Cancer Care Cannot Wait: Delivering Services in a Resource-Limited Setting

Cancer care delivery in low- and middle-income settings faces persistent challenges related to increasing disease burden, delayed presentation, and limited healthcare infrastructure. Bihar, India, a predominantly rural and socioeconomically underserved state, lacked dedicated comprehensive tertiary oncology services until the establishment of the Homi Bhabha Cancer Hospital and Research Centre, Muzaffarpur, under the Tata Memorial Centre network. To address regional cancer care needs while permanent infrastructure was under development, clinical services were initiated in February 2021 through a phased operational model using modular infrastructure within an existing government medical college setting. Electronic medical records were implemented from inception, supported by local workforce recruitment and specialist mentorship from established tertiary centers. Over the initial 4-year period, the center registered more than 17,000 new patients, with substantial expansion in outpatient, inpatient, surgical, chemotherapy, preventive oncology, and palliative care services. Preventive oncology initiatives screened more than 2.3 million individuals, while palliative care services expanded community-based support through home visits. This retrospective descriptive service evaluation describes the phased establishment of a tertiary cancer center in a resource-constrained setting, highlighting operational strategies, service utilization trends, and implementation experiences that may inform oncology service expansion in similarly underserved settings.