How would you describe the current state of radiotherapy in India? What are the major challenges faced by the radiotherapy sector in India?
Response: India is witnessing a leap in cancer care thanks to technological advancements in radiotherapy. Recently, there has been a noticeable improvement in the availability and quality of radiotherapy services thanks to the government’s focus on improving cancer care facilities. Technology, like precision radiotherapy, is being adopted by leading cancer care centers, enhancing treatment outcomes for patients. However, major developments have been concentrated in metro cities and private hospitals across the country, leaving a gap in cancer care between urban and rural populations.
Despite ongoing advancements, the radiotherapy sector in India faces significant challenges, including a shortage of equipment and specialised professionals, leading to long waiting times and reduced treatment quality. Mature countries have at least 4 radiation therapy units per million people, while India has 0.53 units per million – a deficit exceeding 700 units. Regulatory hurdles and administrative delays further complicate the establishment of new facilities. Additionally, a lack of awareness and late-stage diagnosis exacerbates the issue, necessitating a comprehensive strategy to improve infrastructure, training, and public education.
How does accessibility to radiotherapy services differ between urban and rural areas in India?
Response: In urban areas, accessibility to radiotherapy services is significantly higher due to the concentration of advanced medical facilities and specialised healthcare professionals. These urban centers attract a significant portion of the country’s healthcare resources, enabling timely and advanced treatment options for cancer patients. Conversely, rural areas face substantial challenges in accessing radiotherapy services. The lack of medical infrastructure, limited availability of specialised oncologists, and inadequate funding for healthcare development contribute to the gap in service provision. Many patients from rural regions are compelled to travel long distances to urban centers for treatment, causing delays in receiving necessary care. This geographic and economic disparity exacerbates health inequities, leading to poorer outcomes for rural cancer patients. Addressing these disparities requires targeted investments in healthcare infrastructure, training programs for medical professionals in rural areas, and the implementation of telemedicine solutions to bridge the gap.
What recent technological advancements in radiotherapy are most promising for improving cancer treatment outcomes in India?
Response: Recent technological advancements in radiotherapy hold significant promise for improving cancer treatment outcomes in India. Precision radiotherapy, including Intensity-Modulated Radiotherapy (IMRT) and Image-Guided Radiotherapy (IGRT), has revolutionised cancer treatment by allowing higher radiation doses to be delivered to tumors with minimal damage to surrounding healthy tissues. This precision reduces side effects and enhances treatment efficacy. Moreover, advancements in Adaptive Radiotherapy (ART) are noteworthy. ART involves continuous assessment and adjustment of treatment plans based on real-time imaging and tumor response, ensuring optimal dose delivery throughout the treatment course. This adaptability significantly improves treatment accuracy and outcomes. Implementing these advanced technologies, coupled with increased investment in healthcare infrastructure and training, can greatly enhance cancer treatment outcomes in India.
What kind of approach can be taken for implementing state-of-the-art radiotherapy equipment in India? How are public and private sectors collaborating to enhance cancer care in the country?
Response: Cancer is one of the non-communicable diseases (NCDs) that contribute to the largest number of deaths, mostly because many cases remain undiagnosed. The majority of cancer centers are situated in urban areas, while 70 per cent of the population resides in rural areas. Prioritising comprehensive cancer care delivery at the grassroots level will facilitate early diagnosis and treatment. This can be achieved by improving awareness and screening, and by bridging the gaps in treatment in rural areas with policy reforms. These measures will help make cancer care more accessible and reduce the current cancer burden.
Many private players have been working with the government to address the infrastructure gap in radiation therapy across India under a Public Private Partnership (PPP) model. Under such an arrangement, the space and physical infrastructure are provided by the government, while the radiation therapy equipment and clinical services are provided by the private operator, treating patients at a mutually agreed price. It’s heartening to see that several state governments are now in the process of adopting PPP models for creating radiation therapy capacity in public hospitals. In one remarkable initiative, the Assam Cancer Care Foundation has inaugurated seven state-of-the-art ACCF cancer hospitals in Assam, including the Barpeta Cancer Care center.