also ensure patients remain still while receiving treatment. Minor movements during therapy will activate an instant shutdown, to avoid harming non-malignant tissue. A microphone and camera also let caregivers monitor patients from behind the protective plexiglass divider. The walls are thick concrete and the proton machines weigh 22 tons each, hidden in a separate area behind the gantry.
In fact, these machines are so energy intensive, they are powered by the “cyclotron.” Imported from Belgium, weighing 220 tons and buried three stories down, this mini-nuclear reactor is federally regulated and powers only the proton gantries. Engineers are on permanent standby at MCI, ready to help with any potential reactor problem, to ensure treatments are uninterrupted.
“Each one is three stories high, three stories wide,” said Morales, of the proton machines. “It spins the hydrogen, creates the protons and spits them out into the machine.” But their scale also hints at their limits. Morales explained that “capacity” limits the three machines, unable to serve all of the many cancer patients who need it. Hence, children receive priority.
Proton beam therapy is the least invasive radiation therapy. Other treatments can lead to later side effects more often. However, PBT is more expensive; from $150,000 to over $200,000 for a course of treatment in the U.S.
Cancer treatment, for various reasons including the costly facilities described, is expensive. Averaging $40,000 for initial care, with subsequent costs for later treatments. Meanwhile, 8% of Americans lack health insurance, while half have less than $5,000 saved. With the Trump administration cutting federal grants to healthcare, some industry figures worry over the impact on both research and costs.
“Less people (are) available in the workplace today,” said Steve Holan, vice president of operations at MCI. When describing the healthcare workforce situation, he mentioned how older generations are leaving, with too few younger workers ready to replace them. Nationwide, this shortage is caused by lack of training, job burnout and professional scarcity in rural areas.
Still, the crusade must continue, despite the difficulties.
“A nodule in my breast that tested positive (for cancer),” said Luz, an anonymous patient who spoke in Spanish. Luz is a pseudonym. She had been receiving treatment since last September, speaking gratefully about MCI staff. Luz also praised the design and open spaces, saying, “That is important, that one feels good for the patients.”
Luz is not alone. Breast cancer is the second most-common and second-deadliest cancer for women; explaining why “about 60% of (MCI) patients are women,” said Holan. Hence, why MCI is building the Women’s Cancer Center, to improve wait times and treatment.
But despite the difficulties, patients’ journeys are more than chemo-infusions, radiation and surgeries. These journeys also include buildings built for joy.
The Infusionarium, surrounded by similarly colorful rooms and halls, has four large TVs linked to a DVD player and an Xbox console. “It’s immersive medicine,” said Holan.
The Infusionarium was designed by Michael Hundgen, a senior imagineer from Walt Disney World. Inspired by his own cancer struggles, Hundgen considered what would comfort children experiencing chemotherapy. Of the room, Holan said, “When patients come here, they can go anywhere they want. They can go on safari, they can go scuba diving, they can go to outer space.”
Pediatric patients also celebrate holidays, like at Christmas when “Santa Claus” visits the wing with gifts. Year-round, artists also join children to craft art projects.
Art is also available to adults, alongside massages, acupuncture and yoga. A brain exercise lab lets chemotherapy patients stretch their mental muscles, as cognitive decline is a common side effect.
“One never expects to have it (cancer),” said Luz. “It’s been difficult, but well, I’m in the hands of God.”
