New Delhi: A second opinion service for cancer patients in India has provided a vast majority of its patients treatment plans tailored for costs and access issues, a study has found.

The findings highlight resource constraints that push many patients towards a tier of treatment lower than the ideal best, doctors said.

A study of treatment recommendations provided by the Tata Memorial Centre, a public-funded hospital in Mumbai, and Navya, a privately-held patients' services organisation, to 616 breast cancer patients has found that only 8.6 per cent were what are considered ideal best guidelines.

The findings underline the capacity of the TMC-Navya initiative to provide appropriate treatment guidelines.

The programme relies on India's National Cancer Grid - a digital network connecting oncologists from 108 cancer centres - to provide cancer treatment guidance to patients amid concerns about a severe shortage of oncology teams in the country. India has only about 1,600 oncologists for an estimated 1.8 million patients.

"Patients sometimes lack access to evidence-based therapies - either because of shortage of oncologists or high cost of treatment," Rajendra Badwe, TMC's director who led the study, told The Telegraph. "We wanted to assess whether this network is able to meet its objectives of delivering evidence-based guidance."

Badwe and his colleagues compared the treatment recommendations provided to the 616 breast cancer patients with a set of four-tiered treatment guidelines from the National Comprehensive Cancer Network, a US-based alliance of multiple cancer centres.

The highest so-called "parent" tier contains the best and ideal treatment guidelines and is followed by "enhanced," "core," and "basic" tiers.

Each lower rung is still backed by evidence but further away from the parent tier and intended to deliver the best available to patients under different constraints.

The TMC-Navya study, presented at a breast cancer symposium in the US last week, placed 8.6 per cent in the parent tier and 78.5 per cent in the enhanced tier, and about 2 per cent in the core and basic tiers. About 11.7 per cent of the recommendations did not conform to any of the NCCN tiers but are considered by oncologists in India as effective in specific circumstances.

Over the past three years, more than 17,000 patients have consulted the TMC-Navya initiative, which serves as a platform for a "second opinion", through www.navya.care.