With over three decades of experience across India and the UK, Dr. Bhawna Sirohi, Medical Director, Vedanta Medical Research Foundation – BALCO Medical Centre, Raipur, has emerged as one of India’s leading voices in oncology. Her extensive work in gastrointestinal and breast cancers, combined with her commitment to equitable access and evidence-based care, has helped shape the landscape of modern cancer treatment in India. In this exclusive interview with Medical Tourism Today, Dr. Sirohi shares insights on India’s evolving oncology ecosystem, the importance of early detection, the rise of personalized therapies, and her vision for a patient-centric future.
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Dr. Sirohi, could you briefly share your professional journey and what inspired you to specialize in gastrointestinal and breast cancers?
I have spent two decades in the UK and another decade in India, gaining experience across universal health coverage systems as well as private and government cancer centers. My oncology journey began at Tata Memorial Hospital in Mumbai, India’s most prestigious cancer institute, where I spent four years managing complex cases and witnessing firsthand the challenges of delivering high-quality cancer care in resource-limited settings.
In 1998, I moved to London for advanced training, working at the Royal Marsden Hospital and other leading institutions. The UK’s healthcare system emphasizes sub-specialization, which is essential in oncology given the rapid advancements and complexity of the field.
I chose to specialize in gastrointestinal and breast cancers because they are among the most prevalent worldwide, and I had the privilege of having amazing mentors in both these disciplines who helped shape my career. This focused approach enables me to stay abreast of the latest developments and provide care that is both evidence-based and deeply patient-centric.
How do you see India’s oncology landscape evolving, particularly in tier-2 and tier-3 cities?
India’s oncology space has seen good progress, but there is still a long way to go. Spending on public healthcare must increase to at least 5% of GDP so that we can invest in better infrastructure (comprehensive treatment centers with facilities for surgery, radiotherapy, chemotherapy, and palliative care), workforce, and education, with a focus on universal health coverage. Schemes like Ayushman Bharat (PM-JAY) are a strong beginning, but we need to strengthen implementation and link outcomes to funding. Every Indian should be able to access quality cancer care without facing financial toxicity.
Cancer centers are mushrooming across tier-2 and tier-3 cities with no accountability, which is a matter of concern. We need them, but there must be transparency and accountability so that patients get the care they deserve.
We should also implement widespread awareness, vaccination, and screening campaigns and introduce structural and strategic reforms with policies that make people prioritize their health instead of seeking care as a reactive measure. To improve accessibility, we should decentralize care and reduce the need for patients to travel long distances. Establishing hub-and-spoke models where larger centers mentor and support smaller hospitals through telemedicine, shared protocols, and regular training is the need of the hour.
The involvement of community health workers like ASHA, Mitanin, and AYUSH doctors is also important. They are trusted by villagers and can play a key role in early detection, vaccination, counseling, and referral. We must also establish uniform cancer registries in every state and build a prospective outcomes database to understand the real burden of the disease. This data will guide research and improve patient outcomes.
Could you explain in simple terms what gastrointestinal cancers and breast cancer are, and how these cancers typically develop in the body?
In simple terms, cancer happens when cells in an organ start growing in an uncontrolled way. GI cancers are cancers of the digestive tract — stomach, colon, rectum, esophagus, pancreas, and gallbladder. Breast cancer starts in breast tissue. Often, these changes begin slowly over many years due to a mix of genes, lifestyle, and environmental exposures. Early changes may not cause symptoms, which is why screening and awareness matter.
What are the most significant challenges in diagnosing GI cancers at an early stage?
The main problems are low levels of awareness, non-specific symptoms, and the lack of a national screening program. Early GI cancers may cause mild stomach pain, changes in bowel habits, heartburn, or fatigue — often mistaken for other common conditions. Limited knowledge among primary care physicians in high-patient-volume settings can lead to misdiagnoses or delays in referring patients to specialists for proper evaluation. A significant proportion of diagnostic delays occur in the pre-hospital phase. One of the key challenges we face is late presentation due to patients trying alternative medicine before visiting a cancer center, by which time the cancer may be untreatable or incurable.
In India, people do not discuss GI issues very openly. Furthermore, the procedures necessary for GI cancer diagnosis — such as fecal occult blood tests, endoscopies, colonoscopies, and biopsies — are not easily accessible and are still viewed with hesitation, especially in rural areas.
What are some of the latest advancements in surgical, medical, or radiation therapies for GI cancers?
Surgical techniques are now less invasive: keyhole (laparoscopic/robotic) surgery reduces recovery time. Robotic surgery helps in performing operations in tight, complex areas like the narrow pelvis and delivers better outcomes in some cancers.
In radiation therapy, shorter and more precise schedules are being used safely (de-escalation where appropriate). Precision radiation therapies like IMRT and IGRT are used to protect healthy tissue.
Medically, targeted therapies and immunotherapy have changed the landscape of cancer care. Personalized approaches using liquid biopsies and genomic analysis to tailor treatments based on a patient’s cancer DNA and RNA help individualize therapy. As cure rates have increased, we are now trying to de-escalate treatments to make them smarter and kinder without compromising care. Work is also ongoing to reduce financial and time toxicity, so hospital visits are fewer.
How important is genetic testing in GI cancers, and are these tests accessible to patients across India?
For patients with GI cancers, genetic testing is used for diagnosis, treatment planning, and risk assessment. It is especially important when family history or age at diagnosis suggests a hereditary syndrome (for example, Lynch syndrome in colorectal cancer). It helps guide screening for relatives and sometimes changes treatment.
However, tests are not uniformly accessible across the country due to challenges with cost, awareness, and infrastructure. We must expand counseling services and make testing available through universal health programs or subsidized pathways so that patients who need it can get it. Tele-genetics can help democratize genetic counseling for patients.
What lifestyle factors contribute most to the rise of GI cancers in India, and what preventive measures do you recommend?
Lifestyle factors that contribute to the rise of GI cancers include poor diet (low fiber, high processed foods), obesity, physical inactivity, tobacco use (including smokeless forms), alcohol consumption, and air pollution. Additionally, socioeconomic development plays a key role in increasing the cancer burden.
Prevention is simple and effective: eat a balanced diet with plenty of fruits and vegetables, stay active (30–45 minutes at least five days a week), avoid tobacco, and don’t consume alcohol. Vaccinations such as HPV and hepatitis B, good sanitation, and regular screening where indicated are also important.
I often use the ABCDEF mnemonic with patients — A: Avoid tobacco/alcohol; B: Be vaccinated and be aware; C: Calm (stress management) and compliance with screening; D: Diet; E: Exercise; and F: Family history — know yours.
Since breast cancer is one of your main areas of expertise, what important precautions and screening tests should women follow for early detection? Could you also explain, in simple terms, the common methods used to diagnose and treat breast cancer?
Be breast-aware — know how your breasts normally look and feel, and report any new lump, change in shape, size, or contour of the breast, nipple changes, discharge, or persistent unusual symptoms.
Screening depends on age and risk:
• Younger women or those without symptoms should perform a self-breast exam about 5–7 days after the start of their periods.
• Women above 40: clinical breast exam and mammography as recommended.
• High-risk women (strong family history, genetic mutations) may need earlier imaging with MRI or more frequent screening.
Younger women have denser breasts; hence, mammography is usually not recommended before the age of 40.
Diagnosis usually starts with a clinical examination followed by imaging (mammogram and/or ultrasound) and a biopsy to confirm if the lump is cancerous. Treatment often combines surgery (to remove the tumor), systemic therapy (chemotherapy, hormonal therapy, targeted drugs, or immunotherapy, depending on tumor type), and radiotherapy. Treatment is personalized to the patient and tumor biology, depending on whether the cancer is hormone-driven (ER positive) or HER2-driven (special receptors on cancer cells that guide treatment).
Could you briefly outline the recommended screening protocols for breast cancer in India across different age groups?
A practical approach we use and recommend:
• Women under 40 years with no symptoms: monthly self-breast exams and clinical exams if risk factors are present; once-a-year clinical review with a doctor.
• Women 40–45 years: discuss starting mammograms every two years based on local guidelines and individual risk.
• Women 45 years and above: annual or biennial mammography.
High-risk women (strong family history, known mutation carriers): start earlier with more intensive surveillance (mammogram ± MRI and genetic counseling). These are broad cues; individual advice should come from a doctor.
What are the latest cutting-edge therapies, such as immunotherapy or targeted drugs, available for breast cancer patients at BALCO Medical Centre?
At BALCO Medical Centre, all treatments available in leading cancer centers in Delhi, Mumbai, London, or New York are accessible closer to home. However, some patients still believe that better care is only available in bigger cities. Patients from Raipur want to go to Mumbai or Delhi; patients from Delhi or Mumbai want to go abroad, not realizing that the best care is care closer to family and home.
Patients at BALCO Medical Centre receive individualized care. Most undergo breast-conserving surgery, and we can now de-escalate axillary surgery using sentinel lymph node mapping with the dual method. For radiotherapy, the latest techniques like deep inspiration breath-hold and precise delivery are used. We offer advanced targeted therapies and immunotherapy, tailored to the patient’s genetic profile for better outcomes and fewer side effects.
We also provide scalp cooling therapy to help reduce hair loss during chemotherapy. Beyond breast cancer, we offer cutting-edge options such as CAR-T cell therapy, bone marrow transplants (both autologous and allogenic), and procedures like therapeutic plasma exchange and red cell exchange. We ensure safe transfusion support with irradiated blood products and offer monoclonal therapies for complex conditions like sickle cell disease.
How are artificial intelligence and machine learning being integrated into diagnostics, imaging, and pathology for cancer patients?
AI will help democratize cancer care globally. Currently, it is used to report on scans, especially mammograms — AI algorithms can detect subtle changes and save reporting time. It also has great potential in radiotherapy planning and digital pathology, especially in places where specialist doctors are few.
At BMC, we are piloting AI tools to help triage patients, prioritize urgent cases, and support clinical decisions. AI will never replace doctors, but it can make our work faster, more accurate, and help bring expert-level care closer to every patient.
We use the TMC-Navya second opinion portal for real-time expert consultation. AI will be immensely helpful in predicting drug-drug interactions, matching patients to clinical trials in India or globally, driving precision oncology by deciphering genomic data, and supporting multidisciplinary care.
What is your vision for the future of cancer care in India – both for Indian patients and for those coming from abroad for medical tourism?
Given the positive political will in this space, the future of cancer care in India is on an upward trend, especially with government schemes like Ayushman Bharat, which is India’s strongest effort toward delivering universal healthcare at the ground level. We need to rebalance our priorities in oncology and introduce a paradigm shift across three key domains: treatment, research, and education.
Decisive actions are necessary to reduce both regional and global disparities in cancer care. This includes strengthening infrastructure, improving affordability, and ensuring that care is guided by evidence rather than marketing or geography.
Education and research must remain at the heart of this transformation, as they drive innovation, inform best practices, and ultimately shape patient-centric care. The future I envision is one where a patient’s outcome depends solely on the quality of care they receive — not on where they live or what they can afford.
Given your experience, how can India position itself as a leader not only in affordable cancer care but also in cutting-edge oncology research and clinical trials for international patients?
Recent studies from India show that we have led not only in driving cost-effective cancer care but also in cutting-edge technology and research. We have a huge patient base, which means that the same trial that would take years to recruit in a Western country can be completed in a few months in India, leading to significant cost savings and faster results.
However, to position ourselves as a leader, we need to drive transparency in clinical care and ensure quality treatment for every single patient. Research can only build upon good cancer care that is evidence-based and delivered universally.
Every treatment modality we use today in clinics is based on decades of research and patient participation. Currently, cancer research is heavily focused on high-income countries (HICs). There is a need to rebalance research efforts to address the unique challenges faced by low- and middle-income countries (LMICs). For that, key stakeholders in LMICs must drive quality care and make the regulatory environment transparent and receptive.
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DR. BHAWNA SIROHI
Dr. Bhawna Sirohi is the Medical Director at Vedanta Medical Research Foundation – BALCO Medical Centre, Raipur, India. She is a Consultant in Medical Oncology, specializing in breast and gastrointestinal (GI) cancers. With more than two decades of experience as an oncologist in both the NHS (UK) and India, she has played a key role in establishing new cancer centres across the country in both the private and public sectors.
This experience has enabled her to develop and implement protocols and procedures that help deliver safe and high-quality care to patients. She chairs site-specific cancer sub-committees for the Indian Council of Medical Research (ICMR) to develop guidelines and consensus statements, and also serves on its Scientific Advisory Group.
Dr. Sirohi is deeply involved with charities such as CanSupport, which provides home-based palliative care to patients, helping to avoid aggressive treatment toward the end of life. She has received numerous awards throughout her career in both the UK and India.
This is an informative interview of Dr..Bhawna Sirohi. She has shared a lot of information for the common people.
A wonderful and inspiring interview. Dr. Sirohi’s emphasis on patient-centric care and decentralizing oncology services gives hope for more equitable cancer treatment across tier-2 and tier-3 cities in India.
Thank you for this detailed conversation. The point about integrating AI and tele-genetics to democratize cancer care really resonated. Technology must support, not replace, the human touch in medicine.
I especially appreciate Dr. Sirohi’s comment on reducing financial toxicity. Too often, treatment cost becomes a barrier — aligning clinical excellence with affordability is the way forward.
The hub-and-spoke model she describes is a smart strategy for expanding outreach without diluting quality. Smaller centres guided by larger ones can make a real difference in patient access.
Her ABCDEF mnemonic is so practical and memorable — good advice that anyone can internalize and act upon. Prevention and awareness begin at home.
I liked how she balanced optimism with realism — acknowledging resource constraints while offering concrete solutions like shared protocols, registries, and workforce training.
I hope more cancer centres adopt scalp cooling, precision radiation, and genomic testing as standard offerings, not luxuries. Dr. Sirohi’s work shows that’s possible even outside major metros.
This interview is both informative and motivating. I hope policy makers, hospital administrators, and oncologists alike read this and act — to make patient-centric, accessible cancer care a reality in every part of India.