Why only 30% of Indians have access to advanced cancer care facilities?

Cancer is penetrating India deep and wide. It is one of the leading causes of mortality in the country, with a significantly high prevalence of blood cancers such as leukemia, lymphoma, and multiple myeloma. Despite significant advancements in diagnosis and treatment globally, only about 30% of Indians have access to advanced cancer care facilities. The remaining, scattered across vast rural and semi-urban regions, are left to battle delayed diagnoses, and outdated treatments due to the insurmountable financial burden of modern cancer treatments. For patients with blood cancers—diseases that often progress swiftly and require immediate, intensive intervention—this gap in access is a matter of life and death.

The stats are staggering. Blood cancers account for approximately 8% of all cancers in India, with more than 1.2 lakh new cases diagnosed annually. Leukemia remains the most common form of cancer in children, while non-Hodgkin’s lymphoma and multiple myeloma largely affect adults.

According to the Indian Council of Medical Research (ICMR), one child is diagnosed with leukemia every hour in India. Acute lymphoblastic leukemia (ALL) is the most prevalent pediatric cancer, and while curable in high-resource settings, its outcomes in India depend greatly on where a child is born and how quickly they can access appropriate treatment.

Cancer prevalence in India

Cancer incidence is particularly high in states like Uttar Pradesh, Bihar, West Bengal, Maharashtra, and Gujarat—regions with high population density, industrial pollution, and alarmingly low levels of early detection. In contrast, tribal and rural belts in Odisha, Chhattisgarh, Jharkhand, and Madhya Pradesh report a heartbreaking number of late-stage or completely untreated cases, primarily because specialised care remains a distant dream.

The uneven distribution of cancer care infrastructure is one of the most damaging aspects of this problem. Tertiary cancer centers with the capability to handle complex cases of leukemia, lymphoma, and myeloma—including bone marrow transplants—are concentrated almost exclusively in a handful of metro cities: Delhi, Mumbai, Bengaluru, Chennai, and Hyderabad.

Patients from Tier 2 and Tier 3 towns, or rural districts, are forced to travel hundreds or even thousands of kilometers, often staying away from their homes for months on end. For families, especially those with young children undergoing treatment, this is not only financially draining but emotionally traumatic. It disrupts livelihoods, adds significant out-of-pocket expenses for accommodation and nutrition, and, in many cases, leads to treatment dropout midway.

Shortage of trained oncologists and transplant centers

Adding to the crisis is the severe shortage of trained hemato-oncologists and transplant centers. There are fewer than 300 hematologists and a much smaller number of pediatric hematologists in India who specialise in blood cancers, an alarmingly low number for a population of 1.4 billion. The availability of BMT centers is even more restricted, with fewer than 100 active facilities (majority being low volume centres) across the entire country. The outcome of this imbalance is tragically predictable: long waiting lists, rushed consultations, and missed opportunities for timely intervention. For a disease where timing can mean the difference between cure and relapse, these systemic delays are inexcusable.

Financial burden

Financial inaccessibility compounds the crisis. Advanced blood cancer treatment is among the most expensive forms of medical care in the country. A single cycle of chemotherapy may cost ₹2–5 lakhs, and a bone marrow transplant can set a family back by ₹15–25 lakhs. This does not include the additional ₹5–10 lakhs needed for post-transplant care, immunotherapies, or follow-up testing. While government schemes like Ayushman Bharat or various state-sponsored insurance programs do provide partial relief, many of them do not cover essential but expensive interventions such as CAR T-cell therapy, targeted biologics, or haploidentical stem cell transplants.

Consequently, over 70% of cancer-related healthcare expenses in India are still borne out-of-pocket, pushing countless families into financial ruin. For many, the decision to continue treatment becomes a question of survival not just for the patient, but for the entire household.

Another equally disturbing facet of this crisis is delayed diagnosis. Unlike solid tumors, which may present as palpable lumps or visible symptoms, blood cancers often begin with vague complaints—fatigue, joint pains, fever, or weight loss.

In rural areas and even in many urban primary healthcare centers, these symptoms are often misdiagnosed as infections, anemia, or malnutrition are treated symptomatically including steroids in a number of cases. By the time the patient reaches a tertiary center equipped to confirm a diagnosis, the disease may already be in an advanced stage. Irony is many blood cancers, particularly in children, are highly curable if diagnosed and treated early. But due to lack of awareness, poor frontline training, and scarcity of screening programs, countless lives are lost every year to what should be treatable diseases.

The need of the hour is a multipronged, systemic overhaul of how India approaches blood cancer care. The expansion of specialised cancer units within government medical colleges must become a national priority. District and state hospitals should be upgraded to offer not just diagnosis, but also basic chemotherapy and transfusion support. Creating regional hubs for hematology services would help decentralise care, reduce migration to metros, and allow earlier intervention.

Public-private partnerships can play a transformative role

At the same time, public-private partnerships can play a transformative role by scaling up affordable bone marrow transplant programs, investing in infrastructure, and supporting training for young hemato-oncologists. The emergence of haploidentical transplants—where a full sibling match is not required—offers a promising solution to donor scarcity, but such technologies must be integrated into public health schemes if they are to benefit the masses.

Besides, there is an increasing need to shift focus toward futuristic therapies such as CAR T-cell therapy, which offer promising alternatives to traditional treatments for leukemia and other cancers. Unlike conventional chemotherapy and radiotherapy, CAR T-cell therapy is designed to target cancer cells more precisely, reducing both short- and long-term side effects. As research advances and safety profiles improve, these therapies may soon become frontline treatment options.

Equally critical is the need for a robust blood cancer registry that provides real-time data on disease burden, treatment outcomes, and survival rates. We must also invest in mobile diagnostic labs, community outreach, and tele-hematology services to bridge the urban-rural divide. Mass awareness campaigns focused on early warning signs, particularly in schools and rural healthcare centers, can help catch the disease before it advances too far.

If we are to make any real progress in reducing India’s cancer burden, we must act urgently and with compassion. Advanced cancer care should not be a luxury reserved for the urban elite. It must become a basic right available to every citizen—irrespective of geography, income, or social status.

The writer is a paediatric haematologist in New Delhi, and a researcher, innovating cell therapy solutions.

The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK. 

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