A Whole-Lotta Lead

Stanford Cancer Center Is Loaded With the Material

By Richard Horgan

The $85 million Center for Cancer Treatment and Prevention at Stanford University includes 80 exam rooms, 50 chemotherapy stations and a radiation therapy suite. The Ambulatory Care Pavilion on the top floor of the three-story, 218,000-sq.-ft. structure will focus on outpatient surgery. (photo courtesy of Bob Swanson Images)

More than 10 years after Stanford University first conceived the idea of grouping all resources for diagnosing and treating cancer patients under one roof, a new $85 million facility completed Dec. 31 is finally set to open next month.

The Center for Cancer Treatment and Prevention includes 80 exam rooms, 50 chemotherapy stations and a radiation therapy suite, while the Ambulatory Care Pavilion on the top floor of the three-story, 218,000-sq.-ft. structure will focus on outpatient surgery.

The endeavor marks the latest triumph in the health-care field for Foster City-based general contractor Rudolph and Sletten. The family-owned business has also been involved in medical projects such as the adjacent Lucille Packard Children's Hospital at Stanford; Kaiser Permanente in Fremont, Santa Clara and Roseville; and Children's Hospital in Los Angeles.

"Rudolph and Sletten's team demonstrated an extreme propensity to detail and proactive planning, which translated across the budgeting and scheduling," said John Gaston, project manager for Stanford. "With their assistance, we were able to trim more than 5 percent of the construction budget without adversely impacting the project's functionality or aesthetics."

One of the biggest challenges for Rudolph and Sletten and Lone Star Construction Co., a Houston, Texas-based subcontractor, was the facility's basement, which houses seven machines known as "linear accelerators" that use electricity to form streams of fast-moving atomic particles to treat cancer patients.

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Each machine is housed in a separate vault and required more than 200,000 lbs. of lead bricks on the walls, ceilings and decks above to act as a radiation shielding system. Their encasement is fortified by a concrete wall up to 4 ft., 11 in. thick, a maze wall design and 10 ft. of soil outside each vault.

The lead itself was cut within a specially constructed booth equipped with filters and a continuous exhaust to remove lead particles from the shed and clean the air before it was emitted into the atmosphere. The air inside and outside the linear accelerator rooms was continuously monitored during the two-year construction phase to monitor particulate levels.

"Safety associated with lead installation was addressed for all workers onsite as well as the general public," said Marcus Staniford, project executive for Rudolph and Sletten. "It was of paramount importance to address the safety considerations of the entire lead-shielding process, from air cleanliness to material handling, cutting and installation."

The building's foundation system, which includes spread footings, mat slabs and grade beams, was designed to respond to the extreme building loads of 1.6 million lbs. of lead and large lateral design loads associated with the linear accelerator vault walls.

Additionally, because university-occupied buildings surrounded the construction site on all sides, some of the work had to be performed at night.

"We had to use both a 300-ton crane with a 180-ft. Luffer and a 280-ton boom and gib crane due to limited access around the perimeter of the building," Staniford said.

Seven cancer treatment machines-known as linear accelerators, will be housed in separate vaults that require a radiation shielding system made up of more than 200,000 lbs. of lead bricks on the walls, ceilings and decks. Their encasement is fortified by a concrete wall up to 4 ft-, 11-in. thick, a maze wall design and 10 ft. of soil outside each vault . (photo courtesy of Bob Swanson Images)

To accommodate installation of about 300 precast concrete panels ranging in size from 4 to 32 ft. wide, workers had to utilize a crane that could reach from one side of the building to the other since access was limited on three sides of the structure, Staniford added.

While shielding is often done with just concrete, Rudolph and Sletten used a combination of concrete and lead because of limited space on the construction site. Specifically, 8 in. of lead were added to the nearly 5-ft.-thick concrete walls.

The firm also worked closely with a radiation shielding consultant and physicist, Nisy Elizabeth Ipe, to prevent any escape of secondary emissions from the linear accelerator's powerful radiation beam, which targets a patient at specifically calculated angles.

"As a physicist, I can design the shielding, but if there is no follow-through by the contractor, I have no guarantee that what I designed is what was built," Ipe said. "Rudolph and Sletten were very conscientious about follow-through and making sure that everything [was] done correctly."

Like Rudolph and Sletten, Los Angeles project architects Michael Bobrow and Julia Thomas have carved out a solid reputation in the health care field. Their design for the Stanford cancer center was honored by the Chicago-based trade weekly Modern Healthcare for its "patient-focused care," while their previous work on Inpatient Care Units merits a major section in the Wiley Books publication "Healthcare Facilities."