Bangladesh must invest heavily in cancer research, innovation, AI-driven technologies -- Doulot Akter Mala shows how answers to cancers can be derived from latest know-how
Once a frightening saying that 'cancer has no answer' no longer stands in today's world. In many cases, cancer is no longer a mysterious disease. Modern science has made remarkable breakthroughs in understanding how cancer begins, grows, and spreads at genetic and cellular levels. That knowledge itself is an answer.
Many cancers are now curable, while others have significantly improved prognoses. In the past, cancer treatment relied largely on surgery, chemotherapy, or radiation with limited precision. Today, doctors use AI to research and also analyse tumor genetics, design personalised treatment plans. Early detection dramatically improves survival rates, and targeted therapies have become a game changer. For many patients, cancer is now a long-term, manageable condition -- much like a heart disease or diabetes. These advances are the result of decades of global research and innovation.
Artificial intelligence is further transforming cancer care through drug discovery and precision medicine. Yet the global cancer burden continues to rise, with nearly 20 million new cases diagnosed annually. Aging populations, environmental pollution, plastic exposure, tobacco use, and lifestyle changes are enhancing cancer risks worldwide. Bangladesh is particularly vulnerable due to the widespread and largely unregulated use of smokeless tobacco.
A global study warns that cancer cases could reach 35 million by 2050. While high-income countries are investing heavily in cancer research and treatment, low- and middle-income countries -- including Bangladesh -- are falling behind.
A growing crisis in Bangladesh: Bangladesh has one of the fastest-growing cancer rates in the SAARC region. Around 1.2 million new cases are detected each year, while a large segment of the proportion remains undiagnosed. A major reason is a lack of accessible diagnostic and treatment facilities.
Cancer care in Bangladesh remains heavily centralized. Most specialized services are concentrated in Dhaka, forcing patients from rural areas to travel long distances at high cost. Many regional hospitals lack essential equipment and trained professionals.
In recent years, several private hospitals -- such as Delta, Square, Labaid Cancer Hospital, Evercare, United Hospital, and Green Life -- have invested in advanced cancer-treatment facilities, including AI-driven technologies. While these developments are promising, the services remain prohibitively expensive for most people.
Cancer treatment is among the most expensive forms of medical care. Many families exhaust savings or sell assets to continue treatment. Without a significant increase in public health spending, cancer care will remain out of reach for low- and fixed-income groups. Limited fiscal space has kept Bangladesh's health budget among the lowest in the region, leading to high out-of-pocket expenditure.
Limited progress, persistent gaps: Over the past four decades, Bangladesh has made some progress in cancer treatment. Physicians can now offer structured treatment plans, palliative care, and limited reassurance -- yet the system remains far from adequate.
Bangladesh's journey in cancer treatment dates back to the 1950s, with the installation of the first Cobalt-60 machine at Kumudini Hospital in 1953 (some sources cite 1958). The first public-sector unit was established at Dhaka Medical College Hospital (DMCH) in 1962. Specialized care expanded with the founding of the Rotary Cancer Detection Centre in 1981, which later became National Institute of Cancer Research and Hospital (NICRH) in 1986. NICRH later expanded services with Cobalt-60 therapy in 1995, while private-sector involvement began in 1994 with Delta Hospital installing a Cobalt-60 unit.
Although radiotherapy services now include linear accelerator (Linac) machines in both public and private facilities, severe shortages persist, resulting in long wait in public hospitals. Government facilities are comparatively affordable but suffer from overcrowding, equipment shortages, and delayed therapies. Poor investment in the health sector continues to exact a heavy toll.
Stark statistics: According to The Lancet Oncology, Bangladesh currently has around 1.5 million cancer patients, a number projected to exceed 2.1 million by 2040. Cancer-related deaths recorded so far have already surpassed one million and are expected to reach 1.4 million by 2040. Alarmingly, Bangladesh has the highest cancer mortality rate in the SAARC region -- nearly 70 per cent.
NICRH remains country's primary public cancer-treatment centre and bears an overwhelming patient load. Long queues for radiotherapy are common, with treatment often delayed for months. A visit to NICRH reveals patients from across the country waiting on roadsides due to insufficient space.
Of the country's 36 government medical college hospitals, only 14 have oncology departments, most facing acute shortages of trained staff and modern equipment. Bangladesh has just 17 radiotherapy centres -- only one located in a rural area -- making access nearly impossible for millions.
Data presented at an Oncology Club event showed only 12.9 per cent of cancer patients in Bangladesh have access to radiotherapy -- the lowest rate in the SAARC region. By comparison, coverage stands at 42 percent in India, 45.8 percent in Sri Lanka, 30.4 percent in Pakistan, and 26.6 percent in Nepal.
Bangladesh has only 18-20 linear accelerator machines, while experts estimate a need for at least 180-200. Human-resource shortages are equally alarming: the country has just 250 radiation oncologists, 22 medical oncologists, 47 pediatric oncologists, and 70 medical physicists.
Research and financial barriers: Bangladesh has only one or two molecular laboratories dedicated to cancer research. In many cases, patient samples must be sent to India for testing. Following the recent visa disruptions, patients who relied on cross-border treatment now face severe hardship.
Cancer treatment often leads to catastrophic health expenditure. Nearly 90 per cent of families with cancer patients experience serious financial distress. Average annual out-of-pocket costs range between Tk 547,840 and Tk 639,000 -- well beyond the reach of most households.
Although government hospitals are cheaper, overcrowding forces many patients into private facilities. A single PET-CT scan costs Tk 65,000-70,000, excluding medication, travel, and accommodation. Unable to bear the burden, many patients abandon treatment midway, contributing to high mortality. Those who can afford it increasingly seek care abroad, draining household savings and foreign-currency reserves of the country.
Late diagnosis and policy gaps: The absence of community-based screening programmes means most patients arrive at hospitals in advanced stages of cancer, drastically reducing survival chances. Diagnostic capacity remains limited, with severe shortages of PET/CT, CT, and MRI scanners.
Bangladesh lacks a population-based national cancer registry, making evidence-based planning difficult. There is also no nationally tailored cancer-treatment protocol, forcing physicians to rely on international guidelines that may not align with local realities.
Earlier, the government had announced plans to establish eight comprehensive cancer centres at divisional medical colleges to decentralize services. Local pharmaceutical companies, including Incepta, Renata, and Beacon Pharmaceuticals, now produce cancer drugs domestically, reducing import costs. Community-based screening programmes for breast and cervical cancer, led by government agencies and NGOs, are also expanding.
Still, experts warn these steps are insufficient without sustained investment. Bringing in advanced machines is not enough. Operating and maintaining them require skilled manpower, which we currently lack.
Which way lies the lifesaving remedies is a matter of serious thought for government policymakers. Cancer does not have a single answer -- because it is not a single disease. But, for many cancers, science now offers clear and effective solutions. To benefit from latest advances, Bangladesh must invest heavily in cancer research, innovation, and AI-driven technologies.
A positive development is that Bangladesh now produces around 80 per cent of its cancer medicines domestically. However, the industry remains fully dependent on imported active pharmaceutical ingredients (APIs), exposing the sector to supply-chain vulnerabilities.
Public-private collaboration is essential to decentralize cancer care beyond Dhaka, strengthen research infrastructure, train skilled professionals and ensure affordability by enhancing local raw material-production capacity. Without urgent reform and sustained commitment, thousands of lives will continue to be lost -- not only to cancer, but to a system unable to respond in time.
doulotakter11@gmail.com