Why cancer systems in India need to prioritise the time burden of care

For decades, the fight against cancer has focused primarily on improving survival. Advances in science have slowed disease progression, shrunk tumours, and extended lives by months or years. Yet, for many patients, treatment has not always translated into better quality of living. With cancer cases continuing to spike worldwide, India’s burden is substantial: about 1.41 million new cases in 2022 (roughly 7% of global new cases), including nearly 82,000 new lung cancer cases (around 3.3% of global lung incidence). In addition to the increasing burden, the journey through diagnosis, treatment, and follow-up is increasingly complex and time-consuming for both patients and caregivers. Frequent hospital visits, lengthy treatment administration time, and repeated tests can disrupt life, impacting routines, work, and relationships. That is why cancer’s “time burden” should be treated as an equally important marker of care quality, alongside survival outcomes.

Understanding the time burden

So, what do we mean by the ‘time burden’ of cancer? It includes the total time patients spend on treatment-related activities such as hospital visits, diagnostic tests, therapy administration, and follow-up care. Research shows that people living with cancer spend approximately 20–30% of their days in hospitals for healthcare-related activities. For those receiving intravenous (IV) therapies, hospital visits are long and physically demanding, often consuming most of the day. Over months of treatment, these hours accumulate, competing directly with patients’ employment, family life, and time needed for rest and recovery. Caregivers are also similarly affected, as they have to manage schedules, accompany patients and handle all of the practical demands of caregiving.

At present, India’s cancer care system is overburdened by the rising demands being placed on it. Services are concentrated in a small number of tertiary hospitals, creating bottlenecks, leading to long queues, stretched hospital staff and limited time for patient engagement. Centralisation is a key driver of this strain. Decentralising cancer treatment and care is the practical next step to improve access and ease pressure on both patients and providers.

Lung cancer remains one of the hardest cancers to treat and is often diagnosed at an advanced stage, when treatment is intensive. Patients may begin care while managing symptoms such as breathlessness, persistent cough, fatigue and chest pain, all of which limit daily functioning. In this context, repeated hospital visits to receive therapies that consume much of the day add to physical exhaustion and emotional strain. Here, time is not an abstract concern. Every additional hospital visit demands energy that many patients simply do not have.

The shift in India

In India, cancer treatment delivery is beginning to shift toward simpler, shorter options that can meaningfully reduce the time burden on patients and caregivers. Subcutaneous injectables are one such advancement. By changing the route of administration, these therapies can shorten treatment time and simplify care delivery. They can be administered within minutes as a single therapy, making the process easier for patients and more efficient for healthcare systems.

A great example already exists in breast cancer. Subcutaneous therapies are already available in India, with data from HER2-positive breast cancer showing positive clinical outcomes alongside reduced time spent in hospitals.

There’s a strong opportunity to bring these time-saving treatment innovations into lung cancer care, where needs are often high. Many lung cancers are diagnosed at an advanced stage, so cutting down on the time patients spend in hospitals and on treatment can make a real difference by saving energy for recovery and daily routines while also reducing stress on families. At the same time, simpler delivery can help health systems manage growing caseloads without compromising care quality, creating value for both patients and providers.

Making care humane

Equal attention must be given to how care is delivered and how much time it demands from people already living with illness. Treatments that reduce the time burden can make care more humane for patients, more workable for caregivers, and more sustainable for health systems. By recognising time as a valuable resource, we move closer to a system that supports both longer lives and better-lived ones.

(Dr. Ashish Joshi is director & co-founder, M | O | C Cancer Care & Research Centre. ashjoshi44@mocindia.co.in)