Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, July 1, 1993 TAG: 9307010281
SECTION: CURRENT PAGE: NRV-1 EDITION: NEW RIVER VALLEY
SOURCE: GREG EDWARDS STAFF WRITER
DATELINE: LENGTH: Long
For the past three weeks, Martin, 67, has made a daily van ride with four or five other cancer patients to Lewis-Gale Hospital in Salem for radiation therapy.
Although he's handling therapy well except for his hair falling out, Martin said it would be great to have a treatment center in the New River Valley.
Patients throughout Southwest Virginia have to drive to Roanoke, Salem, Richlands or Bristol, Tenn., for such treatment.
But that may change.
Radford Community Hospital and Pulaski Community Hospital are competing for state permission to set up a cancer treatment center offering radiation therapy. Lewis-Gale Hospital in Salem is also challenging Radford and seeking approval for a second radiation therapy machine.
Because Radford applied in an earlier review cycle than Pulaski to state Commissioner of Health Robert Stroube, it may beat out Pulaski Community for the right to operate a center in the New River Valley.
A ruling by Stroube on Radford's request to build a $3.18 million free-standing treatment center on Arbor Drive in the Market Place shopping center in Christiansburg is already past due. Under a normal time frame, Stroube would have made a decision on Radford's application in early June.
Stroube is waiting on a recommendation from Raymond Perry, a Health Department hearing officer.
But his advice has been delayed until a circuit court judge decides whether Radford's application was filed in a timely manner under Health Department rules.
Lewis-Gale challenged Radford's application in court, saying it was improperly filed. If the judge rules in Lewis-Gale's favor, the Health Department could appeal the ruling to a higher court, which could further delay a decision on Radford's application.
Lewis-Gale, which already offers radiation therapy, has its own competing application pending to buy a second radiation therapy machine.
The Southwest Virginia Health Systems Agency, which reviews applications for health-care projects in this part of the state, has recommended approval of Radford's proposal and denial of Lewis-Gale's.
However, the staff of the Health Department's Office of Resource Development has recommended that both Radford's and Lewis-Gale's applications be denied.
The area to be served by Radford's proposed center is not really that far from the Roanoke-Salem area where there are three machines at Roanoke Memorial Hospital and one at Lewis-Gale, said Paul Parker, director of the Office of Resource Development.
Parker indicated that his staff might look more favorably on the Pulaski proposal, should Stroube deny both the Lewis-Gale and Radford applications. Pulaski is "obviously a little farther away from Roanoke and Salem" and that would have to be taken into account, he said.
The primary service area for the treatment centers proposed by both the Radford and Pulaski hospitals is: Carroll, Floyd, Giles, Montgomery, Pulaski and Wythe counties and the city of Radford.
Dr. Margaret Robinson of the New River Health District says that a cancer center is needed in the New River Valley. Good transportation between the valley and Roanoke is lacking and the trip can be stressful for patients, she said. Both hospitals "are equally qualified to provide the service."
Radford Community is a member of the Roanoke-based Carilion Health System. Radford's proposed center also would offer chemotherapy treatments now provided by a Carilion doctor's group at another location in Christiansburg.
Radford says its center would serve 250 patients yearly by 1995 and 320 yearly when it reaches its top capacity. It plans to offer radiation services at $150 per visit, which represents an 8 percent profit, compared with proposed per visit costs of $328 by Lewis-Gale and $320 by Pulaski Community.
Pulaski Community and its sister hospital in the Health Trust system, Montgomery Regional Hospital, both oppose Radford's plans. The new center would be located near the Montgomery County hospital in the heavily built-up U.S. 11/460 corridor.
Administrators at both hospitals say that Radford's proposal for a free-standing center and its plans to use a rebuilt radiation machine are not in the best interest of cancer patients.
Gene Wright, administrator at Montgomery Regional, said he believes Radford's motives go beyond cancer treatment. He suspects Radford will offer radiology and other laboratory services at the center.
"In all honesty . . . I feel the cancer center proposed by Radford in Christiansburg is a disguise to enter the outpatient market less than a mile from our door," he said.
Montgomery Regional has just spent $11 million to improve its outpatient services and competition from Radford could drive the cost of services up, he said.
By planning a free-standing center, Radford is not offering the same standard of care that Carilion offers patients in Roanoke, Wright said. A hospital patient who needs radiation therapy would be forced out into the weather four different times to visit a free-standing treatment center, Wright said.
"If we are going to do it and do it in the interest of the patient, let's do it right," he said.
By locating the center on U.S. 460 in Christiansburg and closer to Roanoke, Radford is still directing Virginia cancer patients in the western portion of the proposed service area toward Tennessee for treatment, Wright said.
But Susan Lockwood, a spokeswoman for Radford Community, said the hospital does not have room at its current location to build the center. A new Radford hospital planned for the Virginia 177 corridor in Montgomery County will not be finished until 1998, she said.
Chris Dux, administrator at Pulaski Community, agreed that the Christiansburg-Blacksburg area has the largest population in the proposed service area but said it is a younger population and less in need of cancer treatment services than the older population in the western part of the service area.
Pulaski Community has been offering some cancer treatment services for several years through an arrangement with Lewis-Gale. Before the Pulaski and Montgomery hospitals were spun off into Health Trust they were both owned by Hospital Corporation of America, which still owns Lewis-Gale.
Besides offering a better location, his hospital is offering to install a better piece of equipment than the refurbished machine that Radford plans on using, Dux said. Pulaski would buy a new state-of-the-art linear accelerator with two radiation settings, capable of reaching tumors in the body that the Radford unit could not reach, he said.
But Lockwood said Radford is comfortable with using the machine that it has proposed.
The factory rebuilt machine that Radford plans to use can do anything that doctors need it to do, said Dr. Bob Heath, medical director of radiation oncology at Carilion's Cancer Center of Southwest Virginia in Roanoke. Doctors in Heath's group would staff Radford's Christiansburg center.
The rebuilt machine could operate at two different radiation levels, the same as the one proposed by Pulaski; but the center's planners have chosen not to have the higher radiation capability of the machine turned on until it is determined that it's needed, Heath said. The hospital was attempting to be cost conscious in its planning, he said.
Heath said a study of patients coming from the New River Valley to Roanoke for radiation treatments showed that only 10 percent to 15 percent or two to three patients a month might need to come to Roanoke for treatements at the higher level of radiation.
Radiation beam for radiation beam, the used machine proposed by Radford and the new one proposed by Pulaski are identical, Heath said. He challenged anybody to show a difference.
The four-month review period for Pulaski Community's application does not begin until July 10. Radford also has an application pending during that period in the event the court throws out its current application on the technicality.
by CNB