“I stayed home to manage his treatment and care. It wasn’t just about missing college — it was about putting my entire life on hold,” recalled Agrawal, now 31. Her brother eventually quit his job and returned home during their father’s final months, sacrificing career opportunities in a field with limited prospects locally.
Agrawal’s story isn’t unique. Across India, millions quietly shoulder the exhausting responsibility of caring for loved ones with cancer, often becoming invisible casualties of a disease that demands everything from everyone it touches.
The weight of duty
In India, where family obligation runs deep, caregiving is rarely seen as a choice; it’s an expectation. But the emotional and physical toll this takes on families remains largely unspoken, hidden behind cultural notions of duty and sacrifice.
“I associate one word with caregiving: exhaustion. Bone-crushing exhaustion,” said Saumya Sharma, 31, who cared for her father from 2018 until he passed in 2021, and is now supporting her mother through breast cancer treatment. “The other one is probably resentment. Resentment with the sick, maybe sometimes, but mostly it is resentment with the situation. No matter what you do as a caregiver, it is never enough. It is as if you stop existing and now only the sick person exists,” she told indianexpress.com.
A 2022 study cited by mental health expert Anjali Pillai, psychologist and programmes lead at SafeStories, Pune, found that two in five caregivers of cancer patients screened positive for depression. Yet, she says, this is just the tip of a crisis hiding in plain sight.
The consequences
For Pavithra Sekar, 28, caring for her mother with stage 3 breast cancer means living in a constant state of vigilance. “Your brain always has the guard switch on. My mom won’t sleep easily, and often she won’t say what’s bothering her, and we end up in the ER. There are no peaceful nights.”
The financial burden is crushing. “Cancer is a chronic disease, so not all bills are covered by insurance. Surgery and radiation are covered, but chemotherapy and regular medication are not. Medicine alone costs us Rs 20,000 a month,” she said. To manage expenses, Sekar lives on the city’s outskirts, enduring a six-hour daily commute to work.
The personal toll is just as devastating. “I’ve been turned down by men and their families because they fear I’ll also get cancer and they won’t be able to support us,” she said, adding, “No one really understands the intensity of cancer.”
Sharma’s sacrifice was perhaps the most dramatic. After earning admission to an Ivy League MBA programme and working in Boston, she returned to India in 2021 when her father’s health declined. “My company was applying for my H1B, but I dropped the American dream. I don’t regret it. I was restless in the US, knowing my family was suffering.”
The medical perspective
Healthcare professionals are witnessing this crisis firsthand. Dr Srinath, senior oncologist and founder at Asha Hospitals, observed that “caregivers often carry the emotional weight of the diagnosis as heavily as the patient, but with far fewer outlets to express it.”
The impact on patient care is direct and measurable. “When a caregiver’s physical or emotional reserves are depleted, it affects their ability to provide consistent and compassionate care. I have seen instances where caregiver exhaustion compromises the accuracy of medication administration or leads to missed follow-ups,” Dr Srinath said.
Padma Shri Dr Rajendra A. Badwe, chief executive of Tata Cancer Care Foundation and former Director of Tata Memorial Centre, has seen the full spectrum of caregiver experiences: “Caregivers of cancer patients commonly face a range of challenges. Physically, they often experience fatigue and exhaustion from the demands of caregiving. Emotionally and psychologically, anxiety and depression are common, along with an inability to care for their own needs.”
Yet he’s also witnessed remarkable resilience. “Some of them show remarkable courage to face the situation and garner strength to arrange everything so that no stone is unturned in the treatment of their loved ones,” he told indianexpress.com.
The silent suffering
What makes the caregiver crisis particularly acute in India is the cultural context. For Ayushi Mathur, 37, who has been caring for her mother with metastatic breast cancer since 2018, the challenge is compounded by cultural expectations. “Sacrifices and hard work are seen as your duty. You’re just expected to do it.”
Neha Cadabam, senior psychologist at Cadabams Hospitals, said this mindset leaves little space for caregivers to acknowledge their pain. “Many internalise their distress, fearing it would be seen as selfish or inappropriate,” she said.
The trauma can linger long after the crisis ends. “Many caregivers experience flashbacks, anxiety, or a sense of purposelessness once their role ends,” Cadabam said.
The ripple effect
A caregiver’s state of mind can shape the patient’s outlook. “When caregivers are calm and present, patients feel more secure. If they are distressed, patients can internalise that stress,” said Dr Srinath.
Dr Badwe recalled one patient whose husband said, “When so many good things happened to us, we never asked, ‘Why me?’—so why ask now? We will face this together.”
The system’s blind spot
Despite the critical role caregivers play, India’s healthcare system offers them minimal support. “At present, India’s healthcare system is still deeply focused on the patient, with very little formal support for the caregiver,” noted Dr Srinath.
Mathur’s experience, too, reflected this gap: “Unfortunately, this is something that we haven’t witnessed yet. While there have been silent acknowledgements of the emotional needs of a caregiver, however, there hasn’t been any direct conversation or space given to discuss the emotional needs of caregivers.”
Coping in the shadows
Left to their own devices, caregivers develop whatever coping mechanisms they can. Sharma, dealing with the complex emotions of caring for someone with whom she had a “difficult relationship,” sought therapy while in the US. “I had a difficult relationship with my father, and when I was in the US, I took therapy to process how I was feeling about his deteriorating condition,” she said.
“To cope, I do meditation whenever I can. I also write and try my best to go to the gym. I also consume marijuana gummies from time to time when I feel a lot of stress,” Sharma said.
Agrawal’s struggle continues years later. “That uncertainty, never knowing how he’d be the next day, or what news we’d get, weighed on me constantly. It was emotionally exhausting. I didn’t know how to process what I was feeling at the time, and honestly, even today, I struggle. I find it hard to open up or feel emotionally comfortable around people,” she said.
The delayed reckoning
Caregivers often only process their trauma years later. Sharma fell into depression three years after her father’s death. “During the illness, you live in survival mode,” she said.
Pillai said this is common: “Even after recovery or loss, many live as though the next crisis is just around the corner.”
The path forward
Experts call for systemic reform. Dr Badwe recommended patient navigation services, distress assessment tools, and AI-enabled coping apps for caregivers. Pillai said, “Hospitals must integrate routine mental health check-ins and provide on-site counsellors.”
As India grapples with rising cancer rates—with over 1.4 million new cases diagnosed annually—the army of invisible caregivers continues to grow. These family members are sacrificing their careers, health, and happiness to fill the gaps in a healthcare system that hasn’t yet learned to see them.
Hina Khan, who has been battling breast cancer, is being cared for by her husband Rocky Jaiswal (Source: Instagram/Hina Khan) 
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