Before dawn, before work: The long road for some outstation cancer patients who travel to Penang for treatment

GEORGE TOWN, June 24 — At least once a month, Noraziliana Ahmad who lives in Sungai Petani, Kedah, wakes up early in the middle of the night to prepare for more than an hour’s travel to Penang Hospital.

The 45-year-old administrative assistant and her husband leave their home at around 3am, heading south to the general hospital one state over for chemotherapy.

“We arrive early, slightly after 4am, so my husband will drop me at the hospital surau before going to work and I will sleep there until my appointment, which is around 9am,” she said.

Noraziliana’s husband works as a mechanic in RapidPenang, and so is able to give her a ride to the island so she doesn’t have to drive herself there and back again after treatment.

“He starts work at 5am so he has to drop me off early and after I’m done, he will pick me up and bring me to his office where I will wait for him till he finishes work and we go home,” she said.

Noraziliana, who was diagnosed with Stage Two breast cancer, underwent surgery in the Hospital Sultan Abdul Halim in Sungai Petani before starting chemotherapy.

Her first three treatment cycles were carried out at Hospital Sultan Abdul Halim.

Since April, however, she has been travelling to Penang Hospital for her fourth, fifth and sixth chemotherapy cycles after she was referred to continue with her treatment there. 

“I have to come for chemotherapy every three weeks,” she said, explaining that she could choose between Hospital Seberang Jaya and Penang Hospital but opted for the latter because it’s more convenient. 

She counts herself fortunate to be a civil servant who is able to apply for “cancer leave” from work to continue with chemotherapy treatments.

Gruelling, frequent journeys

For 31-year-old factory worker Mohd Fawwaz Faizal, the journey is even more demanding.

Diagnosed with Stage Three testicular cancer, he has been travelling from Baling, Kedah, to Penang Hospital since December last year.

“There wasn’t treatment available for my condition in Alor Setar, so I was referred here,” he said.

Each chemotherapy cycle requires him to be admitted to hospital for five days.

Now undergoing his sixth cycle, Fawwaz and his wife, Nur Atikah Ramli, make the one-and-a-half-hour drive to Penang Hospital whenever treatment is scheduled.

“My wife drives me every time,” he said.

Sometimes he has to come once a month, while at other times treatment requires two trips monthly.

The current cycle is expected to be his last before doctors assess his condition through a CT scan scheduled next month.

“What happens next depends on the results,” he said.

“If the doctors say I need more chemotherapy, then I’ll continue,” he added.

The journeys undertaken by Noraziliana and Fawwaz reflect a reality faced by hundreds of cancer patients across northern Malaysia who travel significant distances to access specialist oncology care at Penang Hospital.

On top of their treatment, they have to foot petrol, parking and toll fares, which costs RMRM5.74 for the first Penang Bridge and RM8.50 for the Second Penang Bridge to go from the mainland to the island. The return leg is toll-free.

Serving Kedah and Perak too

Penang Health director Datuk Dr Fazilah Shaik Allaudin said around 65 per cent of patients receiving treatment in Penang Hospital are from out of state.

“The hospital has served as the northern region’s oncology referral centre since 2005, covering an area stretching from Langkawi in Kedah to Sri Manjung in Perak,” she said in an email reply to Malay Mail.

Currently, the department has nine clinical oncologists, although the number will decrease to eight following the departure of one specialist at the end of this month.

Despite the workload, the general hospital continues to manage a large volume of cases.

Dr Fazilah said that on average, the Penang Hospital records about 250 new cancer cases and 1,500 follow-up appointments each month, alongside approximately 560 chemotherapy treatments administered through its daycare facilities.

In 2025 alone, the department handled 2,967 new patients, 15,451 follow-up cases and more than 11,000 chemotherapy treatments, including both daycare and ward-based procedures.

Closer to home, patients from Seberang Perai and Kepala Batas are also referred to the hospital on the island, although plans are underway to introduce visiting oncology clinics on the mainland half of the state to improve access.

Dr Fazilah said Hospital Seberang Jaya and Hospital Kepala Batas currently provide chemotherapy daycare services, while Hospital Bukit Mertajam offers palliative care.

The other public hospitals in the northern region with clinical oncology units that offer chemotherapy services included Hospital Sultanah Bahiyah and Hospital Taiping. 

Additionally, Hospital Langkawi, Hospital Tuanku Fauziah in Perlis, Hospital Sultan Abdul Halim in Sungai Petani and Hospital Kulim also offer oncology chemotherapy services. 

“Penang Hospital is an accredited training center for both the parallel pathway and the Master of Clinical Oncology (UM),” Dr Fazilah said.

Seven out of the nine clinical oncologists in Penang Hospital are accredited trainers.