7 years on, how a rural throat cancer death birthed life-saving invention in Karnataka

BENGALURU: A curable form of throat cancer claimed a life, not because treatment was unavailable, but because a basic medical device failed in a rural setting. The death of the patient, who suffocated because of a blocked tracheostomy tube while awaiting radiation therapy, became the turning point that pushed a Bengaluru-based oncologist to reimagine tracheostomy care for India and other low-resource regions.

Dr Vishal Rao is now set to launch Dhwani, a patented, low-cost tracheostomy tube designed to prevent such deaths and restore both breathing and speech in throat cancer patients.

Tracheostomy tubes require intensive upkeep. "They need frequent suctioning, often hourly. Without proper care, secretions dry up, form crusts, and block airflow. Families are trained to clean the tube and asked to buy suction machines costing around Rs 5,000," explained Rao, who is currently group director (head and neck surgical oncology and robotic surgery) at HCG Cancer Centre.

The patient, from Chikkamagaluru district, whose death triggered the innovation presented with breathlessness in 2019. "Because the tumour was in the voice box, we performed a tracheostomy — a routine, life-saving procedure commonly done across ICUs in India," Rao said. With curable stage 2 cancer, the patient applied for radiation therapy under the Ayushman Bharat scheme and returned home.

A week later, when doctors called him back after the sanction came through, they were told he had died. "He developed breathlessness at home. The suction machine at the nearby primary healthcare centre was not working, and home suctioning failed as the secretions had thickened. He died while being transported," Rao said.

The incident exposed a critical gap: many rural PHCs lack functional suction machines, making tracheostomy care extremely difficult outside tertiary hospitals. "This is not just an Indian problem — it's a global one," Rao said.

While advanced European tracheostomy tubes exist, they cost over Rs 10,000 and create dependency on imports even in larger centres. "That's when we asked — why can't we design tubes suited for Indian patients?" Rao said. Using AI analysis of thousands of patient datasets, the team — Rao and five others who looked after the engineering and industrial aspects — developed universal sizes and a double-lumen design that allows the inner tube to be removed and cleaned without compromising the airway. Super-hydrophobic materials prevent secretions from sticking, eliminating the need for frequent suctioning.

The tube also incorporates a speaking valve, allowing patients to communicate — something most tracheostomy patients lose — which is said to be unique to this invention. "Speech restoration has a huge impact on mental health and recovery," Rao said. "Our aim was to make a tube that costs less than a suction machine — affordable, scalable, and usable in villages," he said.

After five years of research, including disruptions during Covid, the prototype is ready, with production expected to begin next month for India and nearly 40 countries.