Hospital Formats 101: Centres of Excellence in Oncology

In India, cancer is a growing crisis demanding urgent action. By 2025, the country is projected to see 1.57 million new cancer cases, up

1.46 million in 2022. With an early detection rate of just 29%—and only 15-33% of breast, lung, and cervical cancers caught in stages 1 or 2—mortality remains high: three in five patients succumb post-diagnosis. This surge, driven by ageing populations, lifestyle changes, and pollution, highlights a critical gap in specialised oncology care. Urban India faces overburdened facilities, while rural areas have near-zero access. For investors and healthcare entrepreneurs, this presents a compelling opportunity: building Centres of Excellence (CoEs) that blend cutting-edge care with scalability.

The supply side in India is fragmented. While leaders like Tata Memorial Hospital and Apollo Cancer Centres manage over 70,000 cases annually, India has fewer than 300 dedicated oncology facilities—far short of the 1.57 million annual cases. Most are urban-centric, with limited infrastructure like linear accelerators (~600 nationwide vs. a needed 1,000+). Technology lags: PET-CT scanners is around 150, compared to thousands in the US. Staff training is a bottleneck—India produces ~1,000 medical oncologists yearly, but many lack exposure to advanced protocols. Processes often rely on solo specialists, leading to inconsistent outcomes.

Contrast this with international standards at places like MD Anderson (USA) or Gustave Roussy (France). These CoEs feature 500+ beds, integrated infrastructure with proton therapy suites, and AI-driven imaging for precision targeting. Technology includes robotic surgery (e.g., da Vinci systems) and immunotherapy labs. Training is rigorous: multidisciplinary fellowships ensure doctors rotate across specialities, with 80% of staff certified in evidence-based guidelines like NCCN. Processes emphasise holistic care, from genomic profiling to survivorship programs.

A key example is the Cancer Care Committee—a multidisciplinary review critical to treatment planning. Internationally, these committees meet weekly, involving 10-15 experts (surgeons, oncologists, radiologists, pathologists, psychologists) to debate cases using real-time data and global trials. Decisions are consensus-driven, reducing errors by 20-30% and boosting survival rates. In India, such committees exist in top centers but are rarer (only 20-30% of hospitals), often bi-weekly with 4-6 members due to resource constraints. This leads to siloed decisions: a breast cancer patient might get surgery without radiation input, delaying optimal multimodal therapy. Indian committees are improving—initiatives like IOCI's are standardizing reviews—but the gap in frequency and expertise means 40% of cases miss personalized plans, per regional studies.

True excellence requires a robust ecosystem. Day-care chemo units are essential—handling 70% of treatments outpatient to cut costs by 50% and free beds for inpatients. These setups, with infusion bays and monitoring tech, enable same-day discharges, as seen in Singapore’s models. Rehabilitation is vital: post-treatment programs restore function in 60-70% of survivors, addressing fatigue and mobility via physio, nutrition, and psycho-oncology. Integrating these—plus palliative care and support groups—creates a full-spectrum CoE.

Commercially, the numbers are promising. A 200-bed oncology hospital can generate ₹200-300 crore annually, with 15-20% margins after 3-5 years, fueled by a market growing at 19.8% CAGR to $4.6 billion by 2030. Government plans for 200 new day-care centers by 2026 signal policy support, but private CoEs can capture 30-40% of premium urban demand.

If you’re eyeing healthcare investments, oncology CoEs are transformative. Let’s bridge the gap and save lives. What’s your take on scaling cancer care in India?

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