Abstract The increasing fatality rate of cancer in the modern world has become a global concern. To address this issue, early detection of cancer cells in human blood is essential. In this article, a rectangular spiral shaped photonic crystal fiber has been proposed for sensing cancer cells in terahertz regime. The proposed PCF based sensor features a square shaped core surrounded by rectangular air holes of different sizes in a spiral manner. Finite element method based COMSOL Multiphysics software has been used for the design and analysis of the model. The model is sensitive to refractive index variation for the identification of cancer cells. The values of effective refractive index, effective mode area, relative sensitivity, non-linearity, and confinement loss are obtained for MCF-7, MDA-MB-231, Jurkat, HeLa, Basal and PC-12. The PCF based sensor resulted in excellent results of relative sensitivity and Confinement loss as good as 99.377% and 8.59 × 10−12 dBm−1 respectively. Furthermore, the present PCF based sensor model is fabrication feasible, and we hope that it can be utilized at industrial level for biosensing applications in terahertz waveguide regime.