Cancer in India is a growing public health challenge, with millions of new patients diagnosed every year and projections indicating a continued rise in incidence. Amid this rising tide, traditional models of hospital-centric oncology care are being stretched leading patients and providers alike to explore new pathways of treatment delivery. One such pathway is home-based cancer care, which is rapidly gaining traction as a patient-centric, cost-effective, and clinically viable alternative.
According to Research and Markets report, “The India Chemotherapy at Home Service Market was valued at USD 51.23 Million in 2024, and is expected to reach USD 91.28 Million by 2030, rising at a CAGR of 10.21 per cent.”
Advances in cancer treatment have improved survival—but they have also prolonged the need for supportive care. In response, India is witnessing a decisive shift toward home-based oncology services.
Home healthcare is no longer peripheral; it is becoming a critical extension of oncology care.
Why oncology care is moving home
TechSci Research says, “India faces a significant shortage of hospital beds and oncology infrastructure, a challenge that directly impacts the delivery of cancer treatment across the country. With the rising burden of cancer, the demand for oncology services has surged. India’s healthcare system has faced persistent challenges from a rapidly growing population and inadequate infrastructure. To meet the World Health Organization’s standard of five hospital beds per 1,000 people, the country required an estimated 2.4 million additional beds. This shortfall underscored the urgent need for investment in expanding and strengthening healthcare capacity nationwide.”
Clinicians across the country point to a convergence of clinical, operational, and economic pressures driving the shift of certain oncology services into home settings. Rising cancer incidence has placed excessive pressure not only on patients but also on hospitals and medical personnel.
Clinically, prolonged hospital exposure carries real risks for immunocompromised patients. Repeated visits increase the chances of infection and add emotional strain for both patients and families.
From a clinical standpoint, long hospital visits during chemotherapy increase the chances of infection and cause emotional strain for families. Dr Pallavi Redhu, ConsultantMedical Oncology, Kailash Hospital, notes that, “By providing palliative care at home, patients can foster family support, drive comfort to manage pain, and address nutrition needs. Economically, it reduces financial burden on the patient as well as cuts down hospitals’ expenses such as electricity, staff management etc.”
Beyond individual risk, cancer care itself has evolved. Treatments are increasingly spread out over time, with long phases of supportive care rather than continuous active intervention.
Cancer care today is also increasingly chronic rather than episodic. Dr Manish Singhal, Vice ChairmanMedical Oncology, Yashoda Institute of Cancer Care, emphasises that, “Modern cancer care is increasingly chronic rather than episodic. The longer the patient stays in the hospital, the greater the chances of a HealthcareAssociated Infection (HAI), which can be even more deadly for immunocompromised patients undergoing cancer treatment.”
From a system perspective, hospitals are reaching their limits. Oncology centres across the country are dealing with rising patient volumes, bed shortages, and workforce constraints.
Operational pressures are equally acute. Dr Dinesh Singh, Director Radiation Oncology, Action Cancer Hospital, Delhi, explains that, “Operationally, the oncology centre faces the challenges of bed shortage, rising patient volumes, and workforce constraints, automatically making prolonged inpatient care unsustainable.
Dr Bipin Chevale, CEO, Gleneagles Hospital, Mumbai, adds that, “The move toward home-based oncology care is due to factors such as overcrowded cancer centres, rising treatment costs, a growing need for long-term symptom and supportive care, and patient demand for comfort and continuity. And now hospitals are increasingly reserving inpatient resources for intensive and procedure-driven cancer treatments. So, now home care for cancer is gaining a lot of prominence.”
What often gets overlooked in clinical discussions is how deeply cancer affects daily living. Between hospital visits, patients must manage fatigue, nutrition, emotional stress, and routine activities—often with minimal structured support.
From a care-journey perspective, Prashanth Reddy, Founder and Managing Director, Anvayaa, observes that cancer care today extends far beyond hospital walls. Patients are living longer with cancer, making care an ongoing journey that affects daily life. While medical treatment remains with oncologists, day-to-day wellbeing, managing routines, nutrition, emotional reassurance, and recovery monitoring — happens at home. A structured support system, often led by a dedicated Care Manager, helps families handle this phase with more stability and less stress.
This recognition—that much of cancer care unfolds outside clinical settings—is central to why home healthcare is no longer optional.
Selecting the right patients and ensuring safety at home
Despite the growing shift, clinicians stress that homebased oncology care is not appropriate for all patients. Careful patient selection and robust safeguards remain central to safety.
Patient selection begins with clinical stability and disease assessment.
Dr Ashok Kumar Vaid, Chairman, Medical Oncology, Cancer Care, Medanta, Gurugram explains that, “Patient selection for homebased oncology care requires careful clinical assessment. Suitable patients usually have stable vital parameters, controlled symptoms, and adequate home support. Those with acute complications or high monitoring must remain under hospital supervision. Safety depends on clear care plans, defined protocols, and reliable communication with the treating oncology team. Caregiver education is essential, particularly for accurate symptom recognition. It is imperative that the home environment allows safe storage and administration of medicines. Regular clinical reviews and documentation help ensure smooth continuity of the treatment. A multidisciplinary decision-making process strengthens safety and accountability outside hospital settings.”
Dr Redhu mentions that, “Clinicians assess cancer patient suitability for homebased care by examining the performance status of the disease and its stage using scales such as the Eastern Cooperative Oncology Group (ECOG) score. Those who fall at ECOG 2-3 are potentially homebound and have a manageable disease. However, it is crucial to measure certain protocols, such as standardised clinical treatment, such as caregiver training and trained oncology nurses, regular symptom assessment tools such as PNPC-sv for palliative care, regular clinician assessment, 24/7 telehealth accessibility, and routine monitoring of symptoms.”
Safety is reinforced through structured safeguards. Dr Anil Thakwani, Senior Consultant & H.O.D – Radiation Oncology at ShardaCare-Healthcity, highlights that, “Patients must be medically stable with controlled symptoms and have reliable caretakers who are capable. The house needs electricity for equipment and safe and hygienic medication storage. Comprehensive plans with clear emergency protocols, regular nursing visits, strict safety measures for medication, and infection control for immunocompromised patients are some of the essential safeguards. The key is continuous monitoring and reassessment. In case a patient’s condition deteriorates, they are shifted back to hospital care. Backup plans are important in this case.”
Comprehensive care plans, clear emergency protocols, regular nursing visits, and continuous reassessment are essential safeguards.
In cases involving chemotherapy, safeguards become even stricter, Dr Singhal notes that, Typically, only patients who have successfully completed their first chemotherapy cycle in a hospital without adverse reactions, such as anaphylaxis, are considered eligible for home administration. Conducting a structured home audit is essential to ensure a sterile setting for dressing changes, reliable electricity for medical equipment, and a designated clean zone for safe waste disposal. Critical safeguards include maintaining a crash kit at the bedside, providing 24/7 tele-consultation access to the primary oncologist, and establishing a pre-arranged “Green Channel” for immediate hospital readmission should complications arise.
Reinforcing the importance of coordination, Reddy adds that, “The key safeguards are clarity and coordination. Families need simple, clear discharge instructions, warning signs to watch for, and direct lines of communication with the treating hospital. This is where a Care Manager becomes important, ensuring appointments are not missed, instructions are followed, and families know when to escalate concerns. The goal is not to replace medical care, but to make sure it is supported properly at home.”
Digital tools: The backbone of safe and scalable home oncology
Technology has emerged as a critical enabler of home-based oncology care in India. Remote patient monitoring, tele-oncology, and AI-driven alerts are extending specialist oversight into patients’ homes while maintaining safety.
Dr Indoo Ammbulkar, Director Medical Oncology, HCG Cancer Centre, Borivali, notes that, “Remote patient monitoring enables tracking of vitals, symptoms, and treatment side effects in real time. Tele-oncology ensures continuity of specialist oversight without requiring frequent hospital visits, which is particularly valuable in Tier 2 and Tier 3 cities. AI-driven alerts can flag early warning signs such as rising pain scores, fever patterns, or reduced mobility allowing timely intervention before complications escalate. In India, where specialist access is uneven, these tools help extend expert care beyond hospital walls while maintaining safety and accountability.”
According to Dr Thakwani, “Smartphone apps track symptoms and vital signs. Video consultations connect patients living far from hospitals and clinics, eliminating the exhausting travel. AI systems flag dangerous complications like fever in immunocompromised patients well before they become emergencies. This enables timely intervention. This is a big feat in India, where around 70 per cent of cancer patients live outside metro cities. Challenges, like internet connectivity in rural areas and digital literacy gaps, persist. Despite these challenges, digital tools have managed to make specialised oncology care accessible to thousands.”
Dr Gaurav Jaswal, Director of Radiation Oncology, TGH Onco Life Cancer Centre, adds that, “Digital tools, such as remote patient monitoring, tele-oncology, and AI-driven alerts, facilitate the continuous tracking of symptoms and vitals, early detection of complications, expedited clinical interventions, and informed decision-making. Hence, this makes home-based cancer care safer, scalable, and more accessible across the country.”
From a coordination standpoint, Reddy adds that, “Care Managers use digital platforms to coordinate appointments, set medication reminders, and keep family members informed about daily developments. Remote monitoring devices, where advised by doctors, add another layer of awareness. These tools don’t replace clinicians, they help families stay organised and responsive between hospital visits.
Integration: Closing the gaps between hospital and home
While technology enables home oncology care, integration sustains it. Seamless coordination between hospitals, treating oncologists, and home healthcare teams is critical to avoid fragmented care. Dr Vaid stresses that “Coordination failures often arise from fragmented documentation, unclear accountability during deterioration, and limited real-time information access. Home care teams may lack current treatment protocols, recent diagnostic findings, or defined escalation criteria. This potentially delays interventions and causes care inconsistencies. Effective integration requires shared care plans, clear referral pathways, and reliable communication systems connecting hospital and homebased providers. Strong governance structures and regular clinical reviews are necessary for maintaining quality and continuity across care settings. These elements collectively ensure that home-based oncology services function as seamless extensions of hospital care.”
Seamless integration between hospital oncology units and home-care services is crucial for quality continuity. The most effective models currently involve hybrid pathways, where patients receive initial treatment and stabilisation in the hospital and then transition to home care for subsequent cycles under the same clinical oversight.
Dr Singhal identifies, “One of the most significant gaps in home-based oncology care is the persistence of information silos. Many home healthcare providers operate on fragmented Electronic Medical Record (EMR) systems that are not integrated with hospital platforms, resulting in limited real-time visibility into the care delivered at home, particularly during emergencies. Establishing a unified, patient-centric digital health ID under the Ayushman Bharat Digital Mission is therefore essential. This level of integration would help ensure that the treating oncologist, home nurse, and emergency teams remain aligned, enabling faster, more coordinated, and well-informed clinical decisions.”
Dr Ammbulkar also highlights that, “Integration is absolutely critical. Homebased care cannot function in silos. The treating oncologist must remain the clinical anchor, with seamless information flow between hospital systems and home healthcare teams. Today’s biggest gaps lie in fragmented medical records, inconsistent communication between hospital and home teams and lack of standardised handover protocols.”
Without integration, care becomes reactive rather than proactive. Strong clinical governance models where hospitals lead care planning and home teams execute under clear supervision are essential to close these gaps.
A care manager acting as a single point of coordination ensures hospital guidance translates into consistent home routines, reducing confusion and improving patient security.
Workforce readiness: The core of home oncology
Despite advances in technology, clinicians emphasise that human expertise remains central to delivering complex cancer care at home. India’s home healthcare workforce is expanding, but preparedness for oncology and palliative care remains uneven.
Dr Chevale points out, “Cancer demands timely diagnosis and care, and as India’s home-care workforce adapts to the clinical and emotional complexity of advanced cancer, there is an urgent need for specialised oncology training, formal palliative care certification, stronger clinical supervision, and robust hospitallinked support systems. So, the qualified specialists, nurses, and therapists ensure that patients are able to get customised professional care, promoting their sense of security, dignity, and independence while ensuring a comfortable and speedy recovery.”
Dr Jaswal stresses that, “India’s home healthcare workforce is still unevenly prepared for complex oncology and palliative care, making standardised oncology training, formal accreditation, stronger palliative care skills, and an expanded, empowered role for oncology nurses across hospital and home settings urgently necessary.”
Dr Vaid opines that, “The key gap is the limited availability of oncology-trained nurses, and palliative care competencies across many settings. Managing pain, symptom escalation, infection prevention, nutrition needs, and end of-life care requires specialised skills. Structured training modules, competency-based assessments, and standardised accreditation can improve quality and safety. Regular supervision by senior clinicians and stronger hospital linkage are important for clinical governance. Strengthening the role of oncology nurses through defined responsibilities, continuous education, and integration into care planning can improve outcomes across both hospital and home settings.”
From a non-clinical support lens, Reddy adds that cancer recovery demands patience, emotional sensitivity, and consistency, with Care Managers guiding caregivers and ensuring compassionate, stable support throughout the journey.
Policy, insurance, and the next 5–7 Years
For home-based oncology care to scale responsibly, systemic reform is essential. Insurance coverage for home-based chemotherapy support, nursing visits, and palliative care remains limited, creating financial barriers despite clinical benefits.
Dr Vaid notes that, “System-level support is necessary for home-based oncology care to scale responsibly. Insurance coverage and reimbursement must evolve to include home-based supportive and palliative services, reducing financial barriers for families. Clear operational standards and quality frameworks are needed to define the scope of services, safety requirements, and accountability. Public–private collaboration can help expand access beyond metro cities and reduce the load on tertiary centers.”
Dr Thakwani adds that, “Fundamental restructuring across different domains is needed in India. Insurance providers are yet to recognise home-based chemotherapy, nursing visits, and palliative care as reimbursable services. Currently, most policies cover hospital admissions while excluding home treatments. This creates perverse incentives against home-based care. Policy frameworks need standardised quality benchmarks, licensing requirements for home oncology treatments, and clear liability protections for all stakeholders.”
Looking ahead, Dr Jaswal believes that over the next five to seven years, home healthcare will become a core extension of cancer care, helping reduce hospital burden while improving access, continuity, and quality of life.
Echoing this outlook, Dr Ammbulkar notes that, “Over the next 5–7 years, home healthcare is likely to become a core pillar of India’s oncology ecosystem, not replacing hospitals, but complementing them by enabling continuity, compassion, and cost-effective care across the cancer journey.”
Way forward
Across expert voices, there is clear consensus: over the next five to seven years, home healthcare will emerge as a core pillar of India’s oncology ecosystem—complementing hospitals, easing system strain, and enabling more continuous, compassionate, and cost-effective cancer care closer to home.
Home-based oncology in India must now move from selective adoption to structured scale-up. Clear clinical guidelines, stronger hospital–home integration, and robust digital monitoring will be key to ensuring safety and consistency of care.
Insurance inclusion and supportive policy frameworks can unlock wider access, while focused investment in oncology-trained homecare teams will build confidence among clinicians and patients. With the right safeguards, home healthcare can evolve into a core extension of India’s cancer care ecosystem delivering treatment that is more sustainable.
Kalyani.sharma@expressindia.com
journokalyani@gmail.com