Documente Academic
Documente Profesional
Documente Cultură
A Thesis presented to
The Faculty of School of Architecture Industrial design and the Built
Environment
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 diseases
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 patients betterment. Hopefully
with this design proposal, future hospitals will also invest in nature for
patients 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 diseases stigma by
presenting different methods of conveying the subject matter. Preliminary chapters
discussed cancers 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 Patients 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. Lukes Medical Center;
library research; and case studies of St. Lukes 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 Savers 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 patients betterment. Hopefully with this design proposal, future
hospitals will also invest in nature for patients 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. Lukes
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!
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CONTENTS
1.0 The Problem
1.1 Background / Overview
1.2 Statement of the Problem
1.3 Project Goals, Objectives and Strategies
1.4 Significance of the Research
1.5 Review of Related Literature and / or Studies
1.6 Conceptual Framework
1.7 Research Methodology
1.8 Scope and Limitations of the Study
1.9 Definition of Terms
2.0 Research Focus
2.1 Rationale
2.2 Discussion of principles and relevance to the project
2.3 Recommendations for application
3.0 Architectural Programming Data
3.1 Site Selection Process
3.1.1
Setting the Criteria
3.1.2
Description of Site Options
3.1.3
Site Selection and Justification
3.2 Site Analysis
3.2.1
Laws and Ordinances Pertaining to the Site
3.2.2
Site analysis map/discussion
3.2.3
Site Development Options
3.3 Space Programming
3.3.1
User Profile
3.3.2
Users Analysis
3.3.3
Computation of spaces in relation to spaces
3.3.4
Spatial diagrams
3.4 Architectural Translation
3.4.1
Design concept application of research focus
3.4.2
Site Development Plan
3.4.3
Floor Plans
3.4.4
Sections
3.4.5
Elevations
3.4.6
Details
3.4.7
Perspectives
3.5 Conclusion
Bibliography or References
Appendix
Page
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Chapter 1
The Problem
There are many different kinds of cancers. Cancer can develop in almost any organ or
tissue, such as the lung, colon, breast, skin, bones or nerve tissue. Sadly, even up to
now determining what causes cancer is complex. But there are many things known to
increase the risk of cancer, including drinking excess alcohol, environmental toxins,
excessive sunlight exposure, genetic problems, obesity, radiation, benzene and other
chemicals, and viruses. These can directly damage genes or combine with the existing
genetic faults within cells to cause the disease. The chances of surviving the disease
vary greatly by the type and location of the cancer and the extent of the disease at the
start of the treatment. While cancer can affect people of all ages, and a few types are
more common in children, the risk of developing cancer generally increases with age
(www.medicalnewstoday.com).
United States of America has always been the forefront in science and research
pertaining to medicine and diseases. According to the US National Cancer Institute
Cancer statistics, in their country a new cancer is diagnosed every 30 seconds and one
person dies every minute in the US. Twenty-two point eight percent (22.8%) of their
total deaths is due to cancer.
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.cancertreatment-tips.com).
Cancer has not been perceived as a significant health problem in the Philippines.
Infectious diseases typically receive more attentionavailable resources and
government funding remain grossly inadequate to deal with the alleviating cancer
cases in the country. Statistically, at least 70% of patients have advanced or incurable
cancers at the time of diagnosis. Approximately 70, 000 people die of cancer-related
each year, and it is expected that 100, 000 new cases will be diagnosed (de Guzman,
MD, 2007). This statistics are further elaborated in subchapter 1.7.2 Research
Methodology.
Another critical factor in the fight against cancer is the countrys 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?
What planning concepts or strategies can help the facility promote a selfsustaining healing environment through architecture?
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.
According to the survey, as shown in Table 1, use of private health facilities increases
with economic status, from 1% among persons in the lowest wealth quintile to 6
percent among those in the highest wealth quintile. Information on specific types of
facilities and providers (public and private) visited by persons who sought care are
also included in the survey. Over one third ( ) visited Rural Health Unit (RHU) or a
Barangay Health Center (BHC), one fifth ( ) sought care at a private hospital, and
19% went to a private clinic for care. The use of RHU and BHC services decreases as
household wealth status increases, from 52% in the lowest wealth quintile to 11% in
the highest wealth quintile. The same pattern of results was obtained for the use of
private hospital services. According to the result, the use of private hospitals increases
with economic status, from 5% in the lowest wealth quintile to 46% in the highest
wealth quintile.
Table 2: In-hospital care
In Table 2, it shows the data in terms of in-patient hospital care. Persons who were
confined in a hospital or clinic were about equally likely to have been in a public
facility as a private facility: 51% of in-patients were confined in public health facilities,
while 48% were confined in private health facilities. Private hospitals account for the
largest share of those who were confined, followed by provincial hospitals, regional
hospitals, and district hospitals.
Similarly persons in urban areas are more likely to use private facilities than those in
rural areas. Among those who were confined, use of public facilities decreases as
economic status increases, from 77% among persons in the lowest wealth quintile to
23% among those in the highest quintile.
10
4 had to borrow money and sell property or a carabao to pay for their
hospital bills
The survey pointed to a stark reality that poor patients were stripped of their selfrespect as they were driven into begging and being hugely indebted because the
countrys 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.
11
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.
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 inpatient 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.
12
Location wise, the respondents were also asked for the travel Table 4: Average travel time to health facility
visited
13
14
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 countrys 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 countrys health care services infrastructure.
Figure 1: Top Ten Leading Causes of Deaths: 2005
15
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.
16
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.
17
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
18
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 designers part to create a home-like
environment in a natural setting that will make it different from a typical whitethemed 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 may suffer from short-term memory loss and cannot rely
on traditional way-finding methods.
19
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.
20
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 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
21
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. Publics 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.
22
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.
23
This concept of tree healing itself has an immense relevance to the study. However, it
must be noted that the relationship of the trees healing process and to the studys
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 facilitys 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,
24
function and grow in the best way possible and in a way that the design solution
would be as beautiful as the pinecone.
25
26
Ms. Banal was interviewed last September 3, 2012 in PSMO main office at St. Lukes
Cathedral Heights Building Complex. According to her, the organization is exclusive for
oncology doctors who were trained under these six hospitals namely: St. Lukes
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 proponents 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
PhilHealths program, the Navigator Treatment by the Department of Health offers an
27
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. Lukes 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 patientanddoctor they cannot still directly inform the patient
because he is unstable emotionally. In this situation, the family of the patients is the
doctors 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.
28
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 patients 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 familys
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 handin
hand to fight the disease. Effective treatment does not come from medical devices
29
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 patients 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.
30
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
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.
31
The therapy works with and supports the bodys 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.
32
So far, Ojus has treated over 80 patients with advanced cancers, most of them in
terminal stages. They maintain meticulous records of their patients 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
Cytotrontreatment, 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 Ojuss 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.
33
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. Lukes Hospital in
Global City.
34
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
35
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.
36
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
37
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
38
In developing the cancer screening summaries, the PDQ Screening and Prevention
Editorial Board uses the following definitions:
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.
39
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
40
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.
41
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.
42
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.
43
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.
44
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.
Table 6: Cancer Screening, Laboratory and Treatment Procedures in Doctrates Hospital U.K.
Procedures
Price in Euro
Price in Peso
In-patient services
560.00
29, 680.00
70.00
3,710.00
395.00
20,935.00
45
295.00
15,635.00
730.00 1,320.00
38,690.00 69,960
350.00 850.00
18,550 45,050.00
150.00 2,550.00
7,950 135,150.00
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
Diagnostic Imaging
MRI studies
CT studies
Isotopic studies
Ultrasound Studies
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
46
their medication that will have an effect on how the facility will be designed and
planned.
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.
47
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.
focus
on
cancer
Over the years, NCI Hospital has established itself as a reputable Oncology Centre in
the region, renowned for pioneering precision radiotherapy treatment options. The
48
Immunotherapy
that
Therapy.
The
oncology
team
actively
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
49
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. Lukes Cancer Institute (Quezon City) and National
Cancer Institute Hospital (Malaysia)
St. Lukes
National
Cancer Institute
Cancer Institute
Variables
Physiological Environment
40
storey structure
department
Neutral/Modern Zen
Neutral/Modern Zen
room
3. Theme/color of
walls, floor, ceiling
and alike
50
4. Room area
nge
None
rooms
Psychological Support
1. Art therapy
2. Music therapy
None
3. Other psychological
None
therapy
51
4. In-house
None
psychiatrist
Advance Medical
Treatment
Biological agents
other hospitals
(targeted therapy)
Adjunctive
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.
52
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 treatments 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
53
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.
54
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.
55
Hospitals have a brutal effect on the earth. They consume twice as much energy as
typical office buildings and operate 24/7. Often, theyre 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.
56
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 selfsustaining healthcare environment can.
57
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. Publics 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.
58
Chapter 3
Architectural Programming Data
59
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 publics
attention of going into the facility for their health betterment.
60
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.
61
because
most
importantly
it
62
can
offer
much
more
different
Site
Location/Site
Environmental
Safety
Accessibility
Proximity to
Quality of the
Standards
to Major
Major
Area
Achieved by
Highways
Establishments
Quezon City
Proper Zoning
(40%)
(15%)
(20%)
(25%)
38%
13%
18%
24%
63
Manila City
Las
30%
10%
16%
18%
35%
12%
18%
21%
Pias
City
Total:
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 Pias City. This makes it the best selection for a health
environment for a cancer facility. Second is Pamplona, Las Pias City with 86% and
lastly is Paco, Manila City with 74%.
64
Geographical Location
Figure 15: National Capital Region
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, childrens 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
65
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.
City
is
bordered
by
Manila to
the
southwest,
the
south
lies San
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.
66
Micro Analysis
67
Owner
Sub-Class: Institutional
Area
Unit cost
Lease
68
c. Noise Analysis
69
e. Proximity Map/Inventory
70
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
71
72
73
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 patients impression of
having their continual medication in the facility
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
3.4.7 Elevations
FRONT ELEVATION
REAR ELEVATION
103
RIGHT-SIDE ELEVATION
LEFT-SIDE ELEVATION
104
105
3.4.7 Perspectives
AERIAL PERSPECTIVE
106
MAIN LOBBY
107
ADULTS WARD
CHILDRENS WARD
108
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 natures healing aid
as it works hand-in-hand with scientific medical treatment.
109
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110
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?