Telemedicine for Cancer Care in Resource-Constrained Settings: Benefits, Barriers, and Implementation Priorities

Abstract

Cancer care delivery in low- and middle-income countries (LMICs) remains hindered by late diagnosis, geographic disparities, and limited specialist availability. Tele-oncology has gained momentum as a strategy to bridge these gaps, with adoption accelerated during the COVID-19 pandemic. This narrative review synthesizes evidence from peer-reviewed and grey literature to examine the benefits, barriers, and implementation priorities for telemedicine in oncology within resource-constrained settings, with India as the primary context and comparative insights from other LMICs. Findings indicate that tele-oncology improves access to specialist care, reduces patient travel and cost burdens, supports multidisciplinary decision-making through virtual tumor boards, and maintains continuity of care during service disruptions. Patient satisfaction is consistently high, and emerging models such as tele-genetic counselling, telepathology, and e-palliative care show promise. However, persistent challenges include inadequate digital infrastructure, variable digital literacy, data security concerns, regulatory ambiguities, and limitations of remote assessment for certain cancer cases. Drawing on cross-country examples, the review identifies eight implementation priorities: strengthening infrastructure, establishing oncology-specific policies, expanding workforce training, promoting LMIC research collaboration, fostering service innovation, integrating tele-oncology with national digital health platforms, generating evidence on survival outcomes, and developing clear reimbursement mechanisms. The current evidence base is limited by the predominance of small-scale or observational studies and uneven methodological quality, underscoring the need for robust evaluation of tele-oncology's impact on treatment timeliness and survival in LMIC contexts. Tele-oncology offers a scalable, adaptable adjunct to conventional cancer care, but its long-term sustainability will depend on coordinated policy action, equitable access to technology, and systematic outcome measurement.