Virtual cancer care: Bridging gaps and overcoming challenges

The post-COVID period has significantly accelerated the digitalisation of India’s healthcare system, a change many describe as an `inevitable shift of the times.' This transformation has been particularly critical in the field of psycho-oncology, which addresses the psychological, social, and behavioural dimensions of cancer care.

Psycho-oncology focuses not only on patients but also on their families and caregivers, offering an individual-centred approach to managing the emotional impact of diagnosis and ongoing treatment. Human relationships play a central role in this field, and their adaptation into Virtual Psycho-Oncology Services (VPOS) has raised important questions. Studies conducted among Indian doctors indicate that while virtual services can address several challenges, they are not a panacea for all such issues. In fact, there are significant downsides as well. While we welcome the convenience of telemedicine, it also exposes significant weaknesses in the healthcare system.

The duality of access
The greatest strength of virtual care lies in its open possibilities, but this very feature also creates barriers. Virtual platforms enable treatment to extend beyond physical boundaries, thereby allowing patients in rural areas to continue care without the burden of travel. Yet, behind this convenience lies a critical ethical challenge. The digital divide is a major obstacle, as economically disadvantaged patients often lack access to smartphones or the internet, as attested by physicians.

When cancer care thwarts a family’s financial base, patients may be forced to opt out of counselling services that require online connectivity or additional expenditure. In short, while technology has the potential to facilitate care, it simultaneously excludes the most vulnerable.

A fragile ecosystem
Beyond the issue of healthcare availability, a major challenge is the platform deficit. In the absence of a secure, unified national system, doctors are forced to rely on tools such as WhatsApp or Google Meet. This, in turn, raises concerns about data security. Patient information is distributed across multiple locations (siloed data), hindering the multidisciplinary collaboration essential to cancer care. Technical glitches often demand attention, which prevents doctors from fully focusing on patient care.

The human cost
Technology also alters the nature of the healthcare experience. The therapeutic touch that provides comfort to patients and subtle facial cues that guide treatment decisions are lost in virtual consultations, creating challenges for doctors. The burden of bridging these gaps often falls on caregivers, who become technical intermediaries by spending more time managing devices and connections than providing emotional support. This occurs on top of the already significant stress imposed by a cancer diagnosis.

Ethical tightropes
Handling critical situations online presents a major challenge. When a patient displays suicidal tendencies or severe psychological distress during a video call, doctors are often left feeling helpless, unable to intervene directly. Privacy is another concern, as patients in crowded households may not have a space for open conversation.

The path forward
The future of cancer care may lie in a hybrid model that combines in-person and virtual consultations. With proper planning, this approach can lead to meaningful growth in psycho-oncology. To enable this, a secure national platform linked to hospital records is essential. To prevent treatment interruption due to financial constraints, psycho-oncology should be included in standard cancer care packages.

In addition, building rapport with patients through digital media and training the next generation of therapists in tele-competence helps mitigate risks and deliver effective care online. While virtual care has opened doors, it is vital to ensure these doors are accessible not only to those with digital access but to all patients.
(The authors are MSC in Clinical Psycho-Oncology, Christ University, Bengaluru)