My experience with Varnish was when we tried to use it for something that had relatively complex caching rules. The config/VCL became spaghetti: attaching values to req and restarting the flow. This appeared to be the normal way to write VCL. We ended up writing our own system, with our own high-concurrent LRU cache, that was more tightly coupled with our application servers (and thus able to figure out what the cach…
Varnish gives you enough configurability to do just about anything, but the end result will be a spaghetti mess of VCL, inline C and possibly custom varnish modules. The more sustainable route is to build your own caching front end, however I think it's a bit unrealistic to assume that all startups have the engineering talent (or time) in-house to implement that sort of thing.