Introduction
In Northern Ireland we have approximately 8,700 new cancers per year and approximately 3,800 cancer deaths. Males appear to have higher rates of cancer than females and either sex has a one in three chance of developing cancer in their lifetime. Approximately one in nine cancers are diagnosed before age 45. In addition to the high cancer incidence it has also been noted that cancer outcomes in the early 90’s were among the worst in Western Europe. This resulted in the Chief Medical Officer’s report entitled “Cancer Services – Investing for the Future" (published in 1996). Dr Henrietta Campbell’s report became the catalyst for the re-development of cancer services in Northern Ireland.

The establishment of the Cancer Centre at Belfast City Hospital is one of the core elements of this major programme of change and development in cancer services across Northern Ireland that has been ongoing since 1998. Radiotherapy and chemotherapy services provided at Belvoir Park Hospital (a small radiation hospital) transferred on Friday 17 March 2006 into the modern purpose-built £60 million Cancer Centre at Belfast City Hospital and amalgamated with the existing cancer services on that site.

• multidisciplinary expertise for all common cancers within the local catchment population

• regional multidisciplinary expertise in all other cancers except for some very rare cancers

• specialist diagnostic facilities, including ready access to a full range of clinical imaging services

• specialist therapeutic services, including radiotherapy and complex chemotherapy, delivered in an acute hospital setting where there is the full backing of acute and diagnostic services

• access to high quality clinical trials and academic research

• a regional focus for research, audit, teaching and training.

The Cancer Centre provides an environment that has been designed to support a holistic and patient-centred approach to high quality cancer care. The aim of the new cancer centre building is to ensure that the physical facilities in which care is delivered enables the staff who provide that care to adopt the latest treatment techniques and best practices. Moreover, it facilitates cohesive cancer teamwork and the best use of cancer care skills and resources.
The new Cancer Centre ensures that Northern Ireland is a leader within the UK and Ireland in the development of the Cancer Centre / Cancer Unit model, and allows Northern Ireland to be at the forefront of cancer diagnosis, treatment and research. Through the creation of an environment conducive to delivering sustained improvements in cancer care, cancer patients in Northern Ireland will receive care of the highest international quality and standard.

The numbers of new patients seen by oncologists have increased from 3373 in 1996 to approximately 5462 in 2005. It is expected that by 2007/08 the number of patients per annum could increase to 5800, rising to a maximum of between 6000-6500. A number of factors are contributing to this increase in new patients:

• increases in the incidence of cancer

• increases in referral rates for treatment

• the ageing population.

The new Cancer Centre will improve patient access to the most modern diagnostic and treatment facilities. The content of the Centre is described below:

• Two dual-headed gamma cameras are available

• Space is provided for a Positron Emission Tomography (PET) Scanner

• Ablation therapy isolation facilities are available at ward level. Specialist facilities have been created for the disposal of radioactive therapeutic waste products.

• General X-ray Room

• Digital Chest X-ray Room

• Two Ultrasound Rooms

• Interventional/Screening Suite

• One MRI Scanner will be in operation at the time of the opening of the Centre. There is space for another scanner at a later date

• Three CT Scanners (one for Radiotherapy Planning)

• Picture Archive and Communications System – PACS

• Associated Radiologist Reporting and Teaching Spaces.

• Two simulators (including one SIM-CT) are provided. In addition, there is a CT Scanner for Radiotherapy Treatment Planning purposes

• There are ten Linear Accelerator bunkers, all with radiation protection to 15 MV photon energies

• There are eight Linear Accelerators operational in the Cancer Centre – four 6 MV machines and four 6/15 MV machines. All machines include the latest technology for Multi-Leaf Collimation, Electronic Portal Imaging, Amorphous Silicon etc. Intensity Modulated Radiotherapy is available on at least two Linear Accelerators

• A High Dose Rate Brachytherapy Theatre Suite is provided at the Cancer Centre. An integrated Brachytherapy Unit is housed within the Theatre. This new, beneficial therapeutic technique was not previously available in Northern Ireland

• Suite of eight Radiotherapy Assessment and “On-Treatment Review” Clinic Rooms.

• 84 beds (three 24-bedded areas and one 12-bedded area), at least 50% of the beds are in single room accommodation with associated ensuite facilities. Two Selectron Rooms for Medium Dose Rate Brachytherapy are included within the 84 beds. Also, provision is made for seven source and protective isolation rooms within the complement of 84 beds.

• Engineering Rooms/Dosimetry Laboratories/Dedicated Treatment Planning Suite

• Mould, Preparation and Outline Rooms for preparation of immobilisation devices for eg head and neck patients.

• Occupational Therapy Department including kitchen, bathroom and bedroom to assess the activities of daily living

• Physiotherapy gymnasium and treatment cubicles

• Speech and Language Therapy Treatment Rooms

• Dietetics Offices.

• Multidisciplinary teaching and conference area comprising two 20-person seminar rooms, one 50-person seminar room, an Oncology Library and assortment of general offices

• Patient Review Clinic comprising four clinical rooms and a treatment room located at the entrance to the bridge corridor link to the new Oncology and Haematology Day Hospital

• Numerous counselling/ interview/sitting rooms throughout the building

• Office accommodation for medical and other staff

• Café and shop.

As part of the development of the Cancer Centre at Belfast City Hospital, a new £4million Oncology and Haematology Day Hospital (The Bridgewater Suite) was opened during 2003. The Day Hospital is joined to the first floor of the new Cancer Centre by means of a link corridor. The Day Hospital includes:

• 13 Consulting Rooms

• four Nurse Assessment/Clinical Rooms

• 40 Space Day Hospital

• Apheresis Suite

• Medical Records Facility.

Also, a new purpose-built pharmacy, designed for the preparation of chemotherapy, has been constructed. There are five clean rooms with isolators (including one room set-aside for Gene Therapy).

A new 30 bedded inpatient haemato-oncology unit (with ten Bone Marrow Transplant Rooms) opened in September 2001 at Belfast City Hospital. Also, new Haematology Laboratory accommodation has been constructed on the same floor as the Oncology and Haematology Day Hospital is adjacent to the new pharmacy facility.

The Cancer Centre is a major symbol of the process of cancer service redevelopment in Northern Ireland. Therefore, the development of a comprehensive Cancer Centre as envisaged by the Campbell plan and the creation of integrated programmes of cancer care will ensure the highest quality of care for cancer patients in Northern Ireland for the future.

Consultant Name	Specialties
Dr Russell Houston	Lymphoma radiotherapy Head and neck cancer Gastrointestinal cancer
Professor Patrick Johnston	Gastrointestinal cancer Gynaecological/breast cancer Testicular cancer
Dr Seamus McAleer	Breast cancer Testicular cancer Melanoma
Dr Paul Abram	Breast cancer Total body irradiation
Dr Kieron Moore	Head and neck cancer Breast cancer
Dr Stephen Stranex	Lung cancer Urological cancer
Dr Paul Henry	Breast cancer Gastrointestinal cancer Sarcoma
Dr Robert Harte	Gastrointestinal cancer
Dr Jackie Clarke	Gynaecological cancer Breast cancer
Dr Sarah McKenna	Gynaecological cancer Breast cancer
Dr Angus Patterson	Breast cancer
Dr Ruth Eakin	Lung cancer Urological cancer
Dr David Stewart	Urological cancer Lung cancer Head and neck cancer
Dr Martin Eatock	Gastrointestinal cancer
Dr Richard Wilson	Gastrointestinal cancer Clinical trials
Dr Jackie Harney	Neuro oncology Lung cancer Urological cancer
Dr Joe O’Sullivan	Urological cancer
Dr Yvonne Summers	Breast cancer Lung cancer
Dr Alison Clayton	Breast cancer Urological cancer
Dr David Conkey	Neuro oncology Gastrointestinal cancer
Dr Lin Sum	Urological cancer
Dr Dean Fennell	Lung cancer
Dr Jonathan McAleese	Lung cancer Urological cancer