Dr. Gordon Stillie remembers the first day of his residency as a radiation oncologist in 1978.

The technicians were on strike, so the new doctors were given a half-hour of training and told to run the machines, shooting radiation into patients with cancer.

The huge amount of technical knowledge required today to give a patient radiotherapy is such that, just a few decades later, Stillie’s experience would be unthinkable.

As a result of the increased rates of cancer and increased manpower necessary to treat it, Northwest Montana Radiation Oncology is planning to nearly double in size to accommodate more patients.

“We’ll be able to treat things better,” Stillie said. “We’ll have more defined results. As for us, as things improve for the patient, our lives become more complex.”

With more technology, electronic record-keeping and other medical professionals to keep up-to-date, a single patient can create more administrative work than ever before, and keeping tabs can be straining.

Still, Stillie and fellow radiation oncologist Kendra Harris don’t mind the complexity, as it means those people with cancer can get better and safer treatment.

The building expansion will add 4,230 square feet, including 1,405 square feet for a second radiation vault. The vaults are designed to shield technicians and doctors from the radiation being aimed at a tumor.

The building expansion will cost about $1.8 million, but the largest expense comes from new technologies that come with a price tag of $5.9 million. Stillie said the plan is to begin taking patients in the expanded facility by early summer 2015.

“If you’re going to stay current, you’ve got to spend a lot of money,” Stillie said. “We can do some new techniques now, try some different surgeries.”

The big piece of equipment is a TrueBeam system. The machine can shoot a highly concentrated dose of radiation directly at a tumor. 

Dr. Melissa Hulvat, a breast surgical oncologist, said the technology will be a big step up for Flathead Valley residents with cancer.

“You want to hit the tumor and kill it without touching the healthy tissue around it,” she said. “Like in the brain. You don’t want to touch anything else. This machine has accuracy up to two millimeters. That’s maximum tumor kill.”

The oncologists say this expansion and technology could bring more patients to the valley rather than pushing them to larger markets.

“We can provide all services found at tertiary care and we combine it with the team approach,” Harris said. “In my opinion, there is no reason to leave the valley for your care.”

The expansion of the oncology building is much more complex than just creating office space. Swank Enterprises is doing the construction and is tasked with creating a second radiation vault and reformatting the existing one.

The current vault has a massive, heavy lead-lined door closing off the office from the area where the radiation is utilized. The proposal for the new one is a doorless vault, with a heavy concrete maze that shields technicians and doctors from the radiation without a heavy door that takes precious time to open and close.

Vaults are poured with thick concrete with walls ranging from 3- to 7-feet, 6-inches thick. The roof of the vault is between 2 feet, 8 inches to 4 feet, 6 inches thick. The concrete used in these vaults cures more slowly than typical concrete, taking two to three months to be fully set.

The expansion is not only a good thing for patients, Stillie said, but also an increasingly necessary one.

In the year before Harris, a Bigfork native and Rhodes scholar, arrived to help shoulder some of Stillie’s workload, Stillie was seeing more than 400 patients a year.

“The number is about 250 a year for an average oncologist,” Stillie said. “The magic number is 290. That’s the “burn out” number when doctors just get tired. I saw 412 the year before Kendra came.”

With a growth rate in the number of patients of around 4 percent annually, a single radiation oncologist was unsustainable. 

That isn’t to say the oncologists do it alone. Gone are the days of a resident taking over for a technician. Now, the average cancer patient could have as many as 40 people working on their case, in what the doctors refer to as the “team approach.”

Quinn Lamers, a radiation oncology technician for 26 years, is just one of dozens of people who help see a patient during their radiotherapy.

Whereas in the 1970s a cancer patient undergoing radiotherapy might have five or six steps in treatment, today’s patients have 198 “contact points” or interactions between patient and nurse, doctor, technician or social worker.

“We have an attentiveness to staying safe and making the patient comfortable,” Harris said.

Hulvat said the expansion will allow for comfort of patients even when not receiving treatment, specifically citing the flow of patients planned in the new wing.

“I like the design process,” she said. “Patients coming in for treatment are in a different part of the building than those coming for follow-ups. It’s all about patient dignity and privacy. It’s amazing how someone can change when you take their clothes and tell them to wear a gown.”

Additional space for clinic rooms, a CT scan area, changing rooms and other comforts seek to make what is for many people the most traumatic time in their lives a little easier to handle.

Reporter Ryan Murray may be reached at 758-4436 or by email at rmurray@dailyinterlake.com.