Cancer centers need support well beyond a standard help desk. Core needs include managing oncology information systems such as Elekta MOSAIQ, Varian ARIA, and Epic Beacon, keeping PACS and imaging archives fast and available, and maintaining the HL7 and DICOM interfaces that connect treatment planning, pharmacy, and scheduling. They also need HIPAA security, encrypted backups, disaster recovery, tumor registry and clinical trial data support, and secure remote access for oncologists and physicists.