For a long time, cancer care in India has been guided by a relatively narrow and standardized approach to diagnosis and treatment, often limiting the scope for individualized interpretation.
During the slow evolution of cancer, doctors like Dr. Aparna Dhar chose to move beyond this convention, bringing a more nuanced clinical lens to complex cases. Her work has contributed to expanding diagnostic perspectives and developing more adaptive, case-specific treatment approaches within the field.
The Transition to Oncology
Dr. Aparna Dhar’s academic trajectory did not begin in oncology, but in cardiovascular genetics, shaped in part by a personal context of familial cardiac disease. Her early training focused on understanding inherited predispositions within cardiology, placing her within a broader framework of genetic medicine at a time when its clinical applications were still evolving.
Her transition into oncology occurred gradually during her exposure to international research environments, including the Mayo Clinic and Harvard-affiliated institutions. These settings coincided with a critical phase in medical research, where advances in molecular biology were beginning to redefine the understanding of cancer. The shift was aligned with a growing recognition that cancer could no longer be approached as a singular disease entity. Instead, it required classification based on molecular drivers and genetic alterations.
Targeted Therapies and the Evolving Role of Molecular Diagnostics
Dr. Dhar’s work has consistently centred on integrating genomic science into routine oncology care. Genomic testing, including comprehensive profiling and companion diagnostics, has altered the way oncologists assess and treat malignancies. In her practice, this translates into identifying actionable biomarkers that inform the use of targeted therapies, immunotherapy, or enrolment in clinical trials, focusing on ruling out treatments unlikely to benefit the patient, reducing avoidable toxicity.
Scaling Preventive Oncology Through Genetic Counselling
A significant component of Dr. Dhar’s contribution lies in establishing genetic counselling and telegenetics frameworks within India. Historically, the healthcare system has prioritised diagnosis and treatment over risk assessment and prevention. Introducing genetic counselling required addressing both structural and perceptual barriers.
One of the primary challenges was awareness. Genetic testing was often misunderstood as predictive certainty rather than probabilistic risk assessment. In parallel, access to specialised services remained limited to urban centres, creating disparities in care.
To address this, she has been involved in developing telegenetics programs aimed at expanding access beyond metropolitan regions. These initiatives have enabled remote delivery of genetic counselling, allowing patients and families to engage with specialised services irrespective of geographic constraints.
Her work in this domain has contributed to a gradual shift toward recognising prevention, early detection, and inherited risk assessment as integral components of oncology care.
Interpreting Genomic Data in Practice
In clinical practice, Dr. Dhar places emphasis on the interpretative aspect of genetic information. Her experience counselling a large number of families with hereditary cancer syndromes has reinforced that the utility of genetic testing lies not in the data itself, but in how it is understood and applied.
Patients often approach genetic findings with apprehension, particularly when confronted with terms such as inherited mutations or cancer predisposition. The counselling process, therefore, extends beyond result interpretation to include contextualisation, clarifying what is known, what remains uncertain, and how it should influence clinical decisions.
This becomes particularly relevant in cases involving variants of uncertain significance (VUS). Such findings, which lack sufficient evidence for classification, require careful communication to prevent misinterpretation. In these scenarios, she emphasises that clinical management should continue to rely on established factors such as personal and family history, rather than inconclusive genomic data.
Integrating Advanced Diagnostics in Oncology
Dr. Dhar’s work also reflects the integration of emerging diagnostic technologies into oncology practice. In hereditary cancers, the decision between targeted gene testing and multigene panel testing is guided by clinical indicators such as age at diagnosis, tumour characteristics, and family history patterns. While multigene panels provide a broader assessment, they also increase the likelihood of uncertain findings, reinforcing the need for structured counselling.
In parallel, liquid biopsy and circulating tumour DNA (ctDNA) analysis have introduced less invasive methods for monitoring disease progression. These tools are particularly relevant in lung and gastrointestinal cancers, where they assist in detecting actionable mutations, tracking treatment response, and identifying resistance mechanisms.
However, their application is not without limitations. Factors such as tumour biology and DNA shedding influence their sensitivity. As a result, Dr. Dhar considers liquid biopsy complementary to tissue-based testing, rather than a replacement.
Reframing Cancer Care Through Prevention
Looking ahead, Dr. Dhar advocates for the integration of preventive oncology into mainstream clinical practice in India. This includes expanding access to genetic counselling, improving awareness among healthcare professionals, and incorporating routine family history assessment into patient evaluation.
She identifies early risk detection as one of the most effective interventions in reducing cancer burden, not only at an individual level but across families. Achieving this requires systemic changes, particularly in ensuring equitable access to genomic services across diverse populations. Her long-term objective aligns with bridging the gap between advances in genomic science and their practical application in patient care.
