Singapore Has Been Quietly Treating Cancer With Proton Beams, Malaysia Is Still Waiting
For Malaysian patients, the choice is to travel abroad or go without, because while the technology to spare cancer patients from stunted growth, learning difficulties and lifelong side effects has existed in Singapore since 2023, the political will to build one at home has not.
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When a one-year-old and a 92-year-old are both receiving the same cutting-edge cancer treatment at a hospital in Singapore, it says something about how far the technology has come — and how carefully it is being used.
The National Cancer Centre Singapore (NCCS), part of SingHealth — Singapore’s largest healthcare cluster — has treated 724 patients with proton beam therapy (PBT) since its programme began in June 2023.
Four treatment rooms run at roughly 40 patients a day.
The patients range from toddlers to the very elderly.
Malaysia has no equivalent facility.
PBT is a promising treatment option, not for all patients, but for selected cancer patients, said Dr Kiattisa Sommat, Senior Consultant in the Division of Radiation Oncology at NCCS.
A Clear Path
The distinction matters.
PBT is not a replacement for conventional radiation — it is a precision upgrade for cases where ordinary X-ray radiation carries too high a cost to surrounding healthy tissue.
The physics is what makes it different.
The proton is unique in that it has a clear path, Dr Kiattisa explained.
From the point that it enters your body, at a specified depth, the radiation will stop with very little exit dose. This is as opposed to X-ray radiation, for which the beam penetrates the body, but it doesn’t stop as sharply.
In practical terms, that means a tumour deep in the chest or nestled near the brain or spine can be targeted with far less collateral damage to the surrounding organs.
Where Precision Meets the Patient
NCCS uses what is called pencil-beam scanning — delivering radiation dot by dot, layer by layer, shaped to the three-dimensional contour of the tumour.
It’s a little bit like 3D printing, Dr Kiattisa said.
The clinical benefits are most visible in two groups: head and neck cancer patients and children.
For head and neck cancers, sparing the salivary glands and swallowing structures during treatment directly translates into improved quality of life.
Fewer patients have significant side effects. They have less pain, they are able to eat better.
Dr Kiattisa added that long-term outcomes — dry mouth, scarring, and swallowing difficulties — are also expected to improve.
The Most to Lose, and the Most to Gain
For paediatric patients, the stakes are higher still.
Children treated with conventional radiation can face stunted growth, learning difficulties, and an elevated risk of developing a second cancer decades later.
They have a long trajectory in front of them. It’s very important to make sure that as we treat them effectively, we don’t want to cause long-term damage to their body.
Not every patient qualifies.
Singapore’s Ministry of Health maintains an approved list of cancer types eligible for PBT — currently including head and neck cancers, brain tumours, spine tumours, lung, liver, gastrointestinal cancers, sarcomas, paediatric cancers and prostate cancer.
Breast cancer is not yet on the list, though Dr Kiattisa noted the list is under active review.
There is constantly new data that comes out. When the new list comes out, it may include breast cancer as one of the indications.
PBT is not for every cancer, but for tumours near the brain, spine, and in children, the precision is what makes it viable. (Pix: NCCS)
Expensive, and Not for Everyone
Beyond diagnosis, patient selection involves a second layer of assessment — can the patient lie still, and are there implants that might interfere with beam accuracy?
One patient, Dr Kiattisa recalled, was deemed unsuitable despite being able to afford the treatment, simply because they could not stop swallowing during the procedure.
Cost is not the only factor — though for those who do qualify, it runs roughly two to three times that of standard radiation, across a treatment course lasting anywhere from one week to seven weeks.
The financial weight is not abstract: when badminton legend Datuk Seri Lee Chong Wei was diagnosed with nose cancer in 2018, he travelled to Taiwan for PBT, because Malaysia had no such machine.
After undergoing 33 gruelling sessions of PBT — an experience he called a “nightmare” that left him unable to eat or speak — the former world No. 1 badminton player received a cancer-free all-clear in early 2019.
Lee lost about 5kg but gradually returned to light training, putting his health first.
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Saving More of the Life Being Saved
The clinical picture is still being drawn — the TORPEdO trial, a phase 3 randomised study published in The Lancet, one of medicine’s most cited and authoritative journals, found that PBT and conventional radiation produced similar disease control and functional outcomes for patients with oropharyngeal cancer over two years.
Where PBT showed its edge was not in cure rates, but in the precision of where damage does not occur — reducing radiation doses to the tissues governing swallowing, chewing, taste, and speech, the very functions that define quality of life after treatment.
For health systems weighing the investment, that distinction is the crux of the argument: PBT may not save more lives, but it may spare more of the life being saved.
More than 100 proton centres now operate globally — Japan, China, South Korea, Hong Kong, Taiwan and India all have facilities, but in Southeast Asia, the number is far smaller.
Asked which countries in the region offer proton therapy, Dr Kiattisa’s answer was telling: Singapore, she said, is among the very few, and Malaysia did not come up, because there is nothing to say.
Proton beam therapy for oropharyngeal cancer (TORPEdO): a phase 3, randomised controlled trial https://t.co/1IhGbSAKYv pic.twitter.com/iKaQcFnCk6
— The Lancet (@TheLancet) March 26, 2026
The Machine Exists, The Decision Doesn’t
For Malaysian patients who need PBT, the options are limited: travel abroad at high personal cost, or go without.
The machine itself is expensive — NCCS’s facility, the Goh Cheng Liang Proton Therapy Centre, was built in part through a major philanthropic donation from Goh Cheng Liang, the founder of Nippon Paint.
Without equivalent private generosity or sustained public investment, the barrier to entry is formidable.
Malaysia’s Ministry of Health has previously acknowledged the need to develop more advanced cancer care infrastructure, but no proton therapy centre has been built or formally announced.
Cancer remains one of the leading causes of death in Malaysia.
The gap between what is available two hours across the Causeway and what is accessible at home is not a technical problem.
It is a policy one.
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Source: NCSS
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