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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).

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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,

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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?

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 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

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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.

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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

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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

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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

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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

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 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.

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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.

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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.

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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

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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

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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.

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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.

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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

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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.

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 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.

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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

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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.

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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.

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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,

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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

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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.

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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

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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.

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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

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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

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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.

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 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.

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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.

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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.

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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

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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.

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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

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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

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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.

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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

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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

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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.

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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.

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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

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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

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 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

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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.

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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

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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

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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

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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

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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

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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.

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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.

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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.

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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

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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.

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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.

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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

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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

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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

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Figure 13: Paco, Manila City


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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.

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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%

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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.

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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

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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.

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Micro Analysis

Figure 17: Macro to Micro Site Maps

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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

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b. Sun and Wind Analysis

c. Noise Analysis

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d. Traffic Flow Analysis

e. Proximity Map/Inventory

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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

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3.3 Space Programming

3.3.1 User Profile

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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

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3.3.4 Spatial Diagrams

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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.

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3.4.7 Elevations

FRONT ELEVATION

REAR ELEVATION

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RIGHT-SIDE ELEVATION

LEFT-SIDE ELEVATION

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3.4.7 Perspectives

AERIAL PERSPECTIVE

MAN’S EYE VIEW PERSPECTIVE


view from pedestrian entry/exit

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MAN’S EYE VIEW PERSPECTIVE


view from public parking

MAIN LOBBY

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ADULT’S WARD

CHILDREN’S WARD

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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.

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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/

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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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