Passionate in his advocacy to reduce the stigma associated with seeking help and ensuring equal access to cancer screenings with treatments, oncologist Dr Malwinder Singh, also known as “The Bald Oncologist”, whose journey in the field began 15 years ago, has witnessed numerous challenges and emotional battles.
Passionate in his advocacy to reduce the stigma associated with seeking help and ensuring equal access to cancer screenings with treatments, oncologist Dr Malwinder Singh, also known as “The Bald Oncologist”, whose journey in the field began 15 years ago, has witnessed numerous challenges and emotional battles.
Through it all, he has survived, and has helped numerous patients in their recovery. As a doctor, he also uses platforms such as TikTok and Spotify to leverage both his medical knowledge and his deep personal experience to champion early detection and accessible cancer care options.
Sharing more about his journey with New Sarawak Tribune, Dr Malwinder talks more about how he manages his emotions, his patient’s emotions, and insights into cancer care and treatments.
Can you share more about your background as a doctor and oncologist?
My journey as a doctor and oncologist has been shaped by both personal experiences and a commitment to making a difference in the lives of cancer patients. I began my medical career at Melaka Manipal Medical College, where I earned my Bachelor of Medicine and Bachelor of Surgery (MBBS) in 2006. After working in various medical settings, I pursued my passion for oncology by obtaining a Master of Clinical Oncology (M.Co) from University Malaya in 2015. This specialised training provided me with a solid foundation in cancer care, research, and the latest treatment modalities.
Throughout my career, I’ve been deeply involved in advancing cancer treatment, and I’ve had the opportunity to work at prominent institutions like Hospital Sultan Ismail and Hospital Kuala Lumpur, both of which are significant in Malaysia’s healthcare landscape. I’m now a clinical oncologist at Pantai Hospital Kuala Lumpur, where I focus on providing state-of-the-art cancer care to my patients.
Cancer care is always evolving, and I believe in the importance of clinical trials and cutting-edge research. I’ve been involved in numerous clinical trials, helping to bring innovative therapies to patients. My special interests include treating breast, colon, lung, prostate, and brain cancers, where I work closely with patients and families to ensure a personalised, compassionate approach to care.
Today, as “The Bald Oncologist,” I aim to break down the barriers of fear and stigma associated with cancer, fostering open communication and empowering my patients to take control of their health with confidence and hope.
Your title “The Bald Oncologist” — could you tell us how that came about, and how you feel about it?
The title “The Bald Oncologist” came about quite naturally, and it’s something I’ve embraced with pride. It started as a bit of a personal reflection — I’ve been bald for a while, and as an oncologist who often sees patients dealing with hair loss due to chemotherapy, I realised there was an opportunity to connect on a very human level. For many patients, losing their hair is one of the more visible and emotionally difficult aspects of cancer treatment. So, by calling myself “The Bald Oncologist,” I wanted to bridge that gap and show them that appearance doesn’t define us, and there’s strength in owning who you are, no matter the circumstances.
Personally, I’m very comfortable with the title because it symbolises my philosophy of care — being open, transparent, and empathetic. It’s a reminder that while I’m there to provide expert medical care, I’m also there as a fellow human being who understands their struggles. I think it brings a unique identity to my practice, especially in Malaysia, where cultural sensitivities and personal connections play such an important role in healthcare.
What inspired you to specialise in oncology?
My decision to specialise in oncology was driven by a combination of personal experiences, a deep fascination with the science behind cancer, and a desire to make a profound impact on patients’ lives. Early on in my medical career, I was struck by how cancer affects not just the body but the entire person — their emotions, their family, and their sense of self. This holistic challenge, combining complex medical science with intense human interaction, drew me to the field.
A pivotal moment was seeing my own family members battle breast and stomach cancer. Witnessing their journey — their resilience and the emotional toll on our family — gave me a unique perspective on what patients and their loved ones endure. It shaped my understanding of the personal nature of cancer care and inspired me to pursue oncology with a compassionate and patient-centred approach.
The rapid advancements in cancer research also piqued my interest. Oncology is constantly evolving, with breakthroughs in immunotherapy, targeted therapies, and radiation techniques transforming treatment outcomes.
Ultimately, I was also drawn to the challenge of helping people navigate one of the most difficult moments of their lives. This balance between medical expertise and human connection is what truly inspired me to become an oncologist.
When sharing a cancer prognosis with patients, how do you usually approach the conversation?
When discussing a cancer prognosis with a patient, it’s important to balance honesty with compassion, creating an environment where they feel supported rather than discouraged. Here’s how I typically approach this delicate conversation:
- Prepare the Patient Emotionally
Before diving into the details, I take a moment to gauge the patient’s emotional state. I often start by asking how they’ve been feeling, both physically and mentally, and if they’ve had any particular concerns. This helps set a tone of empathy and ensures they are emotionally ready to receive the information. - Tailor the Information
Some patients prefer direct, clear-cut answers, while others need information delivered more gradually. I might say, “I want to explain where things stand, but please let me know if you’d like more or less detail at any point.” This gives the patient a sense of control over the conversation. - Balance Hope with Realism
I avoid sugar-coating the situation but also ensure I highlight any positive aspects or opportunities for treatment. I tend to focus on what can be done rather than solely on the severity of the diagnosis. - Explain the Prognosis in Manageable Terms
Instead of overwhelming the patient with medical jargon or too many statistics, I break down the information into manageable pieces. I may explain the stage of the cancer and how it typically behaves, but then quickly pivot to what this means in terms of treatment options, next steps, and their role in the process. If they ask about timelines, I present it in a way that emphasises possibilities rather than certainties. - Encourage Questions
I make sure to pause and invite them to ask questions. Sometimes, I’ll say, “It’s okay to take your time and think about what you need to ask. There’s no rush.” This encourages an open dialogue and helps them feel more empowered in managing their care. - Offer Immediate Support
After delivering the prognosis, I often provide options for immediate emotional and practical support, such as recommending a counsellor or connecting them with a cancer support group. I find it helpful to remind them, “You’re not alone in this. We have a team here to help you every step of the way.” This reassurance helps to alleviate the overwhelming weight of the diagnosis.
How do you cope when treating patients with late-stage cancer, particularly when the prognosis is poor?
Treating patients with late-stage cancer, especially when the prognosis is poor, can be emotionally challenging, but it’s also a deeply meaningful part of my work as an oncologist. Over time, I’ve developed both personal coping strategies and professional motivation to continue offering care in these difficult situations.
- Focusing on Patient Comfort and Quality of Life
When the prognosis is poor, my priority shifts towards ensuring the patient’s quality of life. This helps me reframe the situation from being purely about disease progression to focusing on making the patient’s time as comfortable and meaningful as possible. Managing symptoms, alleviating pain, and supporting emotional well-being are aspects where I feel I can still make a significant difference, even if the cancer is no longer curable. This focus gives purpose to my role and helps me cope with the emotional strain. - Building Strong Relationships with Patients
Even in the face of a difficult prognosis, developing a trusting, compassionate relationship with the patient and their family is deeply fulfilling. Seeing the impact of empathy and support on a patient’s emotional state can be incredibly motivating. - Understanding the Bigger Picture
While it’s true that treating late-stage cancer patients can be disheartening, I remind myself that not all outcomes can be measured in survival rates. Sometimes, the most significant contribution I can make is to provide emotional solace, answer difficult questions with honesty, and guide patients through their options with compassion. - Seeking Support from Colleagues
In moments where the emotional burden feels overwhelming, I rely on my professional network — whether that’s talking through difficult cases with colleagues or seeking advice from senior consultants who have experienced similar situations. Having a team to lean on reinforces the fact that I’m not carrying these emotional challenges alone. - Personal Coping Strategies
Outside of the hospital, I’ve developed personal methods to maintain emotional balance. Regular exercise, mindfulness, and spending quality time with family all help me decompress. Establishing boundaries between work and home life has also been essential in managing emotional fatigue. - The Motivation to Keep Going
What keeps me going during the most difficult moments is the knowledge that even in late-stage cancer, I am helping people face one of the hardest periods of their lives with dignity. Being able to offer them comfort, stability, and even hope, whether through palliative care or emotional support, is what motivates me to continue. The gratitude expressed by patients and families, even in the most heartbreaking circumstances, reminds me of why I became an oncologist in the first place.
What are some of the key challenges you face when treating cancer patients?
Treating cancer patients comes with a range of challenges, both medically and emotionally. Each patient’s journey is unique, and as an oncologist, my role is to navigate these challenges and tailor a treatment approach that aligns with the individual’s medical condition, personal circumstances, and overall well-being.
- Medical Complexity and Tumor Variability
One of the main challenges is the variability of cancer itself. No two cancers are exactly the same, even among patients with the same diagnosis. Tumours can differ in their genetic makeup, aggressiveness, and response to treatment. This makes each case unique and requires a highly individualised approach. Some cancers may have well-established protocols, while others may demand more experimental or less conventional treatments.
Approach: I use a combination of diagnostic tests, imaging, and, where applicable, genomic profiling to gather as much information as possible about the tumour’s characteristics. Based on these details, I collaborate with a multidisciplinary team — surgeons, radiologists, and pathologists — to discuss the most effective treatment options tailored to the patient’s specific cancer. This might involve a combination of surgery, chemotherapy, radiation, immunotherapy or targeted therapies, depending on the case. - Balancing Treatment Efficacy with Quality of Life
Another challenge is managing the balance between aggressively treating the cancer and preserving the patient’s quality of life. Some treatments, such as chemotherapy or radiation, can be highly effective but come with significant side effects that may impact the patient’s physical and emotional well-being.
Approach: I have an open and thorough discussion with each patient about the risks and benefits of different treatments, which includes discussing potential side effects, treatment duration, and expected outcomes. I strive to ensure the patient feels empowered to make informed decisions based on their personal values and priorities. - Patient Emotions and Expectations
Cancer patients often face a rollercoaster of emotions — fear, anxiety, and sometimes unrealistic expectations of treatment outcomes. Addressing the emotional toll of a cancer diagnosis and guiding patients through what can be a long and stressful treatment process is another major challenge.
Approach: It’s crucial to create a space where patients feel comfortable expressing their fears and asking questions. For patients who are overwhelmed, I emphasise that they don’t have to go through this journey alone, encouraging them to engage with counselling services or cancer support groups. I also work to ensure they understand the realistic outcomes of treatment so they can set appropriate expectations for themselves and their families. - Limited Access to Resources and Treatment
In Malaysia, access to cutting-edge treatments can vary significantly depending on a patient’s geographical location or financial situation. Patients in rural areas may not have access to advanced diagnostic tests or the latest treatments, making it harder to ensure that everyone receives the best possible care.
Approach: For patients facing these barriers, I try to connect them with resources like government-subsidised healthcare programs, non-profit organisations, or clinical trials that can help offset costs or provide access to newer treatments. In my role at Pantai Hospital, where more advanced treatments are available, I also work with patients from different backgrounds to explore all available options that align with their financial capacity. - Co-morbidities and Patient Health Status
Many cancer patients, especially those who are older, often have co-existing medical conditions such as diabetes, hypertension, or heart disease. These conditions can complicate cancer treatment and may require adjustments in the treatment plan to avoid exacerbating their health problems.
Approach: I take a comprehensive view of each patient’s health, often consulting with other specialists like cardiologists or endocrinologists to ensure the treatment plan accounts for all medical issues. This allows me to customise the cancer treatment to not only target the tumour but also minimise the risks posed by other health conditions. - Developing Personalised Treatment Plans
Creating a personalised treatment plan is an intricate process that involves understanding both the clinical aspects of the cancer and the personal preferences of the patient. The same cancer may be treated very differently based on a patient’s age, general health, family support, and even personal goals, such as whether they wish to continue working or focus on family time.
Approach: Personalising treatment means taking into account:
⦁ Tumour biology: Using molecular profiling or genetic testing to tailor targeted therapies or immunotherapies.
⦁ Patient preference: Having honest conversations about their priorities and lifestyle, such as whether they want to pursue the most aggressive treatment possible or prefer focusing on comfort and quality of life.
⦁ Co-existing medical conditions: Adjusting the treatment to minimise risks or interactions with other medications.
⦁ Support systems: Considering the patient’s family, emotional support, and access to care, which can influence the type and intensity of treatment they can handle.
A successful personalised treatment plan is built through a shared decision-making process with the patient and their family, ensuring it aligns with their medical needs and personal values.
How critical is early detection, and what screening methods do you recommend for early diagnosis?
Early detection of cancer, particularly breast cancer, is absolutely critical as it significantly improves treatment outcomes, increases survival rates, and reduces the need for more aggressive treatments. Catching cancer in its early stages often means the tumour is smaller, less likely to have spread to other areas of the body, and more responsive to treatment options like surgery, radiation, or targeted therapies.
Importance of Early Detection
- Higher Survival Rates: When cancer is detected early, the chance of long-term survival is much higher. For example, early-stage breast cancer can have a survival rate of over 90 percent, while later-stage detection drastically reduces these odds.
- Less Aggressive Treatment: Early detection often allows for more conservative treatments. A smaller, localised tumour may be removed with surgery alone or treated with limited radiation, avoiding the need for aggressive chemotherapy or extensive surgery.
- Improved Quality of Life: Detecting cancer early typically results in a treatment plan that is less physically taxing, allowing patients to maintain a higher quality of life during and after treatment.
In your years as an oncologist, what are some of the most significant advancements in cancer treatment that have had a profound impact on patient outcomes?
Over the past few decades, there have been remarkable advancements in cancer treatment, fundamentally transforming patient outcomes and offering hope where there was once little. These breakthroughs have improved survival rates, reduced side effects, and offered more personalised and targeted approaches to cancer care. Here are some of the most significant advancements that have had a profound impact on cancer treatment:
- Immunotherapy
Immunotherapy has revolutionised the way we treat certain cancers by harnessing the body’s own immune system to fight cancer cells. This approach has been especially impactful for cancers that were previously difficult to treat, like breast, lung, colon cancer and some forms of lymphoma. - Targeted Therapy
Targeted therapies have transformed cancer care by attacking specific molecular targets associated with cancer cells, allowing for more precise and less toxic treatments compared to traditional chemotherapy.
⦁ Tyrosine Kinase Inhibitors (TKIs):
Impact: Patients with CML who once faced poor prognoses now have nearly normal life expectancies thanks to TKIs. For non-small cell lung cancer (NSCLC) with specific mutations, targeted therapy has improved survival rates significantly.
⦁ HER2-Targeted Therapy:
These therapies block the HER2 protein, which promotes cancer cell growth.
Impact: HER2-targeted therapy has drastically improved survival rates for women with HER2-positive breast cancer and reduced recurrence rates, transforming what was once a very aggressive form of cancer into a more manageable condition. - Precision Medicine and Genomic Testing
Precision medicine involves using a patient’s genetic makeup to guide treatment decisions. Advances in genomic testing have allowed oncologists to identify specific genetic mutations or alterations driving cancer growth, enabling more personalised treatment plans.
⦁ Next-Generation Sequencing (NGS)
Impact: Genomic profiling has expanded the use of targeted therapies, helping patients with cancers that have rare mutations (such as BRCA mutations in ovarian and breast cancer or EGFR mutations in lung cancer) receive more effective, personalised treatments.
⦁ Liquid Biopsies
Impact: Liquid biopsies offer the potential for early detection of relapse and monitoring treatment effectiveness, allowing for timely adjustments in therapy. - Advances in Radiation Therapy
Radiation therapy has become more precise and less damaging to healthy tissue, thanks to innovations like stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT), which are especially important for hard-to-reach tumours like those in the brain, lung, or liver.
⦁ Stereotactic Radiosurgery (SRS) and SBRT: These forms of highly precise radiation can deliver concentrated doses of radiation to tumours while sparing surrounding healthy tissue. Gamma Knife are example of these technologies.
Impact: SRS and SBRT have significantly improved outcomes in patients with brain metastases or early-stage lung cancer, offering high local control rates and reducing the need for invasive surgery.
⦁ Proton Therapy: This form of radiation uses protons instead of X-rays to treat cancer. Proton beams can be controlled more precisely, delivering higher doses to tumours while minimising exposure to surrounding healthy tissue.
Impact: Proton therapy has shown promising results in treating paediatric cancers, prostate cancer, and tumours located near sensitive organs (e.g., brain and spinal cord). - Neoadjuvant and Adjuvant Therapies
Using therapies before (neoadjuvant) or after (adjuvant) surgery has become a standard practice in cancer treatment to shrink tumours or reduce the risk of recurrence.
⦁ Neoadjuvant Therapy: Administering chemotherapy, radiation, targeted therapy or immunotherapy before surgery can shrink tumours, making them easier to remove. In breast cancer, for example, neoadjuvant therapy has increased breast-conserving surgery rates (lumpectomy) instead of mastectomy.
Impact: This approach has allowed more patients to undergo less invasive surgeries and has increased the likelihood of achieving clear surgical margins, thus reducing recurrence rates.
⦁ Adjuvant Therapy: Post-surgery treatments like chemotherapy, radiation, or targeted therapy help eliminate any remaining cancer cells and reduce the risk of cancer coming back.
Impact: Adjuvant therapies have contributed to improved survival rates, particularly in breast, colon, and lung cancers. - Advances in Surgery
Surgical techniques have also evolved, becoming less invasive and more precise.
⦁ Minimally Invasive Surgery: Laparoscopic and robotic-assisted surgeries have reduced recovery times, decreased post-operative pain, and led to better cosmetic outcomes.
Impact: Minimally invasive surgeries are now commonly used in treating cancers like colon, prostate, and gynaecological cancers, with faster recovery and less impact on the patient’s quality of life.
These innovations have given patients more treatment options with fewer side effects, enhanced survival rates, and a better quality of life during and after treatment. Innovations that provide convenient to patients such as subcutaneous injections or oral care can provide high quality of life to patients. With more research and innovation will likely bring even more groundbreaking advancements in the future, offering hope for more effective and personalised cancer care.
