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Governor Linda Lingle asked her audience to imagine: You are a woman with two young children and you have been diagnosed with breast cancer or that you are a man who has been told you have prostate cancer. Making her remarks at the grand opening of the Queen's Cancer Center, the Governor was describing the overwhelming nature of a cancer diagnosis, and how the Queen's Cancer Center has brought a multitude of scattered services together in one place of refuge for cancer patients. "This is a leap forward for [cancer] patients and their families," said the Governor, who has been a strong proponent of Queen's Cancer Center since her visit last year. "It is beyond anything I ever imagined."

The Queen's Cancer Center institutes a new era of cancer care: A program that not only provides the most advanced treatments in one place, but also guides patients and their families through every aspect of care and sees that all their needs are met. The patient-centered facility brings together virtually every aspect of cancer diagnosis and treatment, which minimizes the need for patients and their caregivers to make multiple visits to scattered services, or to travel to the mainland for treatment.

Patient Navigators guide cancer patients through every aspect of diagnosis and treatment. They not only help patients and their families coordinate appointments and services, but also assist with very practical issues, like who will take care of young children during treatment. Care management includes pre-admission planning, monitoring of treatment progress, transitional care planning from inpatient to outpatient and identifying follow-up home care. There is also a resource center in the Queen's Cancer Center for patient education, as well as an American Cancer Center staff member on-site one day a week. Patient navigators also direct patients to available community services. For those who are overwhelmed with financial issues, a Queen's Cancer Center financial counselor can help sort out bills. Also available are social workers and case managers. Other services include on-campus housing and coordination of transportation from the airport for those who live off-island.

The Queen's Cancer also offers the most advanced technologies for treating cancer. Queen's provides the world's best imaging technologies, including a new PET/CT scanner, two 64-slice CTs and new MRI equipment—all of which give physicians the most accurate images of tumors and the human bodyís structures possible today. A newly remodeled Radiation Therapy offers CT simulation, stereotactic radiosurgery and tomotherapy. The Queen's Cancer Center offers new chemotherapy infusion areas where patients are made as comfortable as possible during long procedures. On the surgical side, Queen's offers da Vinci minimally invasive robotic surgery.

The Queen's Cancer also offers the most advanced technologies for treating cancer. Queen's provides the worldís best imaging technologies, including a new PET/CT scanner, two 64-slice CTs and new MRI equipment, all of which give physicians the most accurate images of tumors and the human body's structures possible today. A newly remodeled Radiation Therapy offers CT simulation, stereotactic radiosurgery and tomotherapy. The Queen's Cancer Center offers new chemotherapy infusion areas where patients are made as comfortable as possible during long procedures. On the surgical side, Queen's offers da Vinci minimally invasive robotic surgery.

"The number of people to thank is countless, but we embody their spirit and that of the many cancer patients we've served over the years," said Art Ushijima, QHS President & CEO, of realizing the vision the Queen's Cancer Center. "Our role today is to confirm the mission of our founders, King Kamehameha IV and Queen Emma."

A Phillips PET/CT scanner, the most advanced available today, became operational the week before last at the Hamamatsu/Queen’s PET Imaging Center, the only hospital based facility in Hawai’i have one. The Queen’s Medical Center has the largest and most active nuclear medicine department in Hawai’i, combining both clinical nuclear medicine and research.

Both PET (Positron Emission Tomography) and CT (Computerized Tomography) are well established diagnostic imaging tools that physicians use to locate cancer before making treatment recommendations. Both have strengths and limitations. In the past, PET and CT scans were done separately, presenting difficulties in matching the scans due to slightly differing body positions. However, when PET and CT scans are done together and fused, the combined image provides a powerful diagnostic tool that gives complete information on cancer location (structural) and metabolism (physiological).

A patient is first scanned by the CT portion of the scanner and pictures of the body’s internal structures are created, along with the location, size, shape and mass of tumors. The patient, who has been previously injected with a glucose/radioisotope tracer, is then scanned by the PET portion of the scanner. PET images show metabolic hot spots, which often indicate rapidly growing tumors (cancer cells consume glucose faster than normal or benign tissue). Radioisotopes are manufactured at the Liholiho Cyclotron Building at Queen's.

CT and PET images match up perfectly, giving physicians more detailed and accurate information than ever before. In some instances, the CT scan will show that the structure of a tumor has not changed from a previous scan, but the PET will detect where the tumor is growing, indicating that treatment should cover a larger area. The majority of Hamamatsu/Queen’s patients are oncology patients. The PET/CT scanner is used to determine the stage of cancer or the restaging of cancer in response to chemotherapy and/or radiation treatment. The benefits of combined PET/CT scans include earlier diagnosis, accurate staging and localization and precise treatment and monitoring. The system is also capable of doing heart and brain scans.

Patients who desperately need care need to be able to access it—and quickly. So when the staff of the top cardiac care hospital in Hawaii—The Queen's Medical Center—insists on accepting cardiac transfer patients no matter what, it translates to saved lives and better outcomes. All it takes is one call to the Cardiac Transfer Center; Queen's staff does the rest. (The Cardiac Transfer Center can be reached at 808.547.4707, or toll-free at 1.877.762.4931 from the neighbor islands, 24 hours a day, seven days a week.)

The Cardiac Transfer Center was conceived by Queen's Heart two years ago to make transfers of cardiac patients quick and easy when a vital diagnostic test or treatment option is not available at another hospital. With the broadest range of cardiac services in the State, staff at Queen's Heart felt an obligation to meet the needs of cardiac patients. From September 6, 2005 to June 30, 2006, 446 patients were transferred. Transferred patients jumped to well over 700 in the next year.

Not a single patient has been refused. "The key is to say 'yes,'" says Tom Williams, RN, director of Cardiac Non-Invasive Services. Queen's Heart has taken the stance that there is no reason to refuse a patient—unless a transfer is unsafe for the patient. At the heart of the Cardiac Transfer Center is Garla Souza-Roy, RN, and Heather Texeira, RN, who take most of the calls. Three nurse practitioners, Williams and Cathy Young, RN, vice president of Patient Services, Cardiac Medicine and Geriatric Services, help cover.

The Cardiac Transfer Center does a transfer report, secures the services of a requested cardiologist (or finds one) and makes all other arrangements, including air and ground ambulances. The average transfer time is 3 to 4 hours. Souza-Roy and Texiera give a lot of credit to the nurses of Queen's Cardiac Comprehensive Care Unit and Pauahi 6 for their cooperation and flexibility. The Queen's Emergency Department and Bed Control staff also help make transfers a success.

Key to the process are Queen's cardiologists. "The doctors are a huge asset in answering calls at all hours of the night for patients who don't have a cardiologist," says Texiera. Says Souza-Roy: "Ultimately, things get done on behalf of patients, and they receive services they can't get elsewhere."

Renovations of the Admitting area at The Queen's Medical Center were recently completed. The soft green color scheme is dominated by a large curving glass wall creating maximum patient privacy in an area that, for convenience, must be in a public, high traffic zone. There are now two check-in stations in front with the potential for a third should the need arise. A wood floor replaces the previous carpet treatment of the area, facilitating quick and sanitary cleaning.

Patients check in at Admitting from 5:00 am until 9:30 pm. Most are pre-registered and just need to have their registration activated with their signature and ID presentation. Patients who are not pre-registered have a slightly longer process, which is done in the back where patient service representatives can assist them in redesigned cubicles to assure complete privacy.

Although the waiting area looks smaller since the renovation, that's actually a good thing. "We don't want patients waiting too long," says Rae Leong, manager of Admitting & Patient Financial Services. "We should be admitting them quickly, and now we can."

Imaging at The Queen's Medical Center recently made major upgrades in technology. All CT scanners have been replaced with the latest, high tech scanners. In addition, a 1.5 Tesla MRI scanner was also installed. The new MRI scanner uses advanced technology software to provide better and more imaging capabilities to radiologists.

CT, or CAT (computerized axial tomography), scanning, uses x-ray technology, while MRI (magnetic resonance tomography) uses magnetism and radio frequency technology. Although there is some overlap in the two technologies, CT scanning is much faster, taking as little as 10 to 20 minutes for multiple areas of the body, so it is useful for diagnosing trauma patients. MRI scanning is better on soft tissues like the spinal cord and muscles, but can take 30 to 45 minutes, depending on how many parts of the body need scanning.

Queen's purchased two 64-slice CTs and one 16-slice CT. The old CTs were 2- and 4- slice scanners. "Slice" refers to the number of detectors in a scanner. The new CTs are extremely fast and significantly reduce the motion factor. They can image a "slice" of tissue just 0.5 millimeter in thickness, 50% thinner than the old ones, and have greatly increased image clarity to detect smaller lesions. Because more anatomical information can be seen than previously thought possible, problems such as blood clots, infections and cancer can be diagnosed earlier with greater detail and clarity. Also, new computer software can generate three dimensional images from any angle. The speed of the 64-slice CTs allow Queen's radiologists to perform cardiac CT scanning—the imaging of the heart in motion—for the diagnosis of coronary artery disease. The 16-slice scanner is being used for fluoroscopies. When a physician performs a biopsy, they can "see" organs in real time—like watching them on TV—to guide the needle for a faster and safer procedure. For patients, exam times are shorter and there is reduced x-ray exposure.

Down the hall, the new "short bore," 1.5 Tesla MRI allows patients to literally see the light at the end of the tunnel. MRI staff will be able to talk many mildly claustrophobic patients through exams. "Tesla" refers to the strength of the magnetic field; a stronger magnet means better quality images and shorter scan times. Queen's has one long bore and, with the new MRI, two short bores (4 feet deep).

The new MRI will cut scan time in half for inpatients and outpatients. However, the feature which makes the new MRI stand out is the advanced technology software that will be used with it. The software allows physicians to detect the spread of brain tumors earlier by defining white fiber tracks that connect the various areas of the brain. It can also see brain injury otherwise invisible on older MRI scanners, detect prior brain injuries, hemorrhages and congenital abnormalities. Queen’s is the first in Hawai’i to use the advanced technology software.

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