A Blueprint for the Future of Oncology Care in India

At 40, when Medha began experiencing persistent abdominal pain and irregular bleeding, she assumed hormonal changes. Only during her third visit to the gynecologist, was she finally made to conduct a pap smear, resulting in a diagnosis of Stage III cervical cancer. Despite her education and access to information, routine preventive screening had remained out of reach or worse, out of mind.

In a country where there are just two medical oncologists for one million people, compared to 20-25 per million in the U.S., finding the right specialist was a maze of confusion and contradictions. Every 60 days without treatment doubled the costs and raised her risk of death. From juggling appointments and long commutes to managing rising expenses, the treatment also brought logistical and financial burdens. Her chemotherapy and radiotherapy sessions take place at a well-known multispeciality hospital. While the quality of care is reassuring, the general ward lacks the comfort needed for recovery. Noise, constant activity, and limited privacy make rest difficult. After each chemotherapy session, a 60-minute journey back to her house in the afternoon heat worsens her nausea. Sticking to her prescribed nutrition plan and recovery routine hasn’t been easy. This is not how a cancer patient’s treatment journey should be. Caught in Stage I, cervical cancer has a survival rate of 90%.

The age-adjusted cancer death rate has fallen by 33% in the last two decades. Despite advancements in treatment, cancer is seen as a death sentence in India mostly owing to late detection. In India, 2M patients are diagnosed with cancer each year, and only 30% of cases are detected on time in Stages I/II. To stop preventable deaths and enable early diagnosis, the perception of cancer and thereby the patient's treatment journey, needs to change.

Years ago, we saw this play out in cardiology. Around 2.5 million Indians needed heart surgery each year, yet only 12% could access or afford it. An entrepreneurial cardiac surgeon, Dr. Devi Shetty, stepped in to close this gap and Narayana Hrudayalaya was born. Narayana lowered surgery costs by more than 80% (inflation adjusted) by improving cardiologist productivity, increasing operating room and equipment use, and tapping into economies of scale.

Dr. Devi Shetty called it “The Walmart Approach.” He believes, “Oncology in India is today where cardiology was decades ago. Access is limited, care is expensive, and the need is growing rapidly. If we can reimagine oncology delivery with the same rigor, scale, and innovation, we have the opportunity to transform lives at scale and bring cancer care to where the patient needs it.”

Specialized care closer to the community

Think of dialysis 20 years ago. Out of 150,000 Indians diagnosed annually with Chronic Kidney Disease (CKD), only 6,000 underwent dialysis due to limited access, driven by frequent treatments, a shortage of machines, and high costs. Between 2009 and 2011, companies like NephroPlus, Sparsh NephroCare, and DCDC launched standalone dialysis centers using a capital-efficient model with lean staffing. They expanded quickly across cities, reducing travel times for patients and bringing down the cost of care by 30-40%.

Like dialysis decades ago, today access to cancer care and cutting edge treatment is a major challenge. 60% of patients require all three treatment modalities (surgical, medical, and radiation), making Comprehensive Cancer Centers (CCCs) the standard of care. CCCs are capital-intensive, with setup costs upwards of INR 500 million, limiting even established providers to building only 1-2 per city and ~60% of facilities are housed within multispecialty hospitals, where oncology services compete for space leading to long wait times and overcrowded environments.

The key to improving accessibility and experience could lie in redefining where treatment is delivered. A distributed network of smaller, asset-light centers, offering one or two modalities, would decentralize cancer care away from large hospitals and bring it closer to patients’ homes. The success of the US Oncology Network offers a compelling blueprint for India. By building and acquiring independent oncologist practices, it has scaled to 600 locations, ensuring that 40% of the US population has an in-network provider within a 25-km driving distance. Its edge lies in technology: a purpose-built oncology EHR (iKnowMed) with embedded clinical decision support, cost-transparency tools, and biomarker prompts; patient portals that enable secure communication and symptom tracking; and standardized data models (mCODE) that power real-world evidence and value-based care. Ontada’s analytics and Sarah Cannon’s research arm bring precision medicine and clinical trial access into community clinics across 30 states. Together, these innovations have cut time from diagnosis to treatment across 75% of practices and democratized access to life-saving therapies nationwide.

Dr. Sanket Mehta, a surgical oncologist with over two decades of experience, is bringing similar infrastructure and innovation to cancer surgery in India through Specialty Surgical Oncology (SSO), a Mumbai-based chain with five dedicated cancer centers. “We’ve built a team of surgeons who bring organ-specific expertise and have pioneered advanced surgical treatments like Cytoreductive surgery, HIPEC and Parenchyma Sparing Liver Surgery in India - procedures that offer real hope for patients with cancers once thought untreatable,” he says. “Having cancer-specific surgical facilities is critical. It enabled us to build highly specialized teams of nurses and staff, reduce the risk of hospital-acquired infections from non-cancer patients, and invest in the infrastructure and training needed for complex procedures like minimally invasive GI, Gynac, Breast and Head-Neck cancer surgeries. And because we focus only on oncology, we’re able to deliver this care more efficiently and affordably, without compromising quality. ”

Supercharging Oncologist Productivity

The oncologist supply-demand gap is stark. While there are ~2,000 surgical oncologists, 1000 more are needed to address the current cancer burden. The shortage is even more alarming for medical oncologists, where only 2,000 are available, and 3,000 more are required to fill the gap.

While this imbalance underscores a critical need to produce more oncologists by investing in training and education, it demands swifter action. Technology can play a pivotal role by maximizing the productivity of existing clinicians. With an integrated EHR to collect and organize patient data, an AI-driven Clinical Decision Support System (CDSS) can analyze that data to generate personalized treatment plans, as per global protocols.

“After treating thousands of patients, I realized that what makes the biggest difference isn’t just the right protocol but how supported a patient feels amid the chaos of treatment,” says Dr. Sunny Garg, Chief Medical Officer at Everhope, a medical oncologist with over a decade of experience. “As oncologists, we always strive to treat the whole person, not just the cancer. However, the reality is that we’re often strapped for time, and patient and caregiver needs often extend beyond our clinical expertise. We, clinicians must partner with innovators who can address these gaps, using technology, a new cadre of medical professionals such as care managers, and systems built around the patient – closer to the patient.”

Diagnosing early, and treating the patient holistically

Remember waiting hours at an eye clinic for a 15-minute vision test? Consumer eyewear brands solved this by placing easy-to-use autorefractors in showrooms and training staff to conduct eye checks, making eye exams faster, more accessible, and routine.

Cancer diagnosis needs a similar transformation. In India, 70% of patients are still diagnosed in late stages. While AI-powered imaging on mammograms, X-rays, and CT scans, and multi-cancer blood tests are becoming available, access remains limited. Low awareness, cultural hesitation, and difficulty accessing screening continue to delay detection. Like eye care, solving for convenience, education, and ease of access is essential to shifting outcomes.

But an early diagnosis is only the first step; what truly changes outcomes is how holistically we support patients beyond the prescription pad. Leaders in Oncology Care (LOC) built a successful practice in the UK by going beyond just treating the disease. Their model wraps around the patient, offering second opinions, nutrition consultations, psychological therapy, physiotherapy, fertility support, and more.

India needs to move in that direction. For example, scalp cooling can reduce chemo-related hair loss in patients, but in our visits to 60 oncology centers, only 4 offered it. Mental health support could be integrated into chemo sessions as one-on-one counseling, but it is rarely available. Palliative care, which can ease suffering for those with incurable cancers, is largely missing. 98% of Stage IV patients don’t receive it.

Designing Cancer Centers with patients, for patients

In multispecialty hospitals, chemotherapy is typically administered in shared wards with little regard for comfort or privacy. Because chemotherapy has a lower average realization, hospitals have little financial incentive to build dedicated spaces, leaving patients to undergo treatment in high-footfall environments.

World-leading cancer care provider Cleveland Clinic designed its Taussig Cancer Institute incorporating human-centered design (HCD). Their infusion rooms have natural light, comfortable chairs, a wig boutique, a prosthetics centre, art therapy and a quiet room. The concept of time changes after a cancer diagnosis, so the spaces and processes were designed to minimizing waiting time.

We need thoughtfully designed cancer care centers in India where chemotherapy can be administered in private rooms equipped with personalized comforts and services like billing, pharmacy, and OPD can be strategically placed together, away from chemotherapy rooms. Such clinics will reduce patient anxiety, improve engagement, and thus better clinical outcomes.

We witnessed a similar shift in maternity. Previously, baby deliveries, despite being a joyous event, were treated like any other hospital admission, sharing space with trauma and ill patients. Cloudnine, Rainbow, and others recognized this gap and created mother-and-child hospitals. They prioritized human-centered design by making patient-friendly environments their value proposition. Generously colored in pink and other friendly colors, they feel premium with spacious labor delivery rooms and offer modern prenatal and postnatal care with advanced equipment.

Introducing Everhope

On these building blocks, Everhope Oncology was launched in 2025. Everhope is building a diversified network of specialized patient-centric cancer facilities offering surgical and medical oncology, aiming to redefine the perception of cancer care in India. The model delivers high-quality care, from early detection to advanced treatment and follow-up care, closer to home.

Everhope is a Joint Venture between W Health Ventures, a healthcare VC and venture studio that has built and backed 12 healthcare companies, and Narayana Health, a $4 billion hospital system operating 21 hospitals that treat 2.6 million patients annually.

Dr. Pankaj Jethwani, Managing Partner at W Health, believes, “The most forward-looking specialists today are not just exceptional clinicians - they’re entrepreneurs at heart. They deeply understand the patient journey, the operational gaps in care delivery, and the economics that drive it. Many are eager to break free from rigid hospital systems to build care models that are not only clinically superior but also more humane and accessible.”

This article is written by Dr. Nikhil Hegde, Head of New Ventures at W Health Ventures & Gaurav Porwal, Partner at W Health Ventures.

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