Proton therapy

Aarhus Arkitekterne, a Danish architectural firm with a €1.8bn portfolio of hospitals, laboratories and research facilities, has collaborated with contractor HOFFMANN, and engineers Alectia and Royal Haskoning DHV, on the Danish Centre for Proton Therapy at the New University Hospital in Aarhus, the most advanced radiation centre to date and the only one of its kind in Denmark.

Proton Therapy is a type of radiation treatment that uses positively charged particles rather than X-rays to destroy cancer cells. Thus, the interior and exterior are intended to underline the function of the centre and tell the story of precision, a key component of proton therapy as a form of treatment.

The conceptualization process centred on ensuring spaciousness and daylight conditions around the building’s inner framework, while also ensuring optimal conditions of patients and staff in clear, unambiguous pathways and workflows. Mette Dan-Weibel, partner and principal for health at Aarhus Arkitekterne, explains to Julian Turner how the project grew organically from the inside out.

Julian Turner: Please describe the evolution of the design process for the Proton Therapy Centre.

Mette Dan-Weibel: Dynamic initial dialogue meetings with users and professionals meant that the Proton Therapy Centre building was designed from the inside out. A strong focus on functional requirements and interior spatial values means that the project has developed organically.

The design process centred on identifying the optimal functionality while ensuring spaciousness and daylight conditions around the building’s inner framework. Simultaneously, it has been essential to ensure optimal conditions of patients and staff in clear, unambiguous pathways and workflows.

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"The exterior reflects precision, a key element of proton therapy."

The exterior reflects precision, a key element of proton therapy, by orchestrating a strict, restrained mode of expression, while healing, human-scale architecture is the focal point of the inner lay-out. The inner atrium of the centre provides daylight to the ‘backbone’ of the building along the access areas leading to the treatment zones and is a natural orientation axis through the complex.

Textural, warm materials combined with green, hanging gardens ensures an accommodating, yet professional healthcare environment. Spirit and uniqueness are added to the exterior through the meeting of three overlapping elements; an atop lantern, the concrete structure and the façade.

JT: How do the atop lantern, concrete structure and façade combine to create a distinct exterior?

MD: The Proton Therapy Centre consists of three principal elements, each with its own individual characteristics: the lantern at the top, as a light and visible landmark; concrete boxes that merge with the solid concrete bunker; and the surrounding screen that becomes a combining outer skin.                                                                                                                                   
The lantern contains offices, a research department and meeting facilities that adopt a glowing, central and visible location within the new centre and in hospital area at large. The large conference and meeting facilities are placed as a protruding and distinctive architectural element, directly above the main entrance, where they will be easily accessible, even for externally oriented events.

The geometry and resilience of the concrete forms a significant contrast to the ease of the lantern, reminding the spectator of the grave function of the centre. The large concrete structure around the proton accelerators constitute half of the total construction volume. As a clear architectural concept, the two-storey base continues in a smooth, respectful interpretation that continues around the atrium and in the dynamic concrete structure.

The perforated steel façade ties the building together creating overall coherence. As an independent and unifying element, the façade screen appears as an enclosure of the inner concrete structure, and a clear architectural face to the surroundings. The concrete structure’s sheer size and solidity makes for an unusual architectural experience. The construction combined with some of the world’s most advanced and exclusive equipment for cancer treatment, makes the building state-of-the-art.

JT: How do optimal conditions for patients and staff combine with functionality and spaciousness?

MD: The key clinical features are planned from a rational logic that minimises walking distances and optimises daily operations. The patients are challenged by what can be life-threatening diseases, and therefore a strong focus is on making their frequently repeated treatment visits as easy as possible.                                       

At the same time, the centre must be both welcoming, caring and highly professional. A clear vision has been that no patient should have to pass through any area of the building that does not affect their individual course of treatment. Up to 70% of patients will be staying for less than 30 minutes, so a high degree of rationality and intuitive wayfinding ensures they can find their way unassisted.

The main logistical principle divides the patient and staff flow in two separate lines of movement; a central ‘street’ aimed at patients encircled by the flow of personnel called ‘the loop’. Four stairway cores ensure a good vertical connection between the two plans. The compact structure in which the functions are vertically organized and stacked around the atrium ensures short distances for staff.

JT: What does Aarhus Arkitekterne mean by ‘healing’ architecture and how is it employed here?

MD: Patients, relatives, staff, researchers and other visitors will be received in a spacious arrival room with a triple height atrium that combines a healing environment with effective workflows.

"The atrium combines a green, vigorous space with international art and serves as the functional backbone."

The atrium combines a green, vigorous space with international art and serves as the functional backbone of the centre – an area designated for surveillance, distribution and waiting that enables staff to keep track of patients and make their treatment as comfortable as possible. The stairways connected to the atrium tie together the staff flow on all floors, eliminating redundant steps.

The interaction between the function of the building and healing architecture plays a key role in Aarhus Arkitekterne solutions. It is well documented that daylight, effective ventilation, noise reduction and views of green areas have a positive impact on patients. These aspects bring healing architecture into play with its focus on themes such as colour, light, art, music, views and acoustics.

JT: What challenges did the project present compared with previous health sector commissions?

MD: The main challenges have been the 4m-wide solid concrete wall required to contain dangerous radiation and bringing daylight into the building. The latter was solved by having staff and patients “look inwards”. Daylight enters the atrium from above, making the eye meet the sun and vegetation.

By challenging convention about what is inside and what is outside – and where to expect daylight and views – Aarhus Arkitekterne has succeeded in ensuring a healing environment in spite of the technical challenges and limitations. We have now planned more than 1,000,000m2 of health care facilities, cementing our status as cutting-edge specialists in handling complex large-scale projects.