New chemotherapy laboratory complements cancer treatment in Sanderbusch

For patients with particularly complex or difficult-to-treat tumor diseases, medications are needed that must be precisely tailored to each individual patient and are usually only stable for a short period. These so-called cytostatic solutions are often produced in-house by hospital pharmacies — as is the case at the Northwest Hospital Sanderbusch (NWK). Behind the doors of the hospital pharmacy is a small, highly specialized pharmaceutical production. Due to new legal regulations, this cytostatic laboratory was completely rebuilt for 500,000 euros. It now meets the latest safety requirements. The renovation was financed from own funds, as emphasized by Frank Germeroth, managing director of NWK.

Medications for cancer therapy are intended to inhibit tumor cell growth and are subject to the highest safety and hygiene standards during processing and packaging. Therefore, their preparation requires not only sound pharmaceutical knowledge and experience but also specialized technical equipment.

The particular challenge in Sanderbusch was to carry out the conversion of the cytostatic laboratory during ongoing supply operations. Therefore, the old production site was temporarily retained. The storage rooms for medical supplies had to be relocated. Where syringes, dressings, and consumables were previously stored, the entire area was completely gutted, and a cleanroom laboratory and an air handling system were installed. The construction itself and the materials used were subject to special safety conditions. The floors and walls are liquid- and gas-tight and easy to clean.

The laboratory consists of a cleanroom where medications are produced under sterile conditions. An air handling system with a three-stage high-performance filter system removes even the smallest particles from the air and ensures continuous air exchange. Temperature, humidity, and air pressure in the rooms are constantly monitored and recorded. The microbiological quality of the air is checked daily. The heart of the laboratory is a manufacturing corridor over seven meters long, consisting of a safety cabinet and two isolators, connected via four material sluices to each other and to the laboratory room.

The production of cytostatics must be absolutely germ-free. The ubiquitous germs in the normal environment can be life-threatening for cancer patients. Only specially trained staff are allowed to enter the sterile laboratory, all of whom have extensive experience with cytostatics and regularly undergo further training. Only those who have passed through two sluices are permitted entry into the sterile laboratory. One of these is also used for changing clothes. The laboratory team, led by pharmacist Kristina Schneider, wears a fully sealed sterile coverall, double gloves, sterile shoes, mouth, and hair protection in this environment. Dressed this way, the staff resemble astronauts during a moon landing. The actively ventilated sluices are operated via an automatic locking system. Their doors close automatically as soon as another door is opened.

Climate technology, isolators, and safety cabinets are optimally adapted to the high demands of cytostatic production. This ensures a consistently high quality standard for a safe and hygienic workflow and high drug safety.

All production steps are monitored with computer assistance, prescriptions are compared with the specified therapy scheme, and checked for accuracy. High product quality and drug safety are achieved through standardized manufacturing processes, dose verifications, and documentation of the production using specialized software.

The basic area of the new cytostatic laboratory is now approximately 100 m², including all auxiliary rooms. Of this, 55 m² are allocated to the actual cleanroom. A new storage facility will be built in place of the old laboratory. After completing all construction work, the supply of medications and medical supplies, as well as drug logistics and manufacturing, will be closely integrated within the pharmacy premises.

District administrator of Friesland district and chairman of the shareholder assembly Sven Ambrosy is pleased: “We now have one of the most modern cytostatic laboratories in the region, which meets all legal requirements. With this, Sanderbusch has taken another forward-looking step towards safe and high-quality patient care.”

Importance of Cytostatic Production for the Treatment of Oncology Patients in Sanderbusch

The Center for Internal Medicine has extensive experience and expertise in treating cancer patients at all stages of their disease, with its oncology ward and outpatient oncology clinic. These two facilities facilitate seamless transitions between outpatient and inpatient care. The diagnostics preceding treatment are also performed either outpatient or inpatient. An additional advantage for patients is that other specialists from surgical departments, neurology, and radiology are involved in diagnostics and therapy in Sanderbusch. When tumors are detected through ultrasound examinations, gastroscopies, colonoscopies, X-rays, computed tomography, or MRI, they can be quickly evaluated in an interdisciplinary manner. Based on these results, the medical team develops an individualized treatment plan for the patient.

As the spectrum of oncological treatments has significantly expanded in recent years, the number of cytostatic preparations has also steadily increased. To better meet the therapeutic needs of individual patients, regular information exchange between doctors and pharmacists takes place, along with joint ward rounds. In close collaboration with the treating physicians, the hospital pharmacy produces cytostatics for individualized therapy. These are usually administered via infusion. The pharmacy, led by pharmacist Friedrich Cramm, produces over 7,000 cytostatic preparations and more than 1,000 other sterile medications annually. Due to their short shelf life, they must be produced daily. Once the prescribing doctor has made the request, the patient can receive their medications in a short time.

"We place great importance on immediately providing our oncology patients with individually tailored infusion solutions, as this allows us to significantly influence the healing process and optimally utilize therapeutic possibilities," explains senior oncologist Friedrich Natt.

The complexity of treating oncological diseases requires many specialists. The medical team works closely with referring and follow-up outpatient doctors, ensuring continuous and closely monitored care for the patient. This close interdisciplinary cooperation allows for faster and more optimized diagnosis and treatment success. Professional exchange with colleagues from various university clinics, the Weser-Ems tumor network, outpatient specialty practices, and membership in numerous project and working groups, as well as participation in clinical studies, continuously incorporate the latest scientific findings into clinical practice.

For Prof. Dr. Werner-J. Mayet, chief physician of the Center for Internal Medicine, this is a very important aspect of treating oncology patients: "Through scientific research, therapy studies, tumor-specific project groups, and proper documentation, we can continuously improve the quality of tumor care." Patients in Friesland and surrounding areas benefit from a nearby offering, a broad spectrum of diagnostics and treatments, and the close networking of Sanderbusch oncologists with other experts. Furthermore, it is important to the chief physician to incorporate the experience gained into the training of future oncologists and to keep colleagues and staff up to date through regular continuing education.

Already in 2009, the oncology ward was completely rebuilt and has since offered 26 beds with the highest comfort for patients. Two patient rooms also provide the possibility for relatives to stay overnight in a separate room adjacent to the patient’s room. A communal kitchen for patients offers the opportunity to prepare small meals themselves. A lounge designed like a living room provides a retreat and a small change from everyday hospital life. The nursing staff of the oncology ward has specialized training. Additionally, comprehensive care for patients and their relatives is provided by hospital chaplaincy services.

The NWK offers comprehensive treatment options with its modern infrastructure and a competent team of doctors and nurses.