Healing Across Genders: The Bald Oncologist Tackles Cultural Norms in Malaysian Cancer Treatment

WORDS LIM TECK CHOON

FEATURED EXPERT
DR MALWINDER SINGH SANDHU
“The Bald Oncologist”
Consultant Clinical Oncologist
Pantai Hospital Kuala Lumpur
Website and Social Media

In the realm of oncology, gender plays a crucial role in shaping caregiving dynamics and communication between patients and healthcare providers. To give us a better understanding of this, Dr Malwinder Singh Sandhu, also known as “The Bald Oncologist”, joins to share some valuable insights into how gender influences caregiving responsibilities and impacts the support needs of patients navigating cancer treatment.

GENDER NORMS AND CANCER COMMUNICATION

Dr Malwinder reveals that, in Malaysia, cultural expectations and gender norms play a crucial role in shaping the way cancer patients communicate with healthcare providers, adhere to treatment plans, and cope with the challenges of the disease. These gender-specific factors have significant implications for both the diagnosis and management of cancer.

MEN	WOMEN
Expected to be stoic. May downplay symptoms or avoid discussing discomfort, leading to delayed diagnoses and inadequate symptom management.	Might feel more comfortable discussing symptoms but may be hesitant to talk about reproductive health, especially with male doctors. Caregiving responsibilities often cause women to prioritize their family over their own health, which can lead to underreporting symptoms.

GENDER-SPECIFIC BARRIERS TO CANCER CARE

According to Dr Malwinder, gender norms can also present barriers to accessing cancer care,

MEN	WOMEN
Cultural pressures to remain strong may delay seeking treatment until symptoms are severe. Men may also find it hard to adhere to treatment regimens if they feel it interferes with their work or provider roles.	Stigma surrounding certain cancers, like breast and cervical cancer, can cause delays in seeking care. Balancing caregiving duties with their own health needs can also lead to treatment adherence challenges

PSYCHOLOGICAL IMPACT OF CANCER DIAGNOSIS & TREATMENT

“Men and women experience cancer’s psychological toll differently,” Dr Malwinder tells us.

MEN	WOMEN
Often suppress emotions, internalizing anxiety and fear. This can worsen their mental health, but men are also less likely to seek psychological support due to societal expectations of emotional strength.	While women may be more emotionally open, they often worry about becoming a burden on their families. Guilt and anxiety about their family’s future are common psychological challenges.

One way to address these psychological challenges for both men and women is by joining a support group.

These groups provide a safe space for patients to share their concerns, gain emotional support, and learn how to cope with their illness from others facing similar experiences.
Support groups can help break down gender barriers, encouraging both men and women to open up about their struggles, and ultimately improve their overall mental health.

BODY IMAGE CONCERNS IN CANCER PATIENTS

“Changes in physical appearance from cancer treatments, such as surgery or chemotherapy, can cause body image issues,” says Dr Malwinder. “These concerns are also shaped by gender.”

WOMEN	MEN
Physical changes, like hair loss or mastectomies, can severely impact a woman’s sense of identity, exacerbating stress and leading to potential identity crises.	While not discussed as openly, men also struggle with body image issues, especially when treatments cause weakness or weight loss, challenging their sense of masculinity

HOW GENDER INFLUENCES OTHER ASPECTS OF CANCER CARE

Dr Malwinder further shares the following information.

MEN

WOMEN

Treatment adherence and follow-up care. May be less consistent with follow-up appointments, especially if they feel “recovered” enough to resume their responsibilities.
Palliative care. Cultural norms of resilience may prevent men from discussing pain, leading to inadequate pain management.
Support. Tend to have smaller, less emotionally-focused support networks. Cultural expectations of strength can leave them feeling isolated, with limited community support.

Treatment adherence and follow-up care. While balancing family obligations can be a challenge, women are generally more consistent with follow-up care when encouraged by healthcare providers.
Palliative care. Women in traditional caregiving roles may prioritize their family’s needs, making them reluctant to seek end-of-life care.
Support. Often have wider social networks, supported by family and female friends, and are more likely to seek emotional support from community or religious groups.

DR MALWINDER’S RECOMMENDATIONS TO HEALTHCARE PROVIDERS FOR A MORE GENDER-INCLUSIVE APPROACH TO CANCER CARE

Diagnosis

MEN	WOMEN
Oncologists should create a safe environment for men to express vulnerability without judgment.	Healthcare providers should encourage women to prioritize their own health over caregiving responsibilities.

Treatment

MEN	WOMEN
Treatment plans should accommodate men’s work commitments to improve adherence.	Offer support for balancing family care and treatment helps women adhere to their treatment plans.

Follow-up Care

MEN	WOMEN
Regular check-ins with encouragement to stay consistent in their care are vital. Promote support groups to help deal with emotional and psychological challenges.	Support systems that alleviate caregiving burdens can improve treatment adherence. Promote support groups to help deal with emotional and psychological challenges.

Caregiving Support

Acknowledge the different strengths of male and female caregivers.
- Support programs should cater to the strengths and challenges of both genders.
- Female caregivers might need respite care and emotional support, while male caregivers could benefit from guidance in providing more emotional care.
Encourage open communication.
- Open conversations about caregiving and support can break down gender norms.
- Male caregivers should be encouraged to engage emotionally, while female caregivers should feel empowered to ask for help and set boundaries.
Expand support networks for male patients.
- Community programs should be developed to help male cancer survivors and caregivers connect.
- Tailored support groups for men can provide a space to discuss struggles and break cultural barriers.
Establish family support structures.
- Families should be educated on sharing caregiving responsibilities equally, encouraging sons and male relatives to take on more emotional caregiving roles.
Leverage community and religious groups.
- Community and religious organizations play a crucial role in providing social support, especially for female patients.
- Encourage these groups to also support male patients and caregivers as an essential step to extend care networks.