Over the past 25 years, Kerala’s cancer care landscape has undergone remarkable transformation, largely driven by the proactive initiatives of the private sector. In the year 2000, public hospitals were giving basic cancer care through radiation oncology departments and tertiary care at the Regional Cancer Centre at the state capital, Trivandrum. By the beginning of this century, private hospitals and specialised institutes started providing cancer care and have pioneered advancements across diagnostic imaging, surgery, radiation and medical oncology, significantly expanding access, technological sophistication and quality of care. Among these, the Caritas Cancer Institute has emerged as a pivotal institution, exemplifying excellence in comprehensive oncological services, including advanced surgical, medical, radiation and palliative oncology under one roof - with advanced cancer diagnostic and imaging services.

Expansion of Infrastructure and Specialised Facilities

Starting in the early 2000s, private hospitals began establishing dedicated oncology centres, equipped with cutting-edge diagnostic and treatment modalities. Institutions like Amala Institute of Medical Sciences, Amrita Hospital, KIMS, Aster Hospitals, Lakeshore Hospital, MVR Cancer Care, MGM Muthoot Hospital, Cancer Centre Parumala and notably Caritas Cancer Institute, set new standards with their comprehensive facilities.

The Caritas Cancer Institute invested heavily in state-of-the-art diagnostic tools such as PET-CT, high-resolution MRI, and molecular testing laboratories, enabling early detection and precise staging of cancers. Its infrastructure expansion included specialised surgical theatres capable of complex oncological surgeries, advanced radiation therapy units and outpatient chemotherapy facilities, drastically reducing the need for patients to seek treatment outside Kerala.

Advanced Surgical Oncology

A significant contribution of the private sector has been the development of sophisticated surgical oncology services. Over the years, they introduced minimally invasive techniques such as laparoscopic and robotic-assisted surgeries for cancers of the gastrointestinal tract, breast and head and neck regions.

The adoption of these advanced surgical techniques has resulted in reduced operative morbidity, shorter hospital stays, and faster recovery times, improving overall patient outcomes. The institute’s multidisciplinary teams work collaboratively to plan and execute complex surgeries, including limb-sparing surgeries for sarcomas, organ-preserving procedures, and reconstructive surgeries, setting new benchmarks in Kerala.

Furthermore, the private sector’s focus on surgical oncology has expanded access to high-quality, technologically advanced procedures like Sentinel node biopsies, Microvascular Surgical Reconstructions, Hyperthermic IntraPEritoneal Chemotherapy (HIPEC) etc., that were previously limited to metropolitan centres in India. This has been especially impactful for rural and semi-urban populations, who now benefit from expert surgical care closer to home.

Advanced Radiation Oncology

Another cornerstone of private sector innovation has been the introduction of advanced radiation therapy techniques. The Caritas Cancer Institute and other private hospitals in Kerala have incorporated technologies such as Intensity-Modulated Radiation Therapy (IMRT), Image-Guided Radiation Therapy (IGRT), Stereotactic Body Radiotherapy (SBRT) and Stereotactic Radiosurgery (SRS).

These modalities enable highly precise targeting of tumours while minimising damage to surrounding healthy tissues, leading to better local control and fewer side effects. The availability of such advanced radiation options has revolutionised treatment for cancers such as brain tumours, head and neck cancers, thoracic and abdominal malignancies and pelvic tumours.

The private sector’s early adoption of these technologies has contributed to improved survival rates and reduced treatment-related morbidity. The Caritas Cancer Institute, in particular, has been a pioneer in implementing these sophisticated radiotherapy techniques, making high-quality radiation treatment accessible to Kerala’s cancer patients.

Advanced Medical Oncology Access Pan Kerala

Alongside surgical and radiation advances, private institutions have facilitated access to systemic therapies, including targeted agents and immunotherapies, CAR-T Cell Therapy further enhancing treatment outcomes. Autologous and allogeneic bone marrow transplants made accessible to every person in Kerala by the private sector was one of the key points to be noted. The integration of these treatments into multidisciplinary care pathways has allowed for personalised treatment plans, especially in advanced or metastatic cancers.

Decentralisation of Cancer Care in Kerala

The private sector also contributed to the decentralisation of oncology services across Kerala, reducing the need for patients to travel long distances for treatment. Hospitals expanded into Tier 1 cities like Kozhikode, Thrissur - in Northern Kerala, Tier 2 cities like Kottayam, Alappuzha, and even Tier 3 cities like Kozhencherry, Tier 4 cities like Parumala etc., enabling broader access to Advanced Cancer Care services. Additionally, many private institutions established tumour boards and embraced collaborative decision-making models involving medical, surgical and radiation oncologists, pathologists and palliative care specialists.

Fostering Specialised Workforce and Training

The private sector - especially institutions like Caritas - has emphasised capacity building through specialised training programs, fellowships and collaborations with national and international oncology bodies. This has led to the emergence of a skilled cadre of surgical oncologists, radiation oncologists, medical oncologists and supportive care specialists within Kerala.

Conclusion

The past 25 years have seen the private healthcare sector in Kerala emerge as a pivotal force in cancer care. By expanding infrastructure, introducing technology, facilitating affordability, and emphasising human-centred care, private players have complemented the efforts of the public sector. Challenges remain in terms of equitable access and cost management, but the private sector’s role in advancing cancer care in Kerala is both undeniable and indispensable.

As Kerala continues to battle rising cancer prevalence, sustained collaboration between public, private and community stakeholders will be essential in ensuring that the progress of the past quarter-century translates into universal, compassionate and effective cancer care for all in Kerala.