New Cancer Therapies Transforming Care, But Access Remains Beyond Reach For Many Indians: Experts

Once synonymous with despair and death, cancer treatment is undergoing one of the most significant transformations in modern medicine.

Treatments that were unimaginable a decade ago—immunotherapy, targeted therapy, precision oncology, antibody-drug conjugates (ADCs), CAR-T cell therapy, and molecular diagnostics—are enabling many patients to live longer with a better quality of life.

Yet for millions of Indians diagnosed with cancer every year, these advances remain largely out of reach, remaining confined to a handful of tertiary hospitals and those who can afford expensive treatment. India reports an estimated 1.4-1.5 million new cases and nearly 900,000 cancer-related deaths every year.

Speaking at a media roundtable organised by the Indian Cancer Society (ICS) on June 30 to mark Cancer Survivor Month, experts called for a coordinated national strategy that bridges the gap between scientific breakthroughs and equitable access.

The discussion comes amid figures shared by Union Health Minister JP Nadda on the same day at yet another event, stating that more than 35 crore people have been screened for oral cancer, over 16 crore women for breast cancer and more than nine crore women for cervical cancer under the national programme for non-communicable diseases.

He said the programme has identified over 2.3 lakh oral cancer cases, more than 86,000 breast cancers and nearly one lakh cervical cancers.

Jyotisna Govil, Chairperson, ICS strongly felt that "The journey does not end when cancer is detected. It begins there.”

From traditional one-size-fits-all approach of chemotherapy to therapies tailored to the biological characteristics of individual tumours, the cancer treatment is now becoming a ray of hope for many

Immunotherapy helps the body's immune system recognise and destroy cancer cells, while targeted therapies attack specific genetic mutations that drive tumour growth. Precision oncology combines genomic testing with personalised treatment decisions. At the same time, antibody-drug conjugates deliver chemotherapy directly to cancer cells while minimising damage to healthy tissues. CAR-T cell therapy genetically engineers a patient's own immune cells to fight certain blood cancers.

These advances have significantly improved survival for several cancers, including breast, lung, melanoma, lymphoma and leukaemia.

"Cancer is treatable if detected at an early stage," Dr. Ajay Gogia, Dr. Ajay Gogia, Professor of Medical Oncology at the Dr. BRAI Rotary Cancer Hospital, AIIMS, Delhi, said, adding that advances in oncology have also improved outcomes for many patients with Stage IV disease. Lung cancer survivor Swadesh Hooda, who attended the event, was cited by experts as an example of how newer therapies are helping some patients with advanced cancer live longer with a better quality of life.

Dr. Gogia said the future of oncology lies not in simply prescribing the newest drug but in identifying the right treatment for the right patient.

"Precision medicine, supported by scientific evidence and appropriate patient selection, enables us to improve outcomes while making better use of healthcare resources," he said.

However, access to newer therapies remains highly unequal across India, with cost continuing to be the biggest barrier.

“Many targeted therapies and immunotherapy drugs cost several lakh rupees for a single course of treatment. Cellular therapies such as CAR-T treatment can cost several times more, placing them beyond the reach of most households.”

Although prices of some medicines have declined with the availability of biosimilars and generic versions, many cutting-edge therapies remain prohibitively expensive.

Out-of-pocket expenditure continues to dominate cancer care in India, forcing many families into severe financial distress. Even middle-class households, often excluded from government assistance yet unable to afford high-cost therapies, find themselves depleting lifelong savings or borrowing heavily to continue treatment.

Mona, who is caring for her mother undergoing treatment for ovarian cancer, shared at the event that the family falls into what she describes as the "missing middle" of India's healthcare system.

"We are neither below the poverty line nor wealthy. We pay taxes but are not eligible for any financial assistance from the government. I want my mother to receive the best treatment available, but the newer therapies are prohibitively expensive. Our savings are getting exhausted very fast," she said, struggling to hold back tears.

Her experience, oncologists said, reflects the predicament of thousands of middle-class families who earn too much to qualify for publicly funded schemes but too little to absorb the costs of prolonged cancer treatment. For many, a diagnosis of cancer quickly becomes not only a medical crisis but also a financial one, with repeated expenses on medicines, diagnostic tests, hospital visits and travel pushing households into debt.

Dr. Pragya Shukla, Medical Oncologist at the Delhi Cancer Institute, agreed as she said the financial burden extends far beyond medicines.

Many patients struggle to afford travel, accommodation, repeated investigations and loss of income during prolonged treatment.

"There is another India that cannot even afford to travel by train for cancer treatment," she said.

"Between the affluent and the poorest lies the middle class, which is often just one major illness away from financial catastrophe."

Dr. Shukla said scientific advances achieve their true purpose only when every patient who needs them has a fair opportunity to receive them.

Dr. (Prof.) Jyoti Wadhwa, Principal Lead of Medical and Precision Oncology at Apollo Athenaa Women’s Cancer Centre and Apollo Hospital, Delhi, noted that inadequate insurance coverage further widens inequalities.

Although schemes such as Ayushman Bharat have expanded financial protection, coverage remains limited for several advanced cancer therapies, specialised diagnostics and molecular testing.

Private insurance policies also vary widely in their coverage of newer treatments, pointed out Dr. Wadhwa even as Dr. Gogia agreed with her.

As a result, patients often receive conventional chemotherapy even when more effective targeted therapies are available.

The doctors said greater use of Health Technology Assessment could help governments identify therapies that offer the greatest survival benefit relative to cost and prioritise them for public funding.

Dr. Ravi Mehrotra, former Director of the ICMR-National Institute of Cancer Prevention and Research (NICPR), said India need not choose between innovation and affordability.

"Evidence-based prioritisation can ensure that scientific advances translate into meaningful public health gains for the largest number of patients," he said.

The health experts also pointed out that where a patient lives often determines the quality of cancer care received.

Most advanced oncology centres capable of providing precision medicine, molecular diagnostics and newer therapies are concentrated in metropolitan cities.

Rural areas also continue to face shortages of oncologists, radiation facilities, pathology laboratories and specialised diagnostic services, added Dr. Shukla.

The experts said strengthening regional cancer centres and improving referral networks are essential to reduce these geographical inequalities.

Many newer cancer medicines can be prescribed only after specialised biomarker testing confirms that a patient's tumour carries a specific genetic mutation.

However, molecular diagnostic facilities remain limited.

Many hospitals either lack these facilities or depend on private laboratories located in major cities, increasing costs and delaying treatment.

Without timely biomarker testing, patients may never become eligible for therapies that could significantly improve survival.

“Nearly 40 per cent of cancers are considered preventable through tobacco control, vaccination, healthier lifestyles and reduction of environmental risk factors,” pointed out Dr. Gogia.

Many cancers can also be detected early through screening.

However, participation remains low, yet another barrier. According to experts, fear, stigma, poor awareness and weak implementation continue to limit screening uptake.

For instance, for several other cancers, including pancreatic, ovarian, bladder and most blood cancers, effective population-wide screening tests do not exist.

"Lung cancer is another example," Dr. Gogia noted.

"Low-dose CT screening is recommended only for selected high-risk smokers. Many patients who develop lung cancer would never qualify for routine screening."

Ovarian cancer frequently presents with vague symptoms such as bloating or indigestion, delaying diagnosis.

The experts also highlighted the growing problem of misinformation circulating on social media, saying misleading claims frequently delay evidence-based treatment. Responsible public communication, they said, has an important role in encouraging timely diagnosis and countering myths surrounding cancer.

Summing up the discussion, experts said India's next challenge is not developing newer cancer therapies but ensuring equitable access to the right treatment for every patient, regardless of where they live or what they can afford.