Health Facilities in The Philippines PDF

MAPUA INSTITUTE OF TECHNOLOGY
School of Architecture, Industrial Design and the Built Environment

Manila, Philippines
A Proposed Low-Cost Oncology Center for the

Leading Cancer Diseases in the Philippines
Bio-mimetic Approach for Self-Sustaining
Healing Environment
A Thesis presented to
The Faculty of School of Architecture Industrial design and the Built
Environment
In partial fulfillment of the course requirements in

Architectural Design 11: Architectural Translation
For the degree of
Bachelor of Science in Architecture
Submitted by
Mary Gay A. Marquez
On
March 2013
“ Cancer is the killer disease that chooses no one. It is a serious matter that
most are afraid to talk about. This thesis attempted to go beyond the disease’s
stigma by presenting different methods of conveying the subject matter. All the
data gathered aimed to find a solution to the rising number of reported cancer
cases in the country which indicates that medical facilities cannot cope up with
the demand of its users, most especially for those financially incapable.
Healing architecture as influenced by nature was strongly emphasized and

highly recommended as a critical aid for the patient’s betterment. Hopefully
with this design proposal, future hospitals will also invest in nature for
patient’s better and faster recovery, not just from cancer but, also from other
diseases. ”
Abstract
Cancer is the killer disease that chooses no one. It is a serious matter that most are
afraid to talk about. This thesis attempted to go beyond the disease’s stigma by
presenting different methods of conveying the subject matter. Preliminary chapters
discussed cancer’s global and national issues and how to address these problems in
the best way as possible thru architecture. Literatures that were found to be
significant this thesis were Co-relating Filipino Health Awareness with their Health
Care Utilization and Financing, Relation of Physical Environment to Patient’s Wellness,
Trends in Cancer Center Design: Atmosphere that Promotes Healing and Wellness,
Medical Mall: One-Stop Shop for Health Care Needs, Reaching-Out to Patients in a
New Distant Way and Bio-mimicry: Looking at Nature as a Mentor. Methods of
research used were oral investigation with PSMO and St. Luke’s Medical Center;
library research; and case studies of St. Luke’s Cancer Institute and National Cancer
Institute in Malaysia. All the data gathered aimed to find a solution to the rising
number of reported cancer cases in the country which indicates that medical facilities
cannot cope up with the demand of its users, most especially for those financially
incapable.
Data-to-Design translation was discussed in the final chapters of the book. Area
computation of each space was based from governing building standards of the
country and the Time Saver’s Standard for Hospital Planning. The chosen site was
Novaliches, Quezon City, wherein it topped the site criteria list. Healing architecture
as influenced by nature was strongly emphasized and highly recommended as a
critical aid for the patient’s betterment. Hopefully with this design proposal, future
hospitals will also invest in nature for patient’s better and faster recovery, not just
from cancer but, also from other diseases.
Acknowledgements
First of all, I am thanking God for all the emotional and spiritual support
that I needed for the past nine months as I am doing my thesis. For all
those times that I doubting myself, whether to step forward or just give
up, He is always there. Thankfully, today it was finally over.
To my parents, Mr. and Mrs. Nestor C. Marquez, who have given me the
financial support and the opportunity of an education from the best
institutions and support throughout my life.
I owe my deepest gratitude to my thesis adviser, Arch. Anna Christina

Ealdama, whose encouragement, supervision and support from the
preliminary to the final thesis deliberation enabled me to develop a full
understanding of my thesis. Without her guidance and persistent help this
thesis could still be just a dream.
Also to my sister, Mary Grace A. Marquez, M.D., whose medical

knowledge and constructive criticisms help me in doing almost half of my
thesis works. If not for her, I will be blinded, stressfully, with all the
medical terms and hospital flow.
I am also thanking the only two persons among the five institutes who
generously gave their time for my oral investigation, Ms. Erlyn J. Banal
who is the PSMO Secretariat and Dr. Kitchie Antipuesto of St. Luke’s
Cancer Institute.
Lastly, I would like to extend my gratefulness to my Design 9-11 A.Y.

‘12-‘13 family. All the support that we had given to each other is
priceless! I will miss you all. God bless and good luck!
About the Author
Mary Gay A. Marquez is currently on
her fifth year as a student under BS
Architecture in Mapua Institute of
Technology.
She has
been a
member of
United
Architects of
the Philippines Student Auxiliary
(UAPSA Mapua Chapter). She is
passive when it comes to extra-
curricular activities but always on the
go for different school activities like
the annual Amazing Race during the
school week.
CONTENTS
1.0 The Problem Page
1.1 Background / Overview 1
1.2 Statement of the Problem 3
1.3 Project Goals, Objectives and Strategies 4
1.4 Significance of the Research 5
1.5 Review of Related Literature and / or Studies 7
1.6 Conceptual Framework 24
1.7 Research Methodology 25
1.8 Scope and Limitations of the Study 51
1.9 Definition of Terms 52
2.0 Research Focus

2.1 Rationale 54
2.2 Discussion of principles and relevance to the project 55
2.3 Recommendations for application 56
3.0 Architectural Programming Data

3.1 Site Selection Process
3.1.1 Setting the Criteria 58
3.1.2 Description of Site Options 60
3.1.3 Site Selection and Justification
3.2 Site Analysis
3.2.1 Laws and Ordinances Pertaining to the Site 64
3.2.2 Site analysis map/discussion 65
3.2.3 Site Development Options 70
3.3 Space Programming
3.3.1 User Profile 71
3.3.2 Users Analysis 73
3.3.3 Computation of spaces in relation to spaces 77
3.3.4 Spatial diagrams 89
3.4 Architectural Translation
3.4.1 Design concept – application of research focus 91
3.4.2 Site Development Plan 93
3.4.3 Floor Plans 94
3.4.4 Sections 101
3.4.5 Elevations 102
3.4.6 Details 104
3.4.7 Perspectives 105
3.5 Conclusion 108
Bibliography or References 109

Appendix 110
MAPUA INSTITUTE OF TECHNOLOGY 1
Chapter 1
The Problem
1.1 Background / Overview
Cancer is the killer disease that chooses no one. It begins in cells, which are the
building blocks of the body. Normal cells multiply when the body needs them, and die
when the body doesn’t need them. Cancer appears to occur when the growth of cells
in the body is out of control and cells divide too quickly. It can also occur when cells
forgot to die (http://health.nytimes.com).
There are many different kinds of cancers. Cancer can develop in almost any organ or
tissue, such as the lung, colon, breast, skin, bones or nerve tissue. Sadly, even up to
now determining what causes cancer is complex. But there are many things known to
increase the risk of cancer, including drinking excess alcohol, environmental toxins,
excessive sunlight exposure, genetic problems, obesity, radiation, benzene and other
chemicals, and viruses. These can directly damage genes or combine with the existing
genetic faults within cells to cause the disease. The chances of surviving the disease
vary greatly by the type and location of the cancer and the extent of the disease at the
start of the treatment. While cancer can affect people of all ages, and a few types are
more common in children, the risk of developing cancer generally increases with age
(www.medicalnewstoday.com).

United States of America has always been the forefront in science and research
pertaining to medicine and diseases. According to the US National Cancer Institute
Cancer statistics, in their country a new cancer is diagnosed every 30 seconds and one
person dies every minute in the US. Twenty-two point eight percent (22.8%) of their
total deaths is due to cancer. Whereas globally, according to World Health
Organization (WHO) cancer statistics, worldwide deaths due to cancer is projected to
increase 9 million in 2015 and as high as 12 million in 2030 thus, an increase of 1
million deaths every 5 years.
In relation with this alarming statistics, there is a growing argument between the cure
rates of orthodox/conventional cancer treatment and natural/holistic cancer
treatment. In Germany, 1,500 people die from cancer every day after treated with
chemotherapy. According to Professor Abel of the German research center on cancer
in Heidelberg, 98% of patients treated with chemotherapy drugs die within 7
years, and 95% of them die within 5 years. It was noted that 98% of those patients
who did not previously receive treatments with chemo survived (www.cancer-
treatment-tips.com).
Cancer has not been perceived as a significant health problem in the Philippines.
Infectious diseases typically receive more attention—available resources and
government funding remain grossly inadequate to deal with the alleviating cancer
cases in the country. Statistically, at least 70% of patients have advanced or incurable
cancers at the time of diagnosis. Approximately 70, 000 people die of cancer-related
each year, and it is expected that 100, 000 new cases will be diagnosed (de Guzman,

MD, 2007). This statistics are further elaborated in subchapter 1.7.2 Research
Methodology.
Another critical factor in the fight against cancer is the country’s inherent economic
status. Philippines, being one of the Third World countries, have a very high poverty
rate. Along with this unlikeable poverty rate is the common thinking that a certain
percentage of diagnosed cancer victims are poor. It is a fact that treatment is very
costly and will leave behind additional burden to the patient and their family, what
more if they are only minimum wage earners of Php420.00 a day? The situation
continually creates an immense challenge not only to the medical community but as
well as the whole Filipino nation. What would be the necessary strategies that could
help address these challenges?
1.2 Statement of the Problem
The rising number of reported cancer cases in the country indicates that medical
facilities cannot cope up with the demand of its users, most especially for those
financially incapable. Specifically, the study aims to answer the following questions.
 What approaches are necessary to promote an atmosphere of healing and
wellness in spite of the fact that the subject matter seems like very negative
and depressing?
 What architectural factors can greatly affect the competency of cancer
healthcare facilities as compared with those existing cancer institutes in the
country?

 What planning concepts or strategies can help the facility promote a self-
sustaining healing environment through architecture?
1.3 Project Goals, Objectives and Strategies
1.3.1 Client’s Goal
The main goal of the client is to enhance the quantity (longevity of their life
expectancy) and the quality (physical and emotional state) of life of those afflicted
with cancer; and meets the challenges on the national cancer awareness and
prevention.
1.3.2 Project Goal
The client’s goal can be achieved by the project if it can be able to determine the
significance of architecture in cancer management and prevention through identifying
which factors do existing facilities are lacking.
1.3.3 Objectives and Strategies
In line with the two given goals, here are its objectives:
 To develop a systematic flow of how users will move inside the
complex starting from cancer screening and prevention up to their
cancer diagnosis and survival
o Strategy 1: Research on the ambulatory services that
hospitals cater to their patients, especially for cancer cases,
and each corresponding cost

o Strategy 2: Research on screening techniques and latest
technology and approaches in managing cancer
o Strategy 3: Research on Filipino modern lifestyle that have a
direct effect on their health and being prone to risk factors
concerning cancer
 To know the psychological needs of cancer patients in determining
its impact on promoting an atmosphere of healing and wellness
o Strategy 1: Research on the most common psychological
needs of cancer patients based on other studies
o Strategy 2: Interview medical experts on how they approach
their cancer patients
 To develop a situational analysis of the existing cancer institute that
will highlight its positive and negative points
o Strategy 1: Compare and contrast foreign and local facilities
of successful cancer institutes
1.4 Significance of the Research
1.4.1 National/Economic significance
Most importantly, the study is beneficial to the poor cancer patients and their family.
The study does not only seek for their financial assistance but for their betterment in
the long run. It is not just a small talk but more of initiating extended opportunity for
their situation to be recognized by the government and non-government associations.
Once successful, it is likely hitting two birds with one stone wherein it create a great
impact on the country’s fight against poverty and health.

In addition, the study will also be a great help to the Philippine Society of Medical
Oncology (PSMO), aside from being the hypothetical client of the project. This is just
one of the few organizations that hold the principal responsibility of preventing and
managing cancer in the Philippines. Among all the other cancer organizations, PSMO is
the only organization exclusive for professional oncologist practicing in the country. It
is chosen by the researcher as one of the primary benefactors of the project because
the study could give them a chance to extend their practice and improve the quality of
their treatment for their patients.
Minor to the PSMO are the agencies of Department of Health (DOH), Philippine
Cancer Society (PCS) and other government and non-government agencies concerned
with fighting cancer. The study can somehow make them understand that there
should be vast improvements in public and professional cancer education initiatives
and sound implementation and coordination of multidisciplinary approaches to
cancer care within the framework of a cost-effective allocation of resources.
1.4.2 Architectural significance
If ever that the project would be implemented, it will be the first of its kind in the
Philippines. It will break the trend of cancer institute as only being part of the hospital
complex. Of course, the reason behind this context was also subject to proponent’s
investigation. Also, issues on cancer as a killer disease can give architects a chance to
practice their expertise in planning and building. They must take-in mind that cancer
patients are different from other patients and must receive utmost care in an efficient

environment. Therefore, this presents them a greater challenge in excelling in their
chosen field.
1.5 Review of Related Literature and/or Studies
The researcher has found the following studies and literature as relevant to the study
being proposed.
1.5.1 Co-relating Filipino Health Awareness with their Health Care Utilization and
Financing
The 2008 National Demographic and Health Survey (NDHS) included a module of
questions concerning health care utilization and costs. Full tabulated data of the said
survey results are given in the Appendix section of this study.
Table 1: Use of specific types of health facilities

According to the survey, as shown in Table 1, use of private health facilities increases
with economic status, from 1% among persons in the lowest wealth quintile to 6
percent among those in the highest wealth quintile. Information on specific types of
facilities and providers (public and private) visited by persons who sought care are
also included in the survey. Over one third ( ⁄ ) visited Rural Health Unit (RHU) or a
Barangay Health Center (BHC), one fifth ( ⁄ ) sought care at a private hospital, and
19% went to a private clinic for care. The use of RHU and BHC services decreases as
household wealth status increases, from 52% in the lowest wealth quintile to 11% in
the highest wealth quintile. The same pattern of results was obtained for the use of
private hospital services. According to the result, the use of private hospitals increases
with economic status, from 5% in the lowest wealth quintile to 46% in the highest
wealth quintile.
Table 2: In-hospital care

In Table 2, it shows the data in terms of in-patient hospital care. Persons who were
confined in a hospital or clinic were about equally likely to have been in a public
facility as a private facility: 51% of in-patients were confined in public health facilities,
while 48% were confined in private health facilities. Private hospitals account for the
largest share of those who were confined, followed by provincial hospitals, regional
hospitals, and district hospitals.
Similarly persons in urban areas are more likely to use private facilities than those in
rural areas. Among those who were confined, use of public facilities decreases as
economic status increases, from 77% among persons in the lowest wealth quintile to
23% among those in the highest quintile.
In a privilege speech delivered at the House of Representatives by Rep. Satur C.
Ocampo of Bayan Muna Party-List, he mentioned a survey conducted on August 15 to
September 15, 2007 among 1, 005 patients in seven major hospitals in Metro Manila
(Pinoy Press, 2007). Key findings of the survey show that for every 10 patients
admitted to public hospitals:
 6 were from families who are jobless and presently unemployed
 3 worked as drivers, construction workers and peddlers
 1 was a low-income professional
 7 were not immediately admitted to hospitals because they either
had no money, there were no available beds and no doctor was
present to attend to them

 5 were not able to do requisite “laboratory procedure” because they
had no money to pay for the service
 4 had to borrow money and sell property or a carabao to pay for their
hospital bills
 7 were not members of PhilHealth
The survey pointed to a stark reality that poor patients were stripped of their self-
respect as they were driven into begging and being hugely indebted because the
country’s public hospitals can no longer provide for the health and medical needs of
our numerous indigent countrymen and women.
It is very obvious in the survey that economic status has a great impact in the quality
of treatment patients can have. This should not be the case because good quality
health care must be available for all, especially for cancer patients. But it is also a fact
that Philippines is a third world country, poverty holds a great percentage of the
Filipinos. However, the study aims to answer the problem on the uprising number of
cancer diagnosis and deaths. The situation poses a great challenge to be able to
address the demanding needs of poor Filipino cancer patients. Although nothing can
be offered for free. If the project will cater those who cannot afford the treatment,
they will increase the demand for resources and lower the quality of treatment for
those who are paying. One factor will surely suffer if the services offered cannot be
paid back. Ironically, if this happens those who are paying will the ones who will
suffer. Thus, a balance distribution of all resources and financial support are a very
critical for cancer management.

The statistics prove that only those in the high wealth quintile can afford private
hospitals. The facility will have to be income-generated to continue its worthwhile
services for cancer management and prevention. However, if it will cater the middle
income earners and the poor it will set a boundary line among other cancer centers in
the country.
Table 3: Cost of health care in public and private facilities
As expected, the cost of health care received in private facilities is substantially higher
than the cost of care received in public facilities (Table 3). The average cost of
treatment for a visit to a private health facility (2,864 pesos) is almost three times the
cost of a visit to a public health facility (1,051 pesos). Similarly, the average cost of in-
patient care at private facilities (24,278 pesos) is almost three times that of
confinement at a public facility (9,849 pesos). This is just a simple illustration of how
promising the return of investment in a private hospital rather than a public hospital.
This is a great supporting factor that can justify that a private cancer facility for middle
and low wealth quintile can fulfill its services with continual source of funds from its
income and additional funding from NGOs.

Location wise, the respondents were also asked for the travel Table 4: Average travel time to health facility
visited
time from their residence to the health facilities (Table 4).
Average travel time is longer for persons in rural areas (45
minutes) than for those in urban areas (32 minutes). Looking
at economic status, the average travel time was longest for
persons in the lowest wealth quintile (47 minutes) and the
shortest for those in the highest wealth quintile (35 minutes).
Immediate treatment must always be provided for the
patients. People tend to look forward for treatments in the
urban areas because they know that there is a better quality
of treatment as compared to the rural area. If the facility
would be located at rural areas, even if it offers good quality
of health care people will always have second thoughts
because of this medical stereotyping. To avoid this matter, it
is just wise enough to set the facility in the urban area where
people would get to know it better and have easy access.

Table 5: Aspects of in-patient care
Table 5 shows the most common reasons for visits to health
facilities are illness or injury (68%) and medical checkups (28%);
2% come for dental care and 1% for medical requirement. It has
also been proven that culture has a great influence to pain
tolerance and management of the people. Filipinos do not
respond to illness until it is advanced, they have taken to bed, or
are in severe pain. It is also a fact that Filipinos are stoic, they
endure pain and this suffering is an opportunity to demonstrate
virtue (www.ncbi.nlm.nih.gov).
It can be interpreted that Filipinos have low health care
awareness. People will only come to hospitals if they are already
feeling ill. The same thing goes for cancer patients. Their cancer
will only be detected once it is an incurable stage. Low
percentage of those coming for medical checkups is parallel to
their disease awareness and prevention. This is a great challenge for the study
because it is the people’s culture that must be reformed.
1.5.2 Analyzing Philippine Cancer Statistics to Recognize its Severity
Malignant Neoplasm (Cancer) in the Philippines: 2005, contains detailed cancer death
statistics conducted by the National Statistics Office. The information presented was
obtained from the death certificates or the Municipal Form No. 103 submitted by the

City/Municipal Registrars from all over the country to the Office of the Civil Registrar
General for processing and archiving purposes.
A total of 426,054 deaths were recorded in the Philippines in 2005. Said number is 5.7
percent higher compared to 403,191 deaths recorded in 2004. Figure 1 shows the top
ten leading causes of deaths in 2005.
Out of 426,054 deaths recorded in 2005, 77,060 (18.1%) were reportedly cause by
diseases of the heart and 45,037(10.6%) were due to cerebrovascular diseases. There
were 41,697 (9.8%) records that stated that malignant neoplasm or more commonly
known as "cancer" as the reason for death. This makes cancer as the third leading
cause of death in the country in 2005.
Even if cancer is the country’s third most common cause of death, its number is still
alarming. With the population continually growing and also aging, more and more are
getting expose to the possibility of having cancer. It is becoming an increasingly
significant burden on the country’s health care services infrastructure.
Figure 1: Top Ten Leading Causes of Deaths: 2005

Figure 2: Number of deaths by the ten leading cancer type and sex: 2005
These results clearly illustrate the four leading cancer type in both sexes. One in every
six person who died of cancer was diagnosed to have developed malignant neoplasm
of the trachea, bronchus and lungs, which gained the top spot in the list. Specifically,
about 7,215 (17.3%) deaths reported to have been due to this type of cancer. Breast
cancer is responsible for 4,480 deaths (10.7%) and is on second place followed by
colon cancer (2,657 or 6.4%) on third. Deaths caused by leukemia or blood cancer in
both the male and female sexes accounted for 2,398 cases (5.8%).
These four leading types of cancer are the areas that the researcher would like to
address in managing cancer. Eliminating other types in the study does not mean that
they are of less importance. By limiting the study to the core of cancer deaths in the
Philippines, it can maximize all the efforts in focusing to minimal but manageable and
of high importance subject matter. These numbers are parallel to the number of
prospective patients that the study would like to address. More patients can only
mean more profit and most importantly, many can receive proper healthcare.

Figure 3: Cancer deaths by age group and by sex: 2005
Based from the figure, the highest number of deaths caused by cancer was at age
group 65-69. The total fatalities of the said age group numbered to 5,019 or 12.0% of
the total cancer deaths reported in 2005 of which 2,908 (57.94%) were males and
2,111 (42.06%) were females. This means that as someone grows older he is more
prone to having cancer. Utmost care must be given to senior citizens what more if
they have cancer. Age bracket between 40-84 years old set over a thousand cases of
cancer deaths. This sets another consideration for the study since adults and elderly
have different needs as compared to other age groups. The same as what is discussed
in the previous paragraphs, the higher the number of recorded patients are the higher
percentage of profit and healthcare can be given to the investors and the patients.

1.5.3 Relation of Physical Environment to Patient’s Wellness
Good environment makes us feel better, and feeling better is the key in
getting better. It has a positive effect on central nervous system of humans, animals
and plants. It also provides most people with more natural energy, reduces stress and
provides peace and tranquility.
Most people working in hospital understand the impact of the hospital environment
on the patient experience. There is evidence that good environments can have a
therapeutic effect on patients. What constitute this good environment are the mind,
body and spirit that are always striving to maintain resonance with the environment.
If that environment is unbalanced it will use up its energy in maintaining its life force.
This is why many people are sick and/or tired most of the time. On the other hand,
where the environment is balanced and in harmony with nature, little energy is
needed to maintain the body in health.
We perceive our environment through our five senses: sight, smell, touch, taste and
hearing. The information we pick up from our senses is relayed to the brain which in
turn will affect our physiological, emotional, psychological and ultimately physical
condition. Healing environment leads to faster patient recoveries, reduced pain, fewer
cases of infection, greater patient satisfaction and reduced stress level among staff
(www.allnurses.com).
There is no doubt that people have different needs in different spaces and cancer
healing environment is not an exemption. Some studies clearly show that a whole

range of environmental factors including lighting, color, views, art, and sound have a
powerful healing and therapeutic effect on patients. These are just some of the
factors that most hospitals are considering. Just the fact of having cancer immediately
has a negative effect on the patients. It can only lengthen their treatment if their
environment also fosters negative impact on their situation. Aside from their family
and their doctor, it is their environment that works twenty-four hours a day to either
heal or sicken them. It is a great challenge on the designer’s part to create a home-like
environment in a natural setting that will make it different from a typical white-
themed hospital. It must have an atmosphere that relaxes mind, body and soul and
helps physical and psychological recovery.
1.5.4 Trends in Cancer Center Design: Atmosphere that Promotes Healing and
Wellness
The Health Facilities Management Executive Dialogue Series provides frank discussion
of issues and ideas by health care executives and industry experts focused on
challenges facing hospitals. There had been a closed-door dialogue between Health
Forum and the American College of Healthcare Architects. They convened a group of
architects and their health care clients to examine the trends in cancer center design.
Some key points that were highlighted in their discussion are as follows:
 Cancer patients want an atmosphere that promotes healing and wellness.
 Cancer is a family disease.
 Cancer patients may suffer from short-term memory loss and cannot rely
on traditional way-finding methods.

 A flexible space allows for patients to choose whether they want to
receive their treatment in private or among other cancer patients.
 Cancer patients often have low energy levels.
Cancer being a family disease is something that struck the researcher. It simply means
that family members have a great part in the healing process of cancer patients. One
must take note that cancer facilities must not only take into consideration its patients
but also their family. Creating a homelike setting that includes space for families can
reduce stress for patients. There is a need for them to be able to go to different places
within the facility. They can periodically check on their loved one, but it does not
mean that they will have to stay for a long period of time. Their movement can create
a positive dynamics. However, it will only depend on how the designer plans the
workflow inside the facility. This is another challenge in the planning process since the
additional user will make the project more complex.
Travel distance between an area to another is a significant factor in planning the
workflow of each user. From the patient’s perspective, there is a need to create a
healing environment that helps release stress and improve their satisfaction,
experience and reduced waiting time. Therefore, a cancer center must be built for
efficiency to modernize patient flow and improve workflow. Cancer centers must also
address the unique characteristics of the disease, providing healing environments to
enhance the patient and family experience.

1.5.5 Medical Mall: One-Stop Shop for Health Care Needs, Reaching-Out to Patients in
a New Distant Way
Hospitals introduced the "medical mall" concept about 20 years ago to bring health
care closer to residential neighborhoods. The appeal of a medical mall is that it
creates a one-stop shop for outpatient visits, dental services, primary care, pharmacy,
physical therapy, government services, and other health care needs. Medical malls
offer the convenience of being close to where patients live, and they provide an
alternative to inpatient care at a major hospital. Hospitals saw the opportunity to
reach out to the growing number of households in the newer and more distant
suburbs. There are five primary reasons for a hospital to establish a medical mall.
They are:
 To modernize the site with new equipment and structure to provide
additional space for clinics and new equipment without expensive and
disruptive remodeling of the hospital
 To offer ambulatory care and diagnostics at one site
 To offer health care outreach to growing or underserved populations
 To provide office space for physicians and health-related services
 To increase profitability
Some medical malls have been established by physicians and/or by private investors.
For physicians, the creation of a medical mall offers combined services with office
space in close proximity to major hospitals. The physician/investor initiated medical
malls tend to be smaller in size than hospital-affiliated malls and to be located near
retail corridors. Combining some retailing in the medical mall such as a bank, health

food restaurant, and some personal services, could be attractive as a convenience.
The advantages for the owners of a physician/investor-initiated medical mall are
(www.pgplanning.org):
 Easy access for patients and physicians
 Complete care in one location
 Increased patient referral base
 Quick return on investment
 Increased control through ownership
One of the objectives of the study is to determine how to drive the public interest in
preventing cancer. Even if the concept of having a medical mall is not that new, it is
undoubtedly a concept that can attract people. However, adapting the whole concept
is not suited for the project. Maybe just getting the idea of a one-stop shopping
medical care infused with the facility can help it achieve its goal. With the constant
price increases in fuel, medicine and health, food and other commodities, centralizing
ambulatory services related to cancer can be a promising marketing strategy that
gives a win-win situation for the owner, doctors and patients. The owner can gain
additional profit other than those who are confined. Doctors can extend their practice
as they can manage their own consultation offices and have more patients than usual
if they are located in a typical hospital. Public’s curiosity will drive them inside the
facility and then in turn will have their checkups for possible cancer risk or be aware of
cancer prevention. Of course all of these are just assumptions at the moment, but
hopefully the study can prove its favorable outcome.

1.5.6 Bio-mimicry: Looking at Nature as a Mentor
Bio-mimicry comes from the two words of bios, meaning life, and mimesis, meaning to
imitate. It is a new discipline that studies nature's best ideas and then imitates these
designs and processes to solve human problems. It introduces an era based not on
what we can extract from the natural world, but what we can learn from it.
The core idea is that nature has already solved many of the problems that humans are
struggling with. Animals, plants, and microbes are the consummate engineers. They
have found what works, what is appropriate, and most important, what lasts here on
Earth. This is the real news of bio-mimicry: After 3.8 billion years of research and
development, failures are fossils, and what surrounds us is the secret to survival. The
conscious efforts on continual development of all sorts of advancements like in
technology, medicine, researches, etc., are a survival strategy for the human race, a
path to a sustainable future (biomimicryinstitute.org).
An article written by Stacy Kish, a staff of the United States Department of Agriculture
Cooperative State Research, Education, and Extension Services (USDA CSREES)
entitled Tree – Heal Thyself featured the research conducted by the agency on how
the tree rejuvenate itself. When a tree is injured, these cells regenerate in a pattern
that appears to flow around the wound, producing the characteristic knots on the
plant's surface. By diverging around the wounded area, the cells can continually
supply nutrients and water to other parts of the tree.

This concept of tree healing itself has an immense relevance to the study. However, it
must be noted that the relationship of the tree’s healing process and to the study’s
health nature is not as petty as it might seem at the start. It was interpreted by the
proponent in a way that the tree represents the cancer facility and the wound as the
cancer disease. Failure of facility to correspond to the challenges brought by cancer
simply means that there is something wrong with the facility. If not probably, the only
or best solution to the uprising number of cancer diagnosis would depend on the
facility itself. This is for this reasoning that the proponent saw the potentially of the
project as architecturally challenging. The probability of the proposed facility’s success
can only be determined on how it functions accordingly with the cancer patients, their
family, the staff and the community.
Another concept of bio-mimicry that can be applied to the project is the lifecycle of
the pine cone. During its lifecycle, it opens and closes during different points of its life,
often dependent on the conditions which surround it. For instance, the pinecone
scales grow in order to protect its seeds after being fertilized. Then, those scales close
to allow for the seeds to develop. Once the seeds are ready, those scales will open to
release the seeds — allowing them to fly away as far as possible
(sensingarchitecture.com).
In the end, that pinecone was on a mission — to allow for the fertilization of seeds, to
protect them and then to disperse them at just the right time. Just the same as for a
health facility, the patients are the seeds. It protects them, allow them to flourish,

function and grow in the best way possible and in a way that the design solution
would be as beautiful as the pinecone.
1.6 Research Framework
The proponent provides a conceptual framework to analyze the identified problem of
the uprising number of cancer cases in the Philippines. The illustration shows the
problem that cancer issues must be immediately addressed. Therefore, the proponent
will do a deep research on analyzing its nature, problems that cancer patients are
encountering, and most importantly preventive measure from the disease.
Figure 4: Research Framework

1.7 Research Methodology
Cancer has a very negative nature just like all the diseases. But its severity set the
border line as compared to other diseases. Facts say that most of cancer deaths are
not caused by the disease but because of painful medication. Even doctors say that
they would rather die than be under medication like chemotherapy. Beyond its dark
side, certainly there are positive feedbacks after decades of continuous cancer
researches. This section will discuss how the researcher handled a non-bias
investigation of this sensitive issue.
Descriptive research is used to obtain necessary information regarding each topic.
Both quantitative and qualitative analyses are used to have a better understanding on
cancer. Quantitative data are gathered from the different surveys conducted by the
NSO’s. Whereas, qualitative data are obtained from electronic references,
researcher’s oral investigation through interviews, and doing case studies of existing
cancer institute through observing and comparatively analyzing its facilities.
1.7.1 Oral Investigation
Interviews were conducted with Ms. Erlyn J. Banal who is the PSMO Secretariat and
Dr. Kitchie Antipuesto of St. Luke’s Cancer Institute. The objective of the interview
given to Ms. Banal is to determine the organization’s perception on the proposed
project, being its hypothetical client. While the interview that was given to Dr.
Antipuseto aims to know how doctors treat their patients, how their patients react to
their environment and how much funding is spent to manage cancer. The following
paragraphs will summarize the data that transpired in the discussion.

Ms. Banal was interviewed last September 3, 2012 in PSMO main office at St. Luke’s
Cathedral Heights Building Complex. According to her, the organization is exclusive for
oncology doctors who were trained under these six hospitals namely: St. Luke’s
Cancer Institute, Buenavides Cancer Institute, Philippine General Hospital, National
Kidney Transplant Institute, Jose Reyes Memorial Medical Center and Veterans
Memorial Medical Center. Doctors who would want to apply for membership will
have to train for two to three years and then take the entrance examination.
The greatest concern of the researcher is why there is no standalone cancer institute
in the Philippines. She explained that once these doctors finished their practice there
is no place for them to continue their endeavors but the hospital that they had their
practice. This is for this reason that the doctors are dispersed in different hospitals
and that the organization is open to the proponent’s proposal of a standalone cancer
institute.
Having the low and middle income earners as the target market of the project, makes
funding or financial aspect as a very critical factor. She discussed two different
financial assistances being offered by Department of Health and PhilHealth. PhilHealth
offers the Z-Package which is a multi-disciplinary approach in treating cancer. It
covers up to Php 100, 000.00 per patient. There are only three hospitals that they
accredited to offer this program. These are Philippine General Hospital, East Avenue
Medical Center and Jose Reyes Memorial Medical Center. As compared to the
PhilHealth’s program, the Navigator Treatment by the Department of Health offers an

all-expense paid cancer treatment except from minor kits that would only amount to
less a thousand. There are also only three hospitals that they accredited to offer this
program namely: Rizal Medical Center, East Avenue Medical Center and Jose Reyes
Memorial Medical Center. However, patients would have to go under strict screening
before they can avail the program. In addition, PCSO also gives financial assistance to
cancer patients but she was not able to elaborate the services that its program is
covering.
Several questions that were asked to Dr. Antipuesto are provided in Appendix A. She
is a Senior General Practitioner at St. Luke’s Cancer Institute and was interviewed last
September 5, 2012.
First part of the discussion was about understanding how to handle cancer patients.
According to her, built-up trust is the key for doctors to address to their patients that
they are cancer positive. But somehow, even if trust is already present in their
relationship as patient–and–doctor they cannot still directly inform the patient
because he is unstable emotionally. In this situation, the family of the patients is the
doctor’s instrument to be the one responsible of telling the patient. However, when
there are cases that the family is also emotionally unstable, consultation with a
psychiatrist is necessary just to be able for them to grasp the situation. It must be
noted that even if psychiatrist plays a role in the acceptance or even during the
disease, having a psychiatrist that is constantly checking on the cancer patient is not
really necessary. She said that it depends on the stability of the patient of accepting
that he has cancer.

Denial stage may be long or short enough to greatly affect the health of the patient,
well it depends on what kind of patient. She also sighted that the occurrence of hope
of being well coming from the patient is the last option for them after undergoing
different of emotional instability. With utmost support coming from the family their
struggle will lessen.
Another notation regarding cancer patients which she contradicted is the inability of
the patient to mingle with healthy people and enjoy normal activities with them. She
exclaimed that their sickness should never be a hindrance to live and be treated
normally by their surroundings. Actually, if they feel that others pity them it can only
add up to their emotional burden and relatively it will transpire in the status of their
health.
The last part that was discussed focused on the treatment that they offer to their
patients. Dr. Antipuesto confirmed that besides evidence-based holistic medical
treatment, other therapies like art and music helps a lot to patient’s wellness. The
support that patients need does not only depend on their families but also from
different support groups. In her opinion, the best group that is second to the family’s
support is the support group of cancer survivors who are sharing their experiences as
they fight for their lives.
These findings imply that cancer involves a big group of people cooperating hand–in–
hand to fight the disease. Effective treatment does not come from medical devices

but as equally important as the treatment that the family, support group and
therapies can give them. The facility must be planned and designed in a way that it
will not only cater the needs of patients but also the needs of their family and support
group. It must also open-up to nature that will enhance art, music and nature
therapies to the patient’s wellness. These are facts there not just gathered as
electronic data. The proponent gathered these as first hand data that will greatly
influence the project.
1.7.2 Library Research
Most of the data needed were gathered through library research because of the
complexity of the subject matter. Other agencies or studies already did the data
gathering in respect of their own profession. The researcher only gathered all the
necessary data and analyzed how they are related to each other and their importance.
This section will show statistical data from NSO and second hand data from other
studies concerning cancer cases and health awareness of Filipinos. It also involves
studies on the latest technology and approaches in managing cancer, most common
psychological needs, screening techniques on cancer, and Filipino modern lifestyle
that have a direct effect on their health that will make them prone to cancer.
1.7.2.1 Different Methods of Managing Cancer through Latest Medical Technology
On May 20, 2011 Mithra Murali wrote an article entitled, “Cytotron®: Revolutionary
New Technology for Cancer Treatment”. Cytotron®, shown in the Figure 4 below, is
probably the first medical device of its type, to be fully conceived and developed in
India and accredited internationally. Dr Rajah Vijay Kumar, Chairman, Organization de

Scalene who has a number of innovations and international patents to his credit, is
the inventor of the tissue engineering technology of Rotational Field Quantum
Magnetic Resonance (RFQMR) therapy as well as its treatment applications using the
Cytotron® device. Essentially, the Cytotron® treatment helps to re-generate cells
and/or to stop the uncontrolled growth of cells. Clinical experience shows that it is
particularly effective for cancer and for arthritis.
Figure 5: Cytotron® Device
In conventional cancer treatment, chemo/radiation therapies physically
destroy cancer cells to arrest tumour growth. However, this can damage the adjacent
normal tissues and organs leading to severe side effects. Cytotron® therapy induces
apoptosis (‘programmed cell death’) by reviving the body’s own mechanisms of
tumour suppression non-invasively and without any side effects.
 The device provides precise doses of safe and non-invasive energy (radio
or sub-radio frequency, non-ionizing, non-thermal electro-magnetic
waves) to tissues in the affected area.
 To begin with, the electrical properties of the affected cells are
normalised.

 This stimulates the production of natural tumor-suppressor genes (such as
the p53) and related nucleo-proteins which induce apoptosis and tumor
death.
 The therapy works with and supports the body’s natural process of
getting rid of cancer cells, in a controlled and phased manner.
 Treated in this manner for 28 days (1 hour per lesion), there is evidence to
show that the cancer cells start dying.
 In severe cases, the treatment can be repeated for 2-3 cycles or even
more without any worry about side effects.
Dr. Nayar, co-founded Ojus Healthcare in 2001, says that as of now, chemotherapy
and radiotherapy remain the most common, conventional methods of treatment.
However, issues of side effects, cost, suitability for the aged, children, debilitated
patients etc., remain serious concerns.
Most patients taking conventional therapies experience debilitating side-effects like
hair-loss, blood-count fall, nausea, reduced immunity, etc. By comparison, the
Cytotron® therapy is an outpatient procedure and is absolutely safe, with no known
side effects. There are no toxic drugs, no harmful radiation; you simply lie down in the
device, which emits radio waves to the carefully targeted areas. Dr. Nayar adds that
he has personally treated children as young as 2 years and some senior citizens in
their 90’s who were very comfortable during the procedure and benefited from the
therapy.

So far, Ojus has treated over 80 patients with advanced cancers, most of them in
terminal stages. They maintain meticulous records of their patient’s progress and
follow up, by way of both quality and quantity of life. One of the most striking
differences that patients notice within 7-10 days of therapy is pain relief, without the
need for medication. They are able to sleep better. There is also marked sense of
wellbeing and improved appetite.
Ojus also emphasises a holistic approach to healing. During and after the
Cytotron®treatment, patients receive advice on diet and lifestyle, alongside therapies
like Ayurveda, Yoga, Meditation, Massage, Homeopathy, Tibetan medicine,
Hypnotherapy and psychological counselling.
Since the technology is relatively new, most of Ojus’s current patients are terminal or
at least advanced cases who have tried all the other mainstream treatments. But since
the treatment is showing such good results, it is gaining popularity in other countries
as well such as, Malaysia, Netherlands, Saudi Arabia, Pakistan, Canada, Hungary, US,
Europe and the Middle East.
This device is a great breakthrough in the field of cancer. Though it may not still
available in the Philippines, it promises a higher chance of cancer survival. What is
good about it is that it is an outpatient procedure. It does not need any confinement
which means that it can be one of the major treatments or services offered in the
ambulatory services of a hospital. It will be the most effective and less painful
procedure as well as being profit generating.

Another medical advancement in particular is Stem Cell Therapy. This was explained in an
article by Alice H. Reyes in Philippine Star last September 4, 2012 entitled
“Understanding Stem Cell Therapy”. This is an intervention strategy that introduces
new adult cells into damaged tissue to treat disease or injury. The ability of stem cells
to self-renew is a potential for the generation of tissues to replace diseased and
damaged areas of the body with minimum risk. Dr. Flores of Makati Medical Center
was interviewed and he explained that we have stem cells in our bodies, different
types of cells in the heart, brain, and other organs which can replicate. The stem cells
come more commonly from the blood, bone marrow, placenta, and umbilical cord,
either from the patient himself or from other human beings. Compared to the stem
cells from the mountain black sheep that are being used in Germany, this is what
doctors here in the Philippines are using.
Stem cells that come from the patient are called autologous, those coming from
genetically different donors of the same species (siblings, parents, children, cousins or
an unrelated match) are allogenic while those from different species such as sheep
are xenogenic.
In the Philippines, stem cell therapy is relatively young, only five to six years,
compared to its practice in Europe and the United States. Besides Makati Medical
Center, the only other hospitals that treat patients with stem cell therapy are the Lung
Center, the Kidney and Transplant Institute, Medical City, and St. Luke’s Hospital in
Global City.

A patient who is to undergo the treatment is first tested in the lab to see to it that
there is no infection. He is then given medicine to increase the stem cells in his body
for a period of five days. On the sixth day, the cells are “harvested” and then purified
in a machine called CliniMacs, the only one in the Philippines, which separates cells to
93-94% purity. In the next two or three weeks, the cells are cultured in an incubator
(with 5% carbon dioxide) to increase or transform them before they are transplanted
in the patient. However, this kind of treatment ranges Php 2.4 million for all kinds of
diseases, less than Php 1.5 million for rejuvenation.
This is good for the medical field in the Philippines because it clearly shows that the
country is not far behind in advancement in medical application. Its promising results
can be a forefront in cancer management. Though it may be costly to be afforded by a
commoner or an average cancer patient, there are many funding organizations for
this. This is a very good opportunity for cancer patients and all that is left is to grab it.
1.7.2.2 Understanding Cancer Psychology for the Utmost Benefits of the Patient
There is a rapidly growing body of research studying the relationship among
emotions, personality characteristics, and disease, especially cancer. The answers are
beginning to emerge, and they demonstrate a definite connection between emotions
and the chances of developing cancer, as well as the prognosis of the disease once it
has appeared. Several psychological characteristics appear to influence the course of
cancer: depression, stress, lacking a sense of control, having a negative outlook, and
lacking an adequate support system. All correlate with a poor prognosis. Having a

sense of control, a positive outlook, and a good support system correlate with a better
prognosis. Some of the key points are discussed in the following paragraphs.
First, characteristics such as the ability to express anger and fight against cancer can
influence the outcome of the disease. Tina Morris reported that women with
malignant breast tumors had more difficulty in expressing anger than those with
benign tumors. Greer also found that cancer patients who had a "fighting spirit" lived
longer. In this study high levels of anger correlated with better outcome, and patients
who felt helpless or hopeless did poorly. These studies are showing us that a patient's
will to live or fighting spirit has a great deal to do with chances for recovery.
Second, those who engaged in denial had a better chance of survival than those who
felt hopeless. Denial included saying such things as "I didn't have cancer. The doctor
only removed my breast as a precautionary measure." A ten-year follow-up confirmed
the original findings. Of those who showed a fighting spirit or denied they had cancer,
55% were still alive, compared with 22% of those who had a helpless/hopeless
response or engaged in stoic acceptance. But why would denial help? Apparently
patients who deny they have cancer feel better and adjust better than those who give
up and feel utterly hopeless. It seems surprising that denial could be an effective
coping mechanism for cancer. However, denial enables a person to concentrate on
current and future goals. Having a purpose and goals seems to be correlated with
improved immune function and a more hopeful prognosis.

Third, while negative emotions predict a poorer prognosis for cancer patients, positive
feelings like joy go together with a better outcome. A seven-year follow-up of breast
cancer patients by Sandra Levy, associate professor of psychiatry and medicine at the
University of Pittsburgh and director of behavioral medicine in oncology at the
Pittsburgh Cancer Institute, showed that those patients who expressed more joy in
their lives when initially tested lived longer. This result does not conflict with the
studies that showed that an angry or fighting response to cancer predicts a better
outcome. It is quite possible to have a sense of joy in life and a fighting spirit at the
same time.
Optimism helps too. A study of women with cervical cell abnormalities reported that
the women with high scores for pessimism, hopelessness, and social alienation were
more likely to progress to cancer of the cervix. On the other hand, optimism and
active coping styles were connected with reduced risk of progress to cancer.
Fourth, stress has a strong effect on the development and outcome of cancer. It has
been shown that there is a correlation between stressful life events such as the death
of a family member or the breakdown of important family relationships and relapse of
breast cancer.
Several studies we have examined show that there is a definite correlation between
emotional stress and the development of disease, including cancer. Likewise, one can
conclude that a positive outlook, lowered anxiety and depression, a sense of control,
and improved mood increase the survival times of cancer patients. There is solid

evidence that stress and mood negatively affect the status of the immune system. If
being optimistic and keeping a happy life can help in resisting cancer cells or reducing
its continual growth, then, Filipinos are very good at it. It is natural for Filipinos to
keep a positive outlook in life and if the context of cancer can be explained in the best
way that a patient understands it, there would be a promising fight against cancer.
However, doctors say that they cannot directly address the situation to their cancer
dying patients. This in turn can give false hopes to the family which is an additional
burden on their part. Acceptance and a drive to fight are the psychological keys that a
patient and his family should have to unlock their freedom from cancer.
1.7.2.3 Early Screening and Change of Modern Lifestyle as Preventive Cancer Measure
There had been studies that behind thousands of cancer deaths, the percentage of
cases that could have been avoided through screening vary from 3% to 35%,
depending on a variety of assumptions. Beyond the potential for avoiding death,
screening may reduce cancer morbidity since treatment for earlier-stage cancers is
often less aggressive than that for more advanced-stage cancers (Kramer, 2004).
Also according to Kramer, several potential harms must be considered against any
potential benefit of screening for cancer. Although most cancer screening tests are
non-invasive or minimally invasive, some involve small risks of serious complications
that may be immediate (e.g., perforation with colonoscopy) or delayed (e.g., potential
carcinogenesis from radiation). In addition to its possible harm is the false-positive
test result, which may lead to anxiety and unnecessary invasive diagnostic
procedures. These invasive diagnostic procedures carry higher risks of serious

complications. A less familiar harm is over-diagnosis, i.e., the diagnosis of a condition
that would not have become clinically significant had it not been detected by
screening. This harm is becoming more common as screening tests become more
sensitive at detecting tiny tumors. Finally, a false-negative screening test may falsely
reassure an individual with subsequent clinical signs or symptoms of cancer and
thereby actually delay diagnosis and effective treatment.
In developing the cancer screening summaries, the PDQ Screening and Prevention
Editorial Board uses the following definitions:
 Screening is a means of detecting disease early in asymptomatic
people.
 Positive results of examinations, tests, or procedures used in
screening are usually not diagnostic but identify persons at increased
risk for the presence of cancer who warrant further evaluation.
 Diagnosis is confirmation of disease by biopsy or tissue examination in
the work-up following positive screening tests. (Following a positive
screening result, cancer can often be ruled out by procedures other
than biopsy or tissue examination.)
Direct or assisted visual observation is the most widely available examination for the
detection of cancer. It is useful in identifying suspicious lesions in the skin, retina, lip,
mouth, larynx, external genitalia, and cervix.

The second most available detection procedure is palpation to detect lumps, nodules,
or tumors in the breast, mouth, salivary glands, thyroid, subcutaneous tissues, anus,
rectum, prostate, testes, ovaries, and uterus and enlarged lymph nodes in the neck,
axilla, or groin.
Internal cancers require procedures and tests such as endoscopy, x-rays, MRI, or
ultrasound. Laboratory tests, such as the Pap smear or the FOB test have been
employed for detection of specific cancers.
Some individuals are known to be at high risk for cancer, such as those with a personal
history of cancer or a strong family history of cancer (in two or more first-degree
relatives); increasingly, as genetic mutations and polymorphisms are found to be
associated with specific cancers, high-risk individuals will be identified through genetic
testing. The type, periodicity, and commencement of screening in high-risk
populations for most cancers reflect the judgment of practitioners rather than
evidence from scientifically conducted studies. Physician judgment is needed in such
circumstances to determine the most appropriate application of available screening
methods. Prudence suggests increased vigilance in the higher-risk populations. At a
minimum, this means that the high-risk person is identified, is counseled
appropriately, and regularly undergoes those screening procedures that have been
shown to be of benefit to the general population.
For nearly all cancers, treatment options and survival are related to stage, which is
generally characterized by the anatomic extent of disease. On this basis, it is assumed

that early detection of cancer at an earlier stage may yield better outcomes. In the
1940s, a generalized staging classification of localized, regional, and distant disease
was developed to show long-term trends, and it is still useful. In the more detailed
TNM system, which has been periodically modified, the tumor size, the status of the
lymph nodes, and the status of distant metastases are also categorized. These
elements are grouped into stages 0, I, II, III, and IV according to their association with
survival. In general, larger primary malignant tumors have a higher incidence of
metastasis to regional lymph nodes and to distant sites. Stage has such a profound
effect on outcome that all randomized treatment trials require the comparison of
similar stages in evaluating differences in outcome. Shifts in stage may also herald
improved survival and decreased mortality, though stage shift alone does not
establish benefit.
Undoubtedly, early screening has its benefits. Though some of the studies mentioned
showed a down-side of it. However, the burden of having cancer is known by all and if
there would be any means to prevent it, surely every person would grab the
opportunity. Alongside with these screenings is a well-disposed outlook towards the
disease upon diagnosis and an improved healthcare awareness even when not
diagnosed. It is always true that prevention is better than cure.
A blog in Open.salon.com dated December 1, 2011, featured “Choose to change your
lifestyle and put cancer in its place”. It is about the encouraging part in the sad picture
of a cancer epidemic is that every person can start to reverse these societal changes in

our own life. One can opt for a new way of life and, in doing so, he simultaneously
help prevent cancer if he is cancer-free, and strengthen his body if he already have it.
Over the years, the lifestyle of society has changed. While some have chosen to
continue living the traditional, slow pace lifestyle of ancestors, most people have
made the permanent switch to a fast paced, modern lifestyle. Busyness has become
the norm. Living this newfound lifestyle has health effects. The following are common
effects of a modern lifestyle on health.
First is an increase in habits and addictions. The presence of a modern lifestyle has
brought about and increase in alcohol consumption and additive habits such as
drinking caffeine, smoking, etc. These habits can be especially bad for your health and
lead to many diseases such as live disease, heart disease, and colon cancer. While
living the modern, fast paced lifestyle is not the only factor that contributes to the
increase in habits and addictions, it certainly plays a role in it.
Second is an increase in the consumption of fast food. A fast paced lifestyle has also
brought about the increase of consumption of fast food. Many families choose to eat
out simply because it is quicker than cooking a meal. Unfortunately, the increase in
the consumption of fast food has had a devastating effect on the health of society as
obesity rates are sky high and there are many health problems reported to be directly
link to the overconsumption of fatty foods found in fast food.

Third is an increase in the use of diet pills and other fad diets that is detrimental to
health. The modern lifestyle has also brought about a focus on appearance. One
must always look his best. Diet pills and fad diets are popular among women to try to
help shed unwanted weight and fit the picture of “perfect” that is portrayed by movie
stars. Unfortunately, fad diets starve the body and diet pills lead to thyroid
functioning problems. These are just a few of the many health problems that can be
the result of using diet pills.
Fourth is loss of sleep. Those who have chosen to live the modern lifestyle will
complain that they get too little sleep. Most adults are now getting as little as 5 hours
of sleep a day as opposed to the recommended 8 hours. The body is never fully
rejuvenated and this can cause loss of functioning along with other health problems.
Sleep is essential to good health.
Fifth is little time to exercise. The fast paced, modern lifestyle leaves both adults and
kids with little time for physical activity. This, in turn, leads to a whole slew of health
problems. From diabetes to heart disease, little or no exercise throughout the course
of a lifetime is an equation for disastrous health.
Sixth is poorer quality of life. Along with many health problems, those who choose the
modern lifestyle have a poorer quality of life. This is because they spend more time
working and engaged in other activities rather than spending time with family and
friends. Work becomes an overly important part of the routine which leads to a
poorer quality of life.

Seventh is weight gain. The busyness of life can bring about unhealthy weight gain.
Little time for exercise, increased stress, and unhealthy habits are all contributors to
weight gain. The modern lifestyle is full of unhealthy habits that lead to weight gain.
For example, visiting coffee shops frequently is one common characteristic of a
modern lifestyle. This can lead to thousands of extra calories every year and is a
catalyst for weight gain.
The last is an increase in health problems from the modern lifestyle. The modern
lifestyle brings about a decline in the overall health and wellbeing of adults. With
cancer rampant and other health factors plaguing society, it can be assumed that the
fast paced, modern lifestyle contributes greatly to the problem.
Most would agree that they live the modern lifestyle especially here in Metro Manila.
The above listed common effects are a few things that they should look out for.
Perhaps it is time to make some changes in lifestyle to help have better health such as
getting rid of addictions, getting more sleep, and exercising daily. Your health and the
fight against cancer are in your hands. What type of lifestyle will you choose to live in
an effort to better your health? It is never too late for change and what really matters
is the willingness for it and the positive effects of it.
1.7.2.4 Understanding Cancer Management Financial System
This is a very critical factor of the project because this would determine if it is really
feasible especially that it aims to offer its services to those who are financially

incapable. The Figure 6 will show a hypothetical concept on how the proponent
envisioned the project and Table 6 will show the cost of each cancer screening and
treatment procedures. It must be noted that the data gathered in Table 6 are based
from the U.K. and not from the Philippines however, pricing is in close range with that
of the Philippines’.
Figure 6: Financial Flow Concept
Table 6: Cancer Screening, Laboratory and Treatment Procedures in Doctrates Hospital U.K.
Procedures Price in Euro Price in Peso
In-patient services
 Inpatient ward per day 560.00 29, 680.00
 Inpatient ward per hour 70.00 3,710.00
 Ward, outpatient visit 395.00 20,935.00

 Care per day 295.00 15,635.00
Diagnostic Imaging
 MRI studies 730.00 – 1,320.00 38,690.00 – 69,960
 CT studies 350.00 – 850.00 18,550 – 45,050.00
 Isotopic studies 150.00 – 2,550.00 7,950 – 135,150.00
 Ultrasound Studies 99.00 – 800.00 5,247 – 42,400.00
Biopsies 610.00 – 3,265.00 32,330 – 173,045.00
Anesthesia 100.00 – 1,000.00 5,300 – 53,000.00
1.7.3 Case Studies
St. Luke’s Cancer Institute was the only facility that the researcher was able to
observe. This was because the medical oncology departments of Buenavides Cancer
Institute, Philippine General Hospital and Jose Reyes Memorial Medical Center
refused to cooperate with the researcher. In spite of their refusal, SLCI, which has a
good reputation of being one of the best hospitals, gave data that are sufficient
enough to compensate those from those three hospitals. However, the researcher
was still able to observe PGH and USTH BCI. As compared to the latter, the researcher
concludes that SLCI has better facilities and that can be compared to foreign cancer
hospitals.
The objective of these case studies is to compare which facilities are more successful
than the other in terms of identified variables. Thus, this can help the researcher
determine what facilities and physical feature can greatly help the patients during

their medication that will have an effect on how the facility will be designed and
planned.
1.7.3.1 St. Luke’s Cancer Institute

Figure 7: St. Luke's Medical Center
Established in 1989, the Cancer Institute
of St. Luke's was the first private cancer center in
the Philippines that gave new hope to cancer
patients. Equipped with the best technological
facilities and top-rate cancer specialists, the
Institute offers a comprehensive and aggressive multidisciplinary approach to cancer
management. Their services include early detection, curative and palliative treatment,
supportive care, rehabilitation programs as well as cancer screening, patient
education and cancer prevention. St. Luke's also established the Cancer Ambulatory
Care Unit in 2001 to provide outpatient services. It offers chemotherapy, minor
surgeries, blood transfusion, and bone-marrow aspiration biopsy, among others
(stluke.com.ph).
Even if the proponent was able to observe inside the facility, taking pictures were not
permitted because of confidentiality and was only allowed to have a walk-through at
corridors and lobby.
1.7.3.2 National Cancer Institute (Malaysia)
The following information was gathered from the NCI official website.

Figure 8: National Cancer Institute (Malaysia)
NCI Hospital was first established in 1999 as Nilai Cancer Institute concentrating on
clinical research. In 2005, it was bought over by TH Group and was renamed NCI
Cancer Hospital and became a pioneer private specialist center in Malaysia focusing
on two core activities: cancer treatment and clinical research.
In 2009, the hospital renamed Figure 9: NCI Ground Floor
itself to NCI Hospital and today
it is a private multidisciplinary
medical centre aiming to serve
the community; not only with a
special focus on cancer
treatment but also medical care
in other areas such as Bariatric Surgery (Weight Management), Orthopaedic,
Obstetrics & Gynaecology, Paediatric, ENT, Interventional Radiology, General
Surgery/Advanced Laparoscopy and more.
Over the years, NCI Hospital has established itself as a reputable Oncology Centre in
the region, renowned for pioneering precision radiotherapy treatment options. The

Cancer Centre of Excellence (COE)

Figure 10: NCI First Floor
continues to forge ahead with the
latest developments in cancer
treatment; and in the recent years
have started to treat patients
using Immunotherapy that
includes Cell Therapies and Vaccine

Figure 11: NCI Second Floor
Therapy.
The oncology team actively
participates and contributes to
international clinical researches for
oncology treatment. Through these researches, better treatment can be developed
and patients benefit from these medical discoveries through what is known as Clinical
Trials. NCI Hospital is ISO 9001 accredited and is one of the few medical centers in
Malaysia that is recognized internationally as a center for conducting randomized
clinical trials by various multinational pharmaceutical companies. NCIH's clinical
research complies with the international Good Clinical Practice (GCP) guidelines that
ensure patient’s rights and safety are protected, and also govern accurate and
verifiable the data.
Away from the hustle and bustle of urban city life, NCI Hospital aims also to provide
high quality medical care with a personal touch in a tranquil setting with lots of open
space and greenery surrounding the hospital. Each staff work together to create a

warm, personal and caring environment to ensure the best possible care management
not only for the patients, but for their families as well.
The table below shows the comparison between SLCI in Quezon City and National
Cancer Institute Hospital in Malaysia.
Table 7: Comparison between St. Luke’s Cancer Institute (Quezon City) and National
Cancer Institute Hospital (Malaysia)
St. Luke’s National

Variables
Cancer Institute Cancer Institute
Physiological Environment
1. Total bed capacity

Not stated but it is a three
of oncology 40
storey structure
department
2. Number of beds per 1 1
room
Neutral/Modern Zen Neutral/Modern Zen
3. Theme/color of
walls, floor, ceiling
and alike

4. Room area 20-25 sq. mts. _
5. Spacious and warm
ventilated
lobby/corridors/lou
nge  
6. Has garden or good
view from the None
rooms

Psychological Support
 
1. Art therapy
2. Music therapy None _
3. Other psychological None _
therapy

4. In-house
None _
psychiatrist
Advance Medical
Treatment
Top service as compared to Biological agents Adjunctive
other hospitals (targeted therapy) immunotherapy
Based from the table above, it can be interpreted that much importance is given to
the physiological environment rather than the psychological factor on cancer
treatment. The results conform to what Dr. Antipuesto said in her interview that
psychological support is not that necessary if the patient is emotionally stable. This
clearly states that much attention must be given to spatial planning and designing the
physical environment of the patients because it will greatly help them overcome the
disease.
1.8 Scope and Limitations of the Study
The scope of the have been initially identified in the previous sections: 2005 Philippine
Cancer Statistics; different methods of treatment applied in the country; cancer
psychology; and new concept of promoting cancer awareness. The research period
will be within a three-month span. Thus, acquiring second hand data from previous

studies serve as very important part of the study especially those of the statistics
conducted by the NSO. Also, it must be noted that the study only considers the top
leading cancers in the country namely: lung, breast and colon for adult; and leukemia
for children. The researcher decided to limit the study into four types of cancer to
lower the scope of the study that will somehow promote profitability of the project.
There is also limited technical and medical background on each treatment’s concept
and how they work. It was written based on the best way the researcher understands
it.
Cancer is a very sensitive subject matter that is why the researcher was suggested not
to interview cancer patient and their family. However, much information needed has
been provided by the medical professionals and archival resources. In addition to that,
the family was still interviewed but only limited to financial matters. It must be noted
that the financial system or the ROI is just rationale at the moment because the study
is still under research
1.9 Definition of Terms
The following terms are used in the study:
a. Bio-mimetic
It is an approach in architecture that uses inspiration on nature on
how to deal with human problems.
b. Leading Cancer Diseases
These cancer diseases are cancer of the lungs, breast, colon and
Leukemia.

c. Medical Complex
It will house different structures which will have the same purpose of
addressing cancer challenges in the country, namely: the ambulatory
services offered by the medical mall; the subsidize hospital; and minor
services of the research facility.
d. Medical Mall
It is a structure that offers ambulatory services in a mall-themed
environment. It will house different services on cancer prevention
awareness ads, cancer screening and oncology doctors’ clinics. Its
services are exclusive for cancer related medical treatment for the
public. It will also cater different commercial stalls and recreational
facilities that will be able to cope up with Filipino modern lifestyle.
e. Self-sustaining
The project will be self-sustaining in a way that it can be able to
service all the needs of the users starting from prevention up to their
recovery from the disease. Centralizing all these services in one
location can maximize the chances of having the optimum treatment
from the disease.

Chapter 2
Research Focus
Bio-mimetic Approach for Self-Sustaining Healing Environment
2.1 Rationale
Bio-mimicry as an approach in a sustainable design would be the best solution for the
project. Human problems on health are continuously uprising and may seem
unending. But if we look at how nature addresses its problems on health, it is evident
that it does not use any chemicals or other intervening factors except from itself. Like
that of a tree when wounded, it heals itself because it only relies on itself for
treatment. In addition, pine cone protects its seed and it will only release the seed
when it is ready to go. Nature has the answer on how to handle cancer as a disease
and what is left for humans is to realize it.
Healthcare facilities have the greatest responsibility towards their patients. They must
be protected with much security and comfort until the time that they have fully
recovered. It will also be the facility and its users that will suffer if there are flaws on
the circulation and poor quality of environment. Occurrence of these situations can be
traced from poor spatial planning or in the design process as the project is being
perceived. Whatever happens, every architect must prevent them from happening for
the best benefit of the patients, their families, the staff and the whole community.

2.2 Discussion of Principles and Relevance to the Project
There is an entire mindset shift going in the field of architecture. New ways to explore,
break down and draw inspiration from nature are happening every minute of every
day. Building green will take on whole new meanings as time progress into the future.
It is not anymore a trend but a standard of not only learning harmoniously to live with
nature but to become part of it in entirely new way (biomimicryinstitute.org).
Hospitals have a brutal effect on the earth. They consume twice as much energy as
typical office buildings and operate 24/7. Often, they’re little better for people: The
$41 billion health-care-construction industry habitually neglects design elements such
as access to daylight that have been shown to boost healing. “Hospitals are the most
challenging building type to make sustainable, but they also present some of the
biggest opportunities for designers,” says Jean Mah, a principal at architecture firm
Perkins + Will.
The new trend to design and build hospitals using sustainable technology, renewable
resources and systems designed to reduce energy consumption and carbon emissions
is making it possible to achieve higher building performance in terms of reduced
energy consumption, improved indoor air quality and a supportive healing
environment.
In designing sustainable healing environments, it is also important to look at the
elements which go beyond the simple numbers. It is vital to look at customer

expectations and the ability of people to choose a healthcare provider. In order to
provide high quality of care patients expect, hospitals have to be able to recruit and
retain the best doctors, nurses and support staff. It is the ability of the hospital's
design to integrate all these needs in a way which is flexible and adaptable over its
lifetime, so that it can continue to serve its mission, without substantial
reconstruction (asianhhm.com).
It has immense relevance to the project in way that through a sustainable design it
can cut down maintenance cost and increase profitability for the patients’ financial
assistance. The facility will heal and protect their patients in the best way that a self-
sustaining healthcare environment can.
2.3 Recommendations for Application
By applying the above mentioned principles of bio-mimicry and sustainable design,
the facility will function as a multi-disciplinary institute for cancer. The facility will
function by gathering all the necessary resources in one place and providing cancer
patients a one-stop Ambulatory Care Unit through a well-defined spatial planning. It
can offer a full spectrum of cancer care and management all the way from the
beginning, starting with screening to early detection, evaluation, treatment planning,
treatment, rehabilitation, after care and prevention. Also, combining some retailing in
the facility such as a bank, health food restaurant, and some personal services, could
be attractive as a convenience.

The researcher keeps on emphasizing that the project is intended for those cancer
patients who are financially capable. If only these people did not have to have cancer,
they do not have to carry the entire burden. This is for this reason that one of the
objectives of the study is to determine how to drive the public interest in preventing
cancer. Even if this concept of integrating all services in one location is not that new, it
is undoubtedly a concept that can attract people. Combining it with facilities essential
to Filipino modern lifestyle like for leisure and health, can help it achieve its goal. This
gives a win-win situation for the owner, doctors and patients. The owner can gain
additional profit other than those who are confined. Doctors can extend their practice
as they can manage their own consultation offices and have more patients than usual
if they are located in a typical hospital. Public’s curiosity will drive them inside the
facility and then in turn will have their checkups for possible cancer risk or be aware of
cancer prevention.

Chapter 3
Architectural Programming Data
3.1 Site Selection Process
The study looks into areas where there is high or middle poverty incidence in
the National Capital Region. Before setting the criteria for the site, Table 8 shows the
list of Small Area Poverty of Estimates of 2009 from NSO. This list helped the
proponent limit the range of where to look for the appropriate site in the National
Capital Region. However, the Third District was intentionally disregarded from the
selection because this area is often being flooded that makes the facility prone to
hazards.
Table 8: City and Municipal-level Small Area Poverty Estimates, 2009

3.1.1 Setting the Criteria
It was discussed before that location has an effect on the patient’s preference on their
healthcare facility. Reviewing the findings is very important in selecting the most
appropriate site. Average travel time is longer for persons in rural areas (45 minutes)
than for those in urban areas (32 minutes). Looking at economic status, the average
travel time was longest for persons in the lowest wealth quintile (47 minutes) and the
shortest for those in the highest wealth quintile (35 minutes). Immediate treatment
must always be provided for the patients.
The primary purpose of this guide is to help the medical sector make the wisest
selection possible, most especially for patients who belong to low and middle income
earners.
The following criteria are set in the Guidelines in the Planning and Design of a Hospital
and other Health Facilities by the Department of Health and by the proponent:
a. Location or Site Proximity to Major Establishments ( 40% )
It will be very convenient if the site will be located near major establishments
like malls and alike where active modern lifestyle is present. This was
highlighted as one of the objective of the project that is to attract public’s
attention of going into the facility for their health betterment.
b. Environmental Quality of Area ( 15% )
The site must be reasonably free from undue noise, smoke, dust, foul, odor,
and flood. Being a healthcare facility, the utmost care to the patients must be

given to them and the extent for them to feel this way is what their
environment is giving them. Also, the site should be located in a favorable
orientation to wind and light. It must be noted that a good environment can
make people feel better.
c. Safety Standards Achieved by Proper Zoning ( 20% )
The site should not be located adjacent to railroads, freight yards,
children's playgrounds, airports, industrial plants and disposal plants. The
project is intended to heal dying people and upon choosing a site that is safe,
it will eliminate the risk of endangering lives because of site hazards.
d. Accessibility to Major Highway (25%)
The site must be accessible to the community by ordinary means of
transportation and most importantly for public transportation. Most of the
intended users of the project are between middle and low income earners
who are using public transport in their everyday lives which makes it a very
important consideration in the healthcare delivery.
3.1.2 Description of Site Options
a. Novaliches, Quezon City

Figure 12: Novaliches, Quezon City
Quezon City, as part of the Second District ranked
first in the poverty incidence survey (refer to Table
2). The candidate site is along Quirino Highway and
corner of Belfast St. It is also within the boundary of
Figure 13: Paco, Manila City

the intersections of four major roads namely: Quirino Highway; Commonwealth
Avenue; Mindanao Avenue; and Regalado Highway. There are lots of major
establishments which are adjacent or accessible to it to name some: SM City Fairview;
Robinson’s Nova Market; Novaliches Public Terminal; Teresa Heights Subdivision;
Commonwealth Medical Center; Mary the Queen Parish; and Sacred Heart Academy.
Zoning wise, it is under Institutional zoning that makes it safe to build a healthcare
facility and has high proximity to major establishments. It is far from getting flooded
because it is located higher than Manila with having somehow cooler temperature.
However, the site is still underdeveloped.
b. Paco, Manila City
Even if Paco ranked eighth in the list under the Figure 13: Paco, Manila
First District, it was still chosen by the
proponent because most importantly it
promises safety from crime, natural disaster like
flood and environmental sanitation for the
project’s users. The candidate site is located along San Ignasio St. and U.N. Avenue.
There Nagtahan and Ayala bridges are also near the site. It is also a good location for
its proximity to malls, banks, car retail, residential, schools and churches. Specifically,
these are Robinson’s Otis, Union Bank of the Philippines, Honda, Toyota and Chevrolet
Car retails, U.N. Garddens, Paco Catholic School, St. Peter the Apostle Catholic School
and Manuel A. Roxas High School, Paco Church and St. Peter the Apostle Church. The
site is zoned under Institutional Zoning.

c. Pamplona, Las Piñas City
Las Piñas was chosen instead of Pateros because Figure 14: Pamplona, Las Piñas City
The site
there was no appropriate site for a healthcare
facility in the latter. In addition, Las Piñas as a
city can offer much more different
establishments as compared to the municipality
of Pateros. Some of these are University of Perpetual Help Dalta Medical Center, SM
Hypermarket, Citimotors, SM Center, Perpetual Help High School and Risen Lord
Parish Church. Zoned as Institutional, it is along the Alabang-Zapote. Even if it has a
city life there are still portions around the area where there are trees and good views
of nature to look at. It is also good that there are lots of medical facilities around the
area like University of Perpetual Help Dalta Medical Center, Callejo Medical Clinic and
the City Health Office to offer additional support to the proposed project.
3.1.3 Site Selection and Justification
Table 9 shows the tabulated percentage computation of the three candidate sites in
the four categories.
Table 9: Site Selection Percentage Tabulation
Location/Site Environmental Safety Accessibility
Proximity to Quality of the Standards to Major
Site Major Area Achieved by Highways
Establishments Proper Zoning
(40%) (15%) (20%) (25%)
Quezon City 38% 13% 18% 24%

Manila City 30% 10% 16% 18%
Las Piñas
35% 12% 18% 21%
City
Total: Quezon City – 93% ; Manila City – 74% ; Las Piñas City – 86%
Site Justification
The site in Novaliches, Quezon City scored 93% and topped the entire
category except for the Proper Zoning Category wherein it garnered the same
percentage with Pamplona, Las Piñas City. This makes it the best selection for a health
environment for a cancer facility. Second is Pamplona, Las Piñas City with 86% and
lastly is Paco, Manila City with 74%.
3.2. Site Analysis
Background
Quezon City is the former capital (1948–1976) and the most populous city in the
Philippines. Located on the island of Luzon, Quezon City is one of the cities that make
up Metro Manila, the National Capital Region. The city was named after Manuel L.
Quezon, President of the Philippines, who founded the city and developed it to
replace Manila as the country's capital. Quezon City is not located in and should not
be confused with Quezon province, which was also named after the president.

Geographical Location
Figure 15: National Capital Region
The city lies on the Guadalupe plateau which is a relatively
high plateau on the northeast corner of the metropolis –
between the lowlands of Manila to the southwest and the
Marikina River valley to the east. The southern portion is
drained by the very narrow San Juan River and its
tributaries to Pasig River, while running in the northern portions of the city is the
equally narrow Tullahan River.
3.2.1 Laws and Ordinances Pertaining to the Site (Department of Health Guidelines in
Planning and Design of a Hospital and other Health Facilities)
a. Environment
A hospital and other health facilities shall be so located that it is readily accessible to
the community and reasonably free from undue noise, smoke, dust, foul odour, flood,
and shall not be located adjacent to railroads, freight yards, children’s playground,
airports, industrial plants, disposal plants.
b. Occupancy
A building designed for other purpose shall not be converted into a hospital. The
location of a hospital shall comply with all zoning ordinances.
c. Safety
A hospital and other health facilities shall provide and maintain a safe environment
for patients, personnel and public. The building shall be of such construction so that

no hazards to the life and safety of patients, personnel and public exist. It shall be
capable of withstanding weight and elements to which they may be subjected.
d. Parking
A hospital and other health facilities shall provide a minimum of one (1) parking space
for every twenty-five (25) beds.
3.2.2 Site Analysis Map/Discussion
Macro Analysis
Quezon City is bordered by Manila to the southwest,
by Caloocan and Valenzuela City to the west and northwest,
to the south lies San Juan and Mandaluyong,
while Marikina and Pasig borders Quezon City to the
southeast. To the north across Marilao River lies San
Jose del Monte in the province of Bulacan and to the
east lies Rodriguez and San Mateo, both in the province
of Rizal. Figure 16: Quezon City
The city can be divided into a number of areas. The southern portion of the city is
divided into a number of places including Diliman, Commonwealth, the Project areas,
Cubao, Kamias, Kamuning, New Manila, San Francisco del Monte, and Santa Mesa
Heights. The northern half of the city is often called Novaliches and contains the areas
of Fairview and Lagro. Most of these areas have no defined boundaries and are
primarily residential in nature.

Micro Analysis
Figure 17: Macro to Micro Site Maps

a. Dimension and Site Area
 Owner : Fairland Development Corp.
 Sub-Class: Institutional
 Area : 14,437 sq. mts.
 Unit cost : Php 26,000.00 or Php 50.00/month if for
Lease
Figure 18: Site

b. Sun and Wind Analysis
c. Noise Analysis

d. Traffic Flow Analysis
e. Proximity Map/Inventory

3.2.3 Site Development Options
Considerations:
- maximize the
environmental potential of
the site
- maximize the view for
greens
- must encourage interest
of the public
50% - open space
40% - buildable
7% - vehicular
3% - pedestrian

3.3 Space Programming
3.3.1 User Profile


3.3.2 User Analysis
Analysis: Evidently, most of the time allotted for medication is under the
tertiary period which indicates that the spaces involved are critical for the
project. However, the primary and secondary spaces must not be reprimanded
because it is through these spaces that will set every patient’s impression of
having their continual medication in the facility
















3.3.4 Spatial Diagrams


3.4 Architectural Translation
3.4.1 Design Concept – application of research focus
Just like a tree that heals itself when wounded, healthcare
facilities that are showing implications of being a “sick
building” must seek treatment through the following design
solutions.











3.4.7 Elevations
FRONT ELEVATION
REAR ELEVATION

RIGHT-SIDE ELEVATION
LEFT-SIDE ELEVATION


3.4.7 Perspectives
AERIAL PERSPECTIVE
MAN’S EYE VIEW PERSPECTIVE

view from pedestrian entry/exit

MAN’S EYE VIEW PERSPECTIVE

view from public parking
MAIN LOBBY

ADULT’S WARD
CHILDREN’S WARD

3.5 Conclusion
Even low to middle income earners deserved a quality healing environment at an
affordable cost. Having the disease in itself is such a burden; they need all the help
that they can get.
Issues on cancer and its treatment can be viewed on different ways, either positive or
negative. This thesis viewed the negative side of cancer and translated it to a positive
way. The main issue that was addressed focused on ways on how a cancer facility can
cater those who are financially incapable of its expensive treatment. Through
architecture, treatment can be affordable or lesser by means of lower construction
cost of the structure, sustainable design thru passive cooling, efficient planning for
lesser travel time, and most importantly, taking in consideration nature’s healing aid
as it works hand-in-hand with scientific medical treatment.

Bibliography
Cancer. Retrieved July 22, 2012,

fromhttp://health.nytimes.com/health/guides/disease/cancer/overview.html
What is Cancer? What Causes Cancer? Retrieved July 22, 2012 from
http://www.medicalnewstoday.com/info/cancer-oncology/
Radaniel, M.t. et.al. (2009). Cancer survival discrepancies in developed and developing
countries: comparisons between the Philippines and the United States. Retrieved July
22, 2012 from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2653748/?tool=pubmed
Cancer Statistics. Retrieved July 22, 1012 from http://www.cancer-treatment-

tips.com/cancer-statistics.html
Creating Environments for Cancer Care. Retrieved July 22, 2012 from
http://www.hfmmagazine.com/hfmmagazine/jsp/articledisplay.jsp?dcrpath=HFMMA
GAZINE/Article/data/11NOV2008/0811HFM_FEA_Dialogue
De Guzman, Roselle. (2007). Cancer in the Philippines. Retrieved July 22, 2012 from
http://www.asconews.org/anf/Past+Issues/July+2007/Cancer+in+the+Philippines?cps
extcurrchannel=1
Ocampo, Satur C. (2007). Philippines: The People’s Health in Crisis. Retrived August
24, 2012 from http://www.pinoypress.net/2007/10/03/philippines-the-peoples-
health-in-crisis/
Biomimicry: Sustainable Design Guided by Nature. Retrieved September 4, 2012 from

http://www.clickrally.com/biomimicry-sustainable-design/

Appendix
Interview Questionnaire:
1. How do you inform your patients if they are cancer positive?
2. How negative it is for them when they know they have cancer?
3. How big is the contribution of family support during their struggle

against the disease?
4. Aside from medical treatment, up to what extent do other

therapies, like art and music therapy, help?
5. Is it necessary to have a psychiatrist constantly monitoring the

patients? How?
6. Does a cancer patient like to be treated as someone who is sick or

like a healthy person who can freely move and enjoy?
7. Is it okay for them to meet/see people other than their relatives,

medical staffs and other patients? How does it affect them?
8. How much does it cost to manage cancer?
9. Where does the funding for charity ward come from?
10. How can you encourage that the medication is not for free?
11. Over-all, what is your funding/financial system of your hospital?

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MAPUA INSTITUTE OF TECHNOLOGY

School of Architecture, Industrial Design and the Built Environment

A Proposed Low-Cost Oncology Center for the

In partial fulfillment of the course requirements in

Healing architecture as influenced by nature was strongly emphasized and

I owe my deepest gratitude to my thesis adviser, Arch. Anna Christina

Also to my sister, Mary Grace A. Marquez, M.D., whose medical

Lastly, I would like to extend my gratefulness to my Design 9-11 A.Y.

2.0 Research Focus

3.0 Architectural Programming Data

Bibliography or References 109

1.1 Background / Overview

forgot to die (http://health.nytimes.com).

School of Architecture, Industrial Design and the Built Environment

pertaining to medicine and diseases. According to the US National Cancer Institute

total deaths is due to cancer. Whereas globally, according to World Health

Organization (WHO) cancer statistics, worldwide deaths due to cancer is projected to

increase 9 million in 2015 and as high as 12 million in 2030 thus, an increase of 1

million deaths every 5 years.

rates of orthodox/conventional cancer treatment and natural/holistic cancer

chemotherapy. According to Professor Abel of the German research center on cancer

in Heidelberg, 98% of patients treated with chemotherapy drugs die within 7

Infectious diseases typically receive more attention—available resources and

School of Architecture, Industrial Design and the Built Environment

help address these challenges?

1.2 Statement of the Problem

 What approaches are necessary to promote an atmosphere of healing and

 What architectural factors can greatly affect the competency of cancer

healthcare facilities as compared with those existing cancer institutes in the

School of Architecture, Industrial Design and the Built Environment

sustaining healing environment through architecture?

1.3 Project Goals, Objectives and Strategies

1.3.1 Client’s Goal

1.3.2 Project Goal

significance of architecture in cancer management and prevention through identifying

which factors do existing facilities are lacking.

1.3.3 Objectives and Strategies

 To develop a systematic flow of how users will move inside the

complex starting from cancer screening and prevention up to their

cancer diagnosis and survival

o Strategy 1: Research on the ambulatory services that

hospitals cater to their patients, especially for cancer cases,

and each corresponding cost

School of Architecture, Industrial Design and the Built Environment

o Strategy 2: Research on screening techniques and latest

technology and approaches in managing cancer

o Strategy 3: Research on Filipino modern lifestyle that have a

direct effect on their health and being prone to risk factors

 To know the psychological needs of cancer patients in determining

its impact on promoting an atmosphere of healing and wellness

o Strategy 1: Research on the most common psychological

needs of cancer patients based on other studies

o Strategy 2: Interview medical experts on how they approach

their cancer patients

 To develop a situational analysis of the existing cancer institute that

will highlight its positive and negative points

o Strategy 1: Compare and contrast foreign and local facilities

of successful cancer institutes

1.4 Significance of the Research

1.4.1 National/Economic significance

their situation to be recognized by the government and non-government associations.

impact on the country’s fight against poverty and health.

School of Architecture, Industrial Design and the Built Environment