CHALLENGES ASSOCIATED WITH POST-OPERATIVE CANCER CARE AND IMPLEMENTATION OF DIGITAL TECHNOLOGY FOR IMPROVED OUTCOMES: A NARRATIVE REVIEW
Main Article Content
Keywords
Cancer, digital technology, healthcare, LMICs, post-operative complications, surgery, telemedicine
Abstract
Cancer diagnosis and subsequent treatment have a profound effect on the lives of patients and their families. Post-surgical care is a critical phase in the cancer treatment continuum, and significantly influences recovery, quality of life, and long-term outcomes. There are multiple challenges associated with post-surgical cancer care. This review aimed to identify barriers to post-surgery cancer care management, particularly in low-resource settings. Additionally, it aim to understand the importance of integrating digital healthcare technologies for efficient healthcare delivery to patients after cancer surgery. A literature search was conducted using the PubMed and Google Scholar databases. Several medical, psychological, and logistical challenges have been identified as barriers to accessing healthcare for patients with cancer. In low- and middle-income countries (LMICs), the main obstacles are financial constraints, lack of accessibility to specialized care, lack of resources and awareness, and the gap in patient-provider communication. The advancement of digital health technology has resulted in the creation of technology-driven approaches to delivering healthcare. It is beneficial in overcoming some of the challenges associated with post-operative cancer care in LMICs. Integrating technology-enabled solutions such as smart mobile applications, remote monitoring tools, telemonitoring, telemedicine platforms, artificial intelligence, and digital therapeutics can transform patient care. Recently, India has seen a surge in the adoption of digital health technologies that are aimed at improving the quality and continuity of care for cancer patients. Although digital technologies have the potential to revolutionize postoperative cancer care in India, strategic implementation focusing on infrastructure, education, policy, and ethical considerations is essential.
References
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38. Dwivedi R, Mehrotra D, Chandra S. Potential of Internet of Medical Things (IoMT) applications in building a smart healthcare system: A systematic review. J Oral Biol Craniofac Res. 2022;12(2):302-18.
39. Jain S, Jain PK, Puranik AK. Digital Health Technology & Cancer Care: Conceptual Framework Leading Comprehensive Fruitfulness. J Healthc Leadersh. 2024;16:525-35.
40. Venkataramanan R, Pradhan A, Kumar A, Purushotham A, Alajlani M, Arvanitis TN. Digital Inequalities in Cancer Care Delivery in India: An Overview of the Current Landscape and Recommendations for Large-Scale Adoption. Front Digit Health. 2022;4:916342.
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44. Zhang Y, Flannery M, Zhang Z, et al. Digital Health Psychosocial Intervention in Adult Patients With Cancer and Their Families: Systematic Review and Meta-Analysis. JMIR Cancer. 2024;10:e46116.
45. Chow PI, Showalter SL, Gerber M, et al. Use of Mental Health Apps by Patients With Breast Cancer in the United States: Pilot Pre-Post Study. JMIR Cancer. 2020;6(1):e16476.
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48. Avery KNL, Richards HS, Portal A, et al. Developing a real-time electronic symptom monitoring system for patients after discharge following cancer-related surgery. BMC Cancer. 2019;19(1):463.
49. Kondylakis H, Bucur A, Crico C, et al. Patient empowerment for cancer patients through a novel ICT infrastructure. J Biomed Inform. 2020;101:103342.
50. Mathkor DM, Mathkor N, Bassfar Z, et al. Multirole of the internet of medical things (IoMT) in biomedical systems for managing smart healthcare systems: An overview of current and future innovative trends. J Infect Public Health. 2024;17(4):559-72.
51. Lombardi M, Pascale F, Santaniello D. Internet of things: A general overview between architectures, protocols and applications. Information. 2021;12(2):87.
52. Shen S, Qi W, Liu X, et al. From virtual to reality: innovative practices of digital twins in tumor therapy. J Transl Med. 2025;23(1):348.
53. Asciak L, Kyeremeh J, Luo X, et al. Digital twin assisted surgery, concept, opportunities, and challenges. NPJ Digit Med. 2025;8(1):32.
54. Mollica L, Leli C, Sottotetti F, Quaglini S, Locati L, Marceglia S. Digital twins: a new paradigm in oncology in the era of big data. ESMO Real World Data and Digital Oncology. 2024;5:100056.
55. Mukhopadhyay M, Banerjee S, Mukhopadhyay CD. Internet of Medical Things and the Evolution of Healthcare 4.0: Exploring Recent Trends. Journal of Electronics, Electromedical Engineering, and Medical Informatics. 2024;6(2):182-95.
2. Organization WH. Global cancer burdengrowing, amidst mounting need for services 2024 [Available from: https://www.who.int/news/item/01-02-2024-global-cancer-burden-growing--amidst-mounting-need-for-services.
3. Sathishkumar K, Chaturvedi M, Das P, Stephen S, Mathur P. Cancer incidence estimates for 2022 & projection for 2025: Result from National Cancer Registry Programme, India. Indian J Med Res. 2022;156(4&5):598-607.
4. Dare AJ, Knapp GC, Romanoff A, et al. High-burden Cancers in Middle-income Countries: A Review of Prevention and Early Detection Strategies Targeting At-risk Populations. Cancer Prev Res (Phila). 2021;14(12):1061-74.
5. Shafi L, Iqbal P, Khaliq R. Cancer Burden in India: A Statistical Analysis on Incidence Rates. Indian J Public Health. 2023;67(4):582-7.
6. Ranganathan P, Dare A, Harrison EM, et al. Inequities in global cancer surgery: Challenges and solutions. J Surg Oncol. 2024;129(1):150-8.
7. Sadler SJ, Torio EF, Golby AJ. Global cancer surgery in low-resource settings: A strengths, weaknesses, opportunities, and threats analysis. Cancer. 2023;129(5):671-84.
8. Saunders AC, Mutebi M, Rao TS. A Review of the Current State of Global Surgical Oncology and the Role of Surgeons Who Treat Cancer: Our Profession's Imperative to Act Upon a Worldwide Crisis in Evolution. Ann Surg Oncol. 2023;30(6):3197-205.
9. van Kooten RT, Bahadoer RR, Peeters K, et al. Preoperative risk factors for major postoperative complications after complex gastrointestinal cancer surgery: A systematic review. Eur J Surg Oncol. 2021;47(12):3049-58.
10. Cata JP. Research in Perioperative Care of the Cancer Patient: Opportunities and Challenges. Curr Oncol. 2023;30(1):1186-95.
11. Geroin C, Weindelmayer J, Camozzi S, et al. Association between ERAS protocol and major postoperative complications and reasons for non-compliance in patients with esophageal cancer. Eur J Surg Oncol. 2025;51(5):109707.
12. Chen X, Yao J, Xin Y, et al. Postoperative Pain in Patients Undergoing Cancer Surgery and Intravenous Patient-Controlled Analgesia Use: The First and Second 24 h Experiences. Pain Ther. 2023;12(1):275-92.
13. Lindberg M, Franklin O, Svensson J, Franklin KA. Postoperative pain after colorectal surgery. Int J Colorectal Dis. 2020;35(7):1265-72.
14. Paice JA, Bohlke K, Barton D, et al. Use of Opioids for Adults With Pain From Cancer or Cancer Treatment: ASCO Guideline. J Clin Oncol. 2023;41(4):914-30.
15. Zehnpfennig L, Ritter M, Montagna G, et al. The impact of delayed wound healing on patient-reported outcomes after breast cancer surgery. J Plast Reconstr Aesthet Surg. 2022;75(11):4125-32.
16. GlobalSurg C, Surgery NGHUoG. Impact of malnutrition on early outcomes after cancer surgery: an international, multicentre, prospective cohort study. Lancet Glob Health. 2023;11(3):e341-e9.
17. Shalata W, Gothelf I, Bernstine T, et al. Mental Health Challenges in Cancer Patients: A Cross-Sectional Analysis of Depression and Anxiety. Cancers (Basel). 2024;16(16).
18. Smith GL, Lopez-Olivo MA, Advani PG, et al. Financial Burdens of Cancer Treatment: A Systematic Review of Risk Factors and Outcomes. J Natl Compr Canc Netw. 2019;17(10):1184-92.
19. Bergerot C, Jacobsen PB, Rosa WE, et al. Global unmet psychosocial needs in cancer care: health policy. EClinicalMedicine. 2024;78:102942.
20. Ahn SK, Oh S, Kim J, Choi JS, Hwang KT. Psychological Impact of Type of Breast Cancer Surgery: A National Cohort Study. World J Surg. 2022;46(9):2224-33.
21. Pramesh CS, Badwe RA, Bhoo-Pathy N, et al. Priorities for cancer research in low- and middle-income countries: a global perspective. Nat Med. 2022;28(4):649-57.
22. Mutebi M, Anderson BO, Duggan C, et al. Breast cancer treatment: A phased approach to implementation. Cancer. 2020;126 Suppl 10:2365-78.
23. Goyanka R, Yadav J, Sharma P. Financial burden and coping strategies for cancer care in India. Clinical Epidemiology and Global Health. 2023;20:101259.
24. GlobalSurg C, Surgery NGHRUoG. Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study. Lancet Glob Health. 2022;10(7):e1003-e11.
25. Datta SS, Ghose S, Ghosh M, et al. Journeys: understanding access, affordability and disruptions to cancer care in India. Ecancermedicalscience. 2022;16:1342.
26. Chintapally N, Nuwayhid M, Arroju V, et al. State of cancer care in India and opportunities for innovation. Future Oncol. 2023;19(39):2593-606.
27. Khanna D, Sharma P, Budukh A, et al. Rural-urban disparity in cancer burden and care: findings from an Indian cancer registry. BMC Cancer. 2024;24(1):308.
28. Bamodu OA, Chung CC. Cancer Care Disparities: Overcoming Barriers to Cancer Control in Low- and Middle-Income Countries. JCO Glob Oncol. 2024;10:e2300439.
29. Meara JG, Leather AJ, Hagander L, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Int J Obstet Anesth. 2016;25:75-8.
30. Brajcich BC, Shallcross ML, Johnson JK, et al. Barriers to Post-Discharge Monitoring and Patient-Clinician Communication: A Qualitative Study. J Surg Res. 2021;268:1-8.
31. Soukup T, Lamb BW, Arora S, Darzi A, Sevdalis N, Green JS. Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature. J Multidiscip Healthc. 2018;11:49-61.
32. Robella M, Tonello M, Berchialla P, et al. Enhanced Recovery after Surgery (ERAS) Program for Patients with Peritoneal Surface Malignancies Undergoing Cytoreductive Surgery with or without HIPEC: A Systematic Review and a Meta-Analysis. Cancers (Basel). 2023;15(3).
33. Zhang Q, Sun Q, Li J, et al. The Impact of ERAS and Multidisciplinary Teams on Perioperative Management in Colorectal Cancer. Pain Ther. 2025;14(1):201-15.
34. Fawcett WJ, Mythen MG, Scott MJ. Enhanced recovery: joining the dots. Br J Anaesth. 2021;126(4):751-5.
35. Venkataramanan R, Pradhan A, Kumar A, Alajlani M, Arvanitis TN. Role of digital health in coordinating patient care in a hub-and-spoke hierarchy of cancer care facilities: a scoping review. Ecancermedicalscience. 2023;17:1605.
36. McLean KA, Knight SR, Diehl TM, et al. Readiness for implementation of novel digital health interventions for postoperative monitoring: a systematic review and clinical innovation network analysis. Lancet Digit Health. 2023;5(5):e295-e315.
37. Arora S, Ryals C, Rodriguez JA, Byers E, Clewett E. Leveraging Digital Technology to Reduce Cancer Care Inequities. Am Soc Clin Oncol Educ Book. 2022;42:1-8.
38. Dwivedi R, Mehrotra D, Chandra S. Potential of Internet of Medical Things (IoMT) applications in building a smart healthcare system: A systematic review. J Oral Biol Craniofac Res. 2022;12(2):302-18.
39. Jain S, Jain PK, Puranik AK. Digital Health Technology & Cancer Care: Conceptual Framework Leading Comprehensive Fruitfulness. J Healthc Leadersh. 2024;16:525-35.
40. Venkataramanan R, Pradhan A, Kumar A, Purushotham A, Alajlani M, Arvanitis TN. Digital Inequalities in Cancer Care Delivery in India: An Overview of the Current Landscape and Recommendations for Large-Scale Adoption. Front Digit Health. 2022;4:916342.
41. Deo SV, Pramanik R, Chaturvedi M, et al. Telemedicine and cancer care in India: promises, opportunities and caveats. Future Sci OA. 2022;8(9):FSO821.
42. Jonker LT, Lahr MMH, Oonk MHM, de Bock GH, van Leeuwen BL. Post-discharge Telemonitoring of Physical Activity, Vital Signs, and Patient-Reported Symptoms in Older Patients Undergoing Cancer Surgery. Ann Surg Oncol. 2021;28(11):6512-22.
43. Singh AV. Digital therapeutics and its role in cancer treatment management: current development and future scope. Rev Assoc Med Bras (1992). 2024;70(6):e20240183.
44. Zhang Y, Flannery M, Zhang Z, et al. Digital Health Psychosocial Intervention in Adult Patients With Cancer and Their Families: Systematic Review and Meta-Analysis. JMIR Cancer. 2024;10:e46116.
45. Chow PI, Showalter SL, Gerber M, et al. Use of Mental Health Apps by Patients With Breast Cancer in the United States: Pilot Pre-Post Study. JMIR Cancer. 2020;6(1):e16476.
46. Girgis A, Durcinoska I, Arnold A, et al. Web-Based Patient-Reported Outcome Measures for Personalized Treatment and Care (PROMPT-Care): Multicenter Pragmatic Nonrandomized Trial. J Med Internet Res. 2020;22(10):e19685.
47. Voruganti T, Grunfeld E, Jamieson T, et al. My Team of Care Study: A Pilot Randomized Controlled Trial of a Web-Based Communication Tool for Collaborative Care in Patients With Advanced Cancer. J Med Internet Res. 2017;19(7):e219.
48. Avery KNL, Richards HS, Portal A, et al. Developing a real-time electronic symptom monitoring system for patients after discharge following cancer-related surgery. BMC Cancer. 2019;19(1):463.
49. Kondylakis H, Bucur A, Crico C, et al. Patient empowerment for cancer patients through a novel ICT infrastructure. J Biomed Inform. 2020;101:103342.
50. Mathkor DM, Mathkor N, Bassfar Z, et al. Multirole of the internet of medical things (IoMT) in biomedical systems for managing smart healthcare systems: An overview of current and future innovative trends. J Infect Public Health. 2024;17(4):559-72.
51. Lombardi M, Pascale F, Santaniello D. Internet of things: A general overview between architectures, protocols and applications. Information. 2021;12(2):87.
52. Shen S, Qi W, Liu X, et al. From virtual to reality: innovative practices of digital twins in tumor therapy. J Transl Med. 2025;23(1):348.
53. Asciak L, Kyeremeh J, Luo X, et al. Digital twin assisted surgery, concept, opportunities, and challenges. NPJ Digit Med. 2025;8(1):32.
54. Mollica L, Leli C, Sottotetti F, Quaglini S, Locati L, Marceglia S. Digital twins: a new paradigm in oncology in the era of big data. ESMO Real World Data and Digital Oncology. 2024;5:100056.
55. Mukhopadhyay M, Banerjee S, Mukhopadhyay CD. Internet of Medical Things and the Evolution of Healthcare 4.0: Exploring Recent Trends. Journal of Electronics, Electromedical Engineering, and Medical Informatics. 2024;6(2):182-95.
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May 09, 2025
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Mr Amey Shirish Shrotri, Somdatta Mukherjee, & Dr. Amit Kumar. (2025). CHALLENGES ASSOCIATED WITH POST-OPERATIVE CANCER CARE AND IMPLEMENTATION OF DIGITAL TECHNOLOGY FOR IMPROVED OUTCOMES: A NARRATIVE REVIEW. Journal of Population Therapeutics and Clinical Pharmacology, 32(3), 1215-1227. https://doi.org/10.53555/ms4tjy65
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Author Biographies
Mr Amey Shirish Shrotri
Doctoral Student, SP Jain School of Global Management, Mumbai, Maharashtra, India,
Somdatta Mukherjee
Medical Writer
Dr. Amit Kumar
Associate Professor,
How to Cite
Mr Amey Shirish Shrotri, Somdatta Mukherjee, & Dr. Amit Kumar. (2025). CHALLENGES ASSOCIATED WITH POST-OPERATIVE CANCER CARE AND IMPLEMENTATION OF DIGITAL TECHNOLOGY FOR IMPROVED OUTCOMES: A NARRATIVE REVIEW. Journal of Population Therapeutics and Clinical Pharmacology, 32(3), 1215-1227. https://doi.org/10.53555/ms4tjy65