PETALING JAYA, August 8 — Public hospitals are facing a critical shortage of oncologists, with most government cancer patients unable to access specialist care due to severe workforce and infrastructure constraints, a clinical oncologist said.
Dr Vaishnavi Jeyasingam, a consultant clinical oncologist at Kuala Lumpur Hospital (HKL) and in the private sector, told a cancer conference that the country has only 184 oncologists nationwide, as of this year.
Of the 184 clinical oncologists in Malaysia, only 59 serve at Ministry of Health (MOH) facilities, while 101 are in private practice, 10 in university hospitals, and 12 have retired.
This is well below the estimated 342 oncologists needed for Malaysia’s population of 34.2 million, based on the International Atomic Energy Agency’s (IAEA) recommendation of 10 oncologists per one million people.
“If we have a cancer patient standing in front of us, or if we ourselves become a cancer patient at some point in our life, I’m sure all of us would want to see an oncologist. I don’t think anyone in this room would be okay with not seeing an oncologist,” Dr Vaishnavi said at the Cancer Financing Summit 2025 organised by the National Cancer Society of Malaysia at Sunway University last June 20.
“But unfortunately, for the majority of our public patients, that is not a reality.”
To illustrate the current state of cancer care in the public sector, Dr Vaishnavi presented a slide listing hospitals that refer patients to HKL. The list showed that HKL serves as a referral centre for seven hospitals in the Klang Valley, three in Perak, four in Pahang, and two in Terengganu.
“The main reason I show this slide is just to illustrate that when it comes to being a cancer patient in the public facility, I think the biggest challenge is with regards to access, with regards to actually being able to get the expertise you’re hoping to get,” Dr Vaishnavi said.
In addition to receiving referred patients, HKL oncologists also conduct “visiting clinics” at several hospitals, travelling once or twice a month to facilities such as Temerloh Hospital and Teluk Intan Hospital in Perak, Kuantan Hospital in Pahang, and Kuala Terengganu Hospital in Terengganu.
These limited visits, at times, result in brief consultations.
“So when we go to those clinics — maybe once or twice a month, or once every two months — sometimes we might see over 100 patients. So maybe we get three minutes with some patients, and sometimes zero minutes with others.
“The medical officers and housemen will see the patients, and if there’s a problem, they’ll highlight it. We try to jump in during the clinic and say, ‘Okay, we’ll do this, we’ll do that.’ But at the end of the day, the treatment will carry on in the respective hospitals that we visit.
“For places where there are no visiting clinics, they’re usually email referrals if the patient needs to be seen. They come down to HKL — which means travelling, even from Kuala Terengganu,” Dr Vaishnavi said.
Government oncologists conduct visiting clinics across multiple hospitals nationwide to extend oncology services beyond major centres, she added.
Oncologists based at the National Cancer Institute (IKN) in Putrajaya cover Alor Gajah Hospital in Melaka and Tuanku Jaafar Hospital in Seremban. Oncologists based at Sultan Ismail Hospital in Johor conduct visiting clinics at Sultanah Aminah Hospital, Batu Pahat Hospital, and Muar Hospital.
From Pulau Pinang Hospital, oncologists travel to Kepala Batas Hospital, Taiping Hospital in Perak, and Alor Setar Hospital in Kedah.
In Sabah, oncologists from Queen Elizabeth Hospital provide services at Tawau Hospital, Sandakan Hospital, Keningau Hospital, Lahad Datu Hospital, Labuan Hospital, and Kota Marudu Hospital, with some destinations requiring air travel.
In Sarawak, oncologists at Sarawak General Hospital cover Sibu Hospital, Bintulu Hospital, and Miri Hospital.
“So, I’m just trying to highlight here, with regards to access and logistics, where our average Malaysians are actually wanting to have better care in the long run. I think as a clinician — where seven out of 10 of the patients we see are B40 patients — they just want to have some access to good care.
“Yes, cost is a factor, but when it comes to actually having treatment which translates to outcome, a big point is waiting time for investigations, biopsies, pathology reporting. Very common, you will hear, ‘If I wait at the government hospital, it will take me weeks to months. Hence, I went to a private hospital to get my investigations done.’
“I think it’s a very, very real issue and something that happens very often. So, I think this is an area where — if we are able to expedite, if we are able to collaborate, if we are able to buy services, if we are able to do one of those things — that would make the biggest impact with regards to our cancer care as a whole,” Dr Vaishnavi said.
Dr Vaishnavi said although Malaysia’s oncology workforce has grown over the years due to the Universiti Malaya’s Masters in Clinical Oncology programme and the Fellowship of the Royal College of Radiologists (FRCR) parallel pathway, retention in public service remains the primary challenge. “That is, I think, the elephant in the room, which we all are aware of.”
The capacity gap between public and private systems has led many cancer patients in government hospitals to delay or forgo treatment entirely. Dr Vaishnavi said many B40 patients are unable to afford out-of-pocket expenses for investigations, scans, or travel.
“During our clinic visits, a good number of patients will tell us, ‘I’m not coming to HKL, doctor. It’s too expensive.’ ‘RM200 nak datang (to come), no one to jaga anak (take care of my child).’ ‘I cannot stop driving my Grab, nanti esok takde makanan (there won’t be food on the table).’
“You know, it’s that kind of a situation, which is a very, very real situation in our country. Of course, it might be a bit biased, because the cohort of patients that we see are predominantly B40.”
Editor’s note: The headline was amended to include the words “in visiting clinics”. Paragraphs 7 and 9 were also amended to remove reference to Kelantan, since Kota Bharu Hospital recently got an oncologist.
