Introduction
According to Modern Healthcare's annual survey, 109 cancer center projects were completed in 1998, which is a significant increase over previous years. (1) This trend shows that cancer centers are becoming an increasingly common facility type.

Understanding the history and evolution of cancer care helps us to understand the recent growth in cancer center construction. It is not surprising that today most people have encountered cancer in some way either personally or through a family or friend. In fact, approximately 8 million Americans alive today have a history of cancer. (2) As access to treatments and efficacy improve, the cancer survivor population will continue to grow. (3)

Cancer is widely recognized because it is the second leading cause of death in the United States, accounting for approximately 24 percent of deaths annually. The prevalence of this chronic disease is significant. Over the lifetime, a male has a 50 percent risk of developing cancer and a woman has a 33 percent risk. (4) The occurrence of cancer increases with age; therefore, most cases affect middle-aged or older adults. Due to the high prevalence of this disease, it has been recognized as a public health problem and is evidenced by the growth of cancer programs.

This paper is organized into four sections. First, the history and patterns of cancer are discussed. Second, the key trends in providing cancer care are summarized. Third, descriptions of three types of cancer care centers are presented, including preliminary programming guidelines. Fourth, guidelines to creating a therapeutic environment based on the psychosocial needs of cancer patients are identified.

Historic Overview
As recently as 25 years ago, the diagnosis of cancer was virtually a death sentence. In most cases, the disease destroyed a relatively healthy body through the rapid spreading and growth of abnormal cells. In the past, people with cancer had very few options for learning about and managing the disease.

The passage of the National Cancer Act by President Nixon in 1971 was a turning point in the field of oncology. Since then, dedicated cancer programs have been developed, treatments have improved, and funding for research has increased. Since 1971, new strategies in the management of cancer have been developed and access to care has improved.