For all types of cancer, treatment modalities, including new technologies, are helping patients to live longer lives with or after cancer.
The changing nature of cancer from a terminal to mostly acute or chronic illness also means that on average patients are visiting hospitals and treatment centers more frequently and over a longer period of time. This shift is driving new approaches to cancer center design that are focused not only on supporting clinical outcomes, but also the emotional, psychological, and social well-being of patients.
“Cancer care has progressed to a point where, in many cases, it can be actively managed over time,” says architect Anthony Treu, principal and healthcare practice leader at Skidmore, Owings & Merrill (SOM; Washington, D.C.). “We want our environments to reflect the reality that with early detection and advanced treatments, oncology is no longer defined solely by urgency or crisis.”
In response, Treu says he’s seeing a shift toward designs that promote a sense of progress, hope, and everyday life, with attention on patient flow, privacy, biophilia, and comfort to better support patients who may be spending more time in their facilities.
Another growing focus, says Gina Chang, a project architect at CO Architects (Los Angeles), is on “whole-person healing,” including bringing more specialized services, from nutritionists to psychologists, into cancer clinics as well as respite and reflection areas to support different needs.
“Emotionally, cancer patients want to get back to living,” she says. “Natural spaces like gardens allow people to experience the normalcy and beauty of life.”
Delivering less clinical environments also means aiming to reduce patient stress and fear. “The constant refrain from our (healthcare) clients is that they want to remove the stereotypes of cancer care that are associated with fear,” Treu says.
Such efforts can also help improve trust between care providers and patients, which leads to patients better adhering to treatment and, ultimately, to improved clinical outcomes, says Dr. Ben Durkee, radiation oncologist at UW Health (Madison, Wis.).
“Cancer care is no longer just about survival—it’s about the whole patient experience. The environment is not a backdrop; it’s part of the therapy,” he says.
Adapting to new technology
As more healthcare organizations strive to create more therapeutic cancer care environments, they’re rethinking facility layouts to hide or de-emphasize the large machinery involved in treatment that can be intimidating to patients.
For example, radiation vaults—encased in thousands of tons of concrete and featuring synchrotrons weighing hundreds of tons—have traditionally been housed in basements to limit radiation exposure, Durkee says.
However, new technology is making it more feasible to lift those vaults out of the basement, which presents more opportunities to deliver patient-centric spaces.
In 2024, UW Health became one of less than 50 cancer centers in the United States offering proton therapy when it opened the Eastpark Medical Center in Madison, Wis., says Michael McKay, director of planning design construction and real estate for UW Health.
The new facility houses an above-ground upright proton therapy synchrotron, which delivers radiation treatment through a beam of particles that stops at the tumor and is less likely to damage nearby healthy tissue.
Because the unit’s radiation-emitting nozzle points only in one direction as the patient rotates around it, the enclosure is about a third of the size of a traditional photon therapy vault and requires only one of the four concrete walls to be 7 feet thick, instead of the more common concrete maze to shield from radiation exposure. As a result, the savings in the cost of concrete alone are in the order of millions of dollars, McKay says.
The size of the upright proton therapy equipment also makes it more feasible to install into existing vaults. “Before, if you’re looking at a traditional vault for proton therapy, you’re talking new construction or massive amounts of renovation, which pose challenges for existing hospitals and ambulatory centers,” McKay says. “This is a paradigm shift for the world of planning, design, and construction for healthcare.”
By rethinking treatment spaces, project teams also are able to deliver environments that feel less clinical.
Opened in May 2023, Winship Cancer Institute at Emory University in Atlanta, designed by SOM in conjunction with May Architecture (Atlanta), eliminated the maze-like entry to its proton therapy suite by employing two heavy, shielded sliding doors to directly block the radiation from the linear accelerator on both sides.
“When both doors are open as the patient enters, the space feels less like a confined bunker,” Treu says. “This helps the patient to feel like they could be in any other room in the hospital, supporting comfort and emotional ease.”
Prioritizing patient experience
Positive distractions in patient, public, and clinical spaces are also playing a bigger role in delivering patient-centric cancer care environments. This includes vibrant, large-scale artwork to celebrate “moments of joy,” CO Architects’ Chang says, often in bolder color palettes, which are in contrast to past preferences for lighter and subtle shades to calm and soothe patients.
For example, at Hope Plaza in Los Angeles, a 350,000-square-foot outpatient cancer center for operator City of Hope (Duarte, Calif.), CO Architects incorporated a blend of abstract art, mosaics, and nature motifs in waiting and dining areas, corridors, and exam rooms, including a large-scale playful and colorful wallpaper in the lobby.
For another recent project, the Proton and Advanced Radiation Center on the Atrium Health Carolinas Medical Center campus in Charlotte, N.C., E4H Architecture (Charlotte) created a Healing Arts area where cancer patients paint and craft artwork, which is displayed in corridors.
“We wanted to design spaces with a multifaceted approach that prioritizes the patients’ emotional and physical well-being,” says Linh Pham, a project coordinator at E4H and designer on the project, which opened in 2024.
Project teams are also prioritizing access to nature and natural light, including in infusion areas where patients may experience long appointments. The 8-story Hope Plaza facility features an all-glass northern façade, “allowing a front-row seat to the San Gabriel Mountains, which change with the seasons and provide calming distraction during long hours of infusion,” Chang says.
Minimizing visible technology, such as complicated headwall systems, is another strategy to make patient spaces feel less clinical and more human and personalized, Treu adds.
For example, ambient patient monitoring and charting utilizes hidden sensors and microphones in patient spaces to track patients’ movement and vital signs such as heart rate, and record and transcribe clinical conversations and consultations with physicians.
Designing for convenience and flexibility
Along with evolving architecture and interior design strategies, cancer centers are also rethinking facility types and service offerings.
“Over the past 10 years, a lot of the more routine treatments have moved closer to home for patients,” says Sheila Cahnman, president of JumpGarden Consulting (Wilmette, Ill.).
Many existing and in-development cancer centers are taking a hub-and-spoke approach that includes a tertiary facility with both inpatient and outpatient services and smaller outpatient facilities in surrounding communities, which offer patients the convenience of care close to home.
“The idea of being able to be treated and to continue on with your life with cancer has really changed,” she says. “People are able to do chemotherapy, but still go to work, to have radiation treatment but then continue with their day.”
Some of these outpatient cancer facilities are being co-located with primary and specialty care providers so that support services—such as imaging, lab, physical medicine, and ion—can be shared among all the providers to reduce costs while also supporting patient convenience.
“Having all of these ancillary services housed in the same place is the ideal,” Cahnman says.
This growth in outpatient cancer facilities in off-campus locations doesn’t negate the need for larger, comprehensive cancer centers, many of which are designated for academic research. Rather, Treu says, these facilities are often on the front lines of innovation, where all the most advanced and untested therapies are delivered. “That’s where care teams are going to push the boundaries,” he says.
For example, Winship Cancer Institute is rethinking its cancer care services to be more efficient by providing infusion, radiation treatment, and surgery via a “care to chair” model. The set-up allows patients to stay in the same room for every stage of their appointment, from blood draws to infusion, while providers come to them.
The facility houses five care communities, each centered on a specific type of cancer such as breast, brain, or prostate cancer. The 2-story units include an inpatient and outpatient floor offering all the services a cancer patient may need, simplifying patient flow and minimizing steps between departments.
The model is also making treatment more efficient, Treu says, noting that despite not having a dedicated infusion floor, those medications are delivered to patients on average 50 percent faster than the baseline.
What’s next in cancer center design?
The fast pace of advances in technology and treatment makes it difficult to predict what the future holds in cancer center design, JumpGarden’s Cahnman says. As a result, many teams are emphasizing flexibility on projects, including added shell space and repetitive prototypical clinic modules that can adapt to multiple uses.
They’re also considering space needs of emerging and advancing treatments, such as theranostics, a combination of imaging and molecular radiotherapy, and cell therapy, in which patients’ cells are re-engineered to eliminate cancer cells, Cahnman says.
“A lot of providers are wrestling with how far and how fast to invest in these modalities. Some of the academic medical centers are very focused on it and are building specialized labs where they are manufacturing the cells,” she says. “But a lot of the buildings that have been built today don’t accommodate these advanced treatment options.”
As new approaches to cancer treatment continue to emerge, healthcare providers and their project teams are standing ready to bring forth new ideas to support the next generation of cancer care facilities. “Now is an exciting and a bit of a nerve-wracking time to be a designer and planner in this space,” Cahnman says.
For a roundup of cancer care projects, go here.
Robert McCune is senior editor of Healthcare Design. He can be reached at [email protected].
