As someone who began his medical journey in Kerala and now leads a haematology and blood and marrow transplant (BMT) and cell therapy programme in the United States, I’ve had the unique privilege of experiencing two very different models of cancer care. This personal and professional journey has shaped my perspective on how we approach haematologic malignancies and transplantation across global health systems.

In Kerala, I started my clinical career at the grassroots level—serving as a medical officer in primary health centres and later working in palliative medicine at the Institute of Palliative Medicine in Calicut. There, I saw firsthand how community-led, resource-conscious initiatives could deliver deeply compassionate care. We provided symptom management, end-of-life support, and home-based palliative services, often under significant resource constraints. Despite limitations in advanced therapies, what stood out was the strength of community engagement and the emphasis on dignity and comfort—something that continues to influence my approach to care even today.

Transitioning to the U.S., I trained and now practise in an environment equipped with cutting-edge technology and and specialised care pathways. As Director of the Blood and Marrow Transplant & Cellular Therapy Programme and Head of Malignant Haematology at the University of Connecticut Health Centre (UCONN), I now have access to advanced therapies like cell therapy, bispecific antibodies, novel targeted agents, and precision medicine approaches. The infrastructure supports robust clinical trials, data-driven decision-making, and highly individualised patient care. But even in such a highly developed system, I am reminded constantly that access is not equal, and financial toxicity remains a major concern for many patients. In my physician entrepreneur role of building a transplant and cell therapy centre at UCONN has furthermore assisted in deeper understanding about the business and administrative challenges of healthcare delivery within the US.

This contrast between the two systems is striking. In Kerala, care is driven by public health principles and social equity, where even palliative care is integrated into the community. In the U.S., innovation is front and centre—but it often comes at the cost of complexity, high expenses, and disproportionate social access. For haematologic malignancies, early detection and standardised referral pathways are crucial, yet in many regions in India, these remain fragmented. Conversely, in the U.S., patients often arrive at tertiary centres quickly—but the affordability of transplant, cell therapies like CAR-T and gene therapy and post-transplant care can be a barrier to long-term success.

I believe there’s a space for mutual learning. The U.S. can adopt Kerala’s community-driven models of palliative and supportive care, especially for rural or underserved populations. Meanwhile, Kerala can gradually incorporate select innovations in haematology, transplant and cellular therapy—such as standardised transplant eligibility pathways, donor registry collaborations, strengthening clinical trial platforms enabling early access and basic cell therapy platforms—adapted to local needs and cost structures. Financial toxicity of haematology drugs, especially cellular therapies, remains universal and needs innovative solutions.

For me, haematology, transplantation and cellular therapies are not just about complex protocols or advanced labs. They are about holistic care—meeting patients where they are, emotionally and medically. My career on both sides of the globe has taught me that while systems differ, our core mission remains the same: to extend life, relieve suffering, and provide hope.

As we gather at this oncology conclave, I hope we can embrace this dual lens—combining innovation with empathy, and high science with deep humanity. That, I believe, is the future of global cancer care.