Spaces of life: Rethinking oncology departments as a fourth therapeutic space

Background Increasing evidence shows that healthcare environments influence physical and psychological well-being. However, the role of oncology spaces as social and relational environments remains underexplored. Methods Between February and April 2025, four approximately 90-min participatory meetings were held at the Oncology Department of Cannizzaro Hospital (Catania, Italy) with patients, caregivers, healthcare professionals, community representatives, and spatial design professionals. Participants shared experiences, needs, and expectations regarding the oncology care environment, generating qualitative and visual materials. These contributions were reviewed by the interdisciplinary team through an iterative process of synthesis and design translation, identifying recurrent experiential, relational, environmental, and functional needs and translating them into the “Spaces of Life” proposal and the “fourth therapeutic space” conceptual framework. Results The participatory process led to the development of the “Spaces of Life” concept, which reinterprets oncology environments as places where clinical care, social interaction, and everyday life converge. Key elements included integrating green spaces, increasing access to natural light in treatment areas, and transforming waiting areas into relational, community-oriented environments. Participants associated these proposed spatial characteristics with greater comfort, opportunities for social interaction, and a more supportive experience of time spent within the department. Conclusions The findings suggest that oncology departments can be reconceptualised beyond purely clinical settings, as relational environments that support patients' lived experiences. The concept of oncology as a “fourth therapeutic space” highlights the potential to integrate spatial, social, and clinical dimensions within a framework for more relational and patient-centred oncology environments.