Fighting to stay at the forefront of cancer research and treatment, the Johns Hopkins Medical Institutions plan to build a $120 million Comprehensive Cancer Center -- and the governor has pledged more than $30 million for the project.
Hopkins is counting on the center to help position itself as a national leader in forging such treatments of the future as gene therapy, a method of fighting cancer by inserting healthy genes into tumors.
Its new strategy is to assemble scientists who explore the frontiers of cancer research in the same building with the doctors, nurses, nutritionists, pharmacists, social workers and behavioral scientists who treat cancer patients.
Now, patients must go elsewhere in the sprawling hospital complex for surgery, and laboratories are scattered through at least four separate buildings.
The new plan should make it easier for doctors and research scientists to collaborate on new discoveries and for cancer patients to get the services they need.
"The new center represents a whole different approach to cancer care at Hopkins and a new commitment to cancer patients," said Dr. James A. Block, president of the Johns Hopkins Hospital and Health System.
"We're talking about a cancer center for the 21st century," said Dr. Michael Johns, dean of the medical school.
"We're not building the hospital of the past. We're building the hospital of the future."
Dr. Martin D. Abeloff, chief of Hopkins oncology, envisions the new building as a home for human trials, now in the planning stages, that would use genes to fight kidney cancer.
If successful, the technique could also be tried on prostate and breast cancer as well as melanoma, a deadly skin cancer.
Gov. William Donald Schaefer said he has pledged $24 million over the next four years to help build the center, supplementing $6.5 million already allocated.
The additional $24 million would have to be approved by the General Assembly.
Mr. Schaefer, whose term expires in early 1995, noted that he will be out of office when the last $6 million is needed, but he doubts his successor would stop a project so far along.
Maryland's distinction as the state with the worst cancer death rate has provided Hopkins -- and the governor -- with a rationale for investing in what could become one of the nation's leading centers for cancer research and treatment.
While Maryland has the worst death rate due to all cancers combined, it ranks among the top six states in deaths from lung, colon, breast and prostate cancers.
"This is a universal problem," Mr. Schaefer said. "The state of Maryland has the best medical facilities in the country. Our role should be support. We'll do our part."
Construction of the 390,000-square-foot center is scheduled to begin in January of 1994 on the site of the Frank M. Houck Building near the Wolfe Street entrance to the Hopkins complex.
Dating from 1913, the five-story Houck building was originally known as the Phipps Psychiatric Clinic and contained the hospital's psychiatric wards.
It was one of the earliest psychiatric buildings in the country, but was converted to office space about 10 years ago.
Administrators say the new building will rise six stories initially but later could be expanded to 10 stories.
Expected to open by late 1996, the new facility will replace the three-story Oncology Center, which cost $19 million when it opened in 1976.
Dr. Abeloff said the new building should provide a more pleasant atmosphere for cancer specialists to explore new approaches to fighting the deadly disease.
The science is already in its infancy: At Hopkins and elsewhere, scientists are learning to identify people who carry the genetic defects that put them at risk. Researchers are beginning to understand the series of genetic changes that occur before cells begin the uncontrolled growth that is the hallmark of cancer.
They are fashioning new drugs, and inserting healthy genes tput cells on a healthy course.
"The idea is to prevent cancer before it takes a foothold," saiDr. Abeloff.
"But as exciting as these developments are, it's going to take years to test them, to look at them in different corners. It would be much too glib to say it's going to be easy to solve these problems."
Even so, a sense of excitement is clearly in the air.
"I believe you're going to see cancer treatment change dramatically in the next 10 years," said Dr. Block.
Preliminary plans call for the new center to include state-of-the-art radiation therapy services, an outpatient chemotherapy treatment area, two inpatient floors, 15 operating rooms, a day-surgery service, a surgical intensive care unit and research laboratories.
It will have 96 beds, 12 more than the Oncology Center.
Although the project has been in the discussion stage for morthan five years, hospital officials say they are moving now for three reasons:
* The governor's commitment of $30.5 million, which must be matched by other sources. Approximately $20 million in private donations has already has been pledged. Among the private donors is Towson businessman Willard Hackerman, the head of Whiting-Turner Contracting Co. Mr. Schaefer said Mr. Hackerman has pledged $5 million toward the project.
* The selection earlier this month of a construction site. Hopkins trustees considered two other parcels before selecting the Houck property. Those were the current site of The Johns Hopkins Inn, and a parking lot at the northeast corner of Orleans Street and Broadway.
* The pressing need for a facility to accommodate new methods for cancer treatment and research and to provide more room to FTC house current programs. The Oncology Center is constantly full. Last year, it treated 4,000 new patients -- triple the number seen when the building first opened in 1976.
Although the increase in the number of beds is modest, officials say, the new center's outpatient treatment area will be much larger than the one in the Oncology Center.
The change reflects an increase in outpatient treatment for cancer.
Hopkins officials say the existing Oncology Center will be phased out of service once the new building opens, freeing its site for other uses that remain to be determined.
More than 800 people now work in the Oncology Center, and officials say the staff is likely to grow in size once the new building opens.