Proton Beam Therapy Halts Recurrent Spinal Ependymoma After Three Surgeries: A Singapore Case Study
核心洞察
A 32-year-old Singaporean singer with a rare spinal ependymoma (搜索) experienced three recurrences over a decade, with the final tumour reaching 23 cm and becoming inoperable.
Proton beam therapy (搜索) at the Goh Cheng Liang Proton Therapy Centre (搜索) at NCCS delivered 28 sessions, precisely targeting the tumour while sparing the heart, lungs, liver, kidneys, and bowels.
A follow-up MRI in January 2026 showed no active tumour growth, and the patient regained leg sensation, balance, and mobility, completing a four-hour hike post-treatment.
A decade-long battle with a rare, recurrent spinal tumour has reached a turning point for Singaporean singer Hasyima Yusof, whose 23 cm spinal ependymoma (搜索) was successfully controlled using proton beam therapy (搜索) at the National Cancer Centre Singapore (NCCS). After three surgeries failed to prevent regrowth, the precision radiotherapy approach delivered tumour control without the debilitating side effects that had previously left her wheelchair-bound.
Hasyima, now 32, was first diagnosed in 2016 at age 22 after a fall onstage during a reality singing competition two years earlier led to worsening pain that affected her sleep, mobility, and quality of life. Scans at a private hospital revealed a 10 cm tumour in her spine. Surgery removed the mass, and a biopsy confirmed it was a benign spinal ependymoma (搜索) — a very rare tumour arising from cells lining the spinal cord.
Spinal ependymomas affect approximately one in 350,000 people, with fewer than five new cases diagnosed annually in Singapore. Sharon Poh, a radiation oncologist at NCCS, explained that while these tumours most commonly occur in childhood, their slow-growing nature means they may remain undetected until adulthood. "While lower-grade tumours can be slow-growing and demonstrate non-invasive behaviour, higher-grade tumours have the potential to behave like cancers and grow aggressively. If left untreated, they can continue to enlarge and compress the spinal cord, eventually leading to weakness, numbness, loss of sensation or paralysis," Poh said.
A pattern of recurrence
Despite the initial surgery, the tumour returned in 2020, now measuring approximately 17 cm. A second operation was performed, but this time Hasyima experienced significant post-surgical complications, including numbness from her hips to her toes that impaired her mobility. "I was not only devastated, but I was also feeling frustrated," she said. "It seemed like every four years, my life had to be put on hold because the doctors had to 'fix' me all over again."
By 2023, persistent numbness, fatigue, and excruciating back pain prompted another routine check-up. Scans confirmed a third recurrence. By 2025, her condition had deteriorated dramatically — the tumour had grown to 23 cm and was intertwined with the spinal cord, making complete surgical removal impossible. Hasyima required a wheelchair and could not lie down to sleep.
Hasyima had first learned about proton beam therapy (搜索) from her initial neurosurgeon, but at the time the treatment was available only in Japan, and the cost was prohibitive. The opening of the Goh Cheng Liang Proton Therapy Centre (搜索) at NCCS in 2023 — supported by a $50 million gift from the Goh Foundation — changed the equation.
Poh explained the rationale for recommending proton beam therapy (搜索) in this case: "Preserving long-term neurological function and quality of life was an important consideration in Hasyima's treatment plan as she was only in her 30s." Unlike conventional radiotherapy, proton beams can be tailored to stop within the tumour without an exit dose, allowing radiation to be delivered more precisely. "With proton beam therapy, we were able to deliver high doses to the tumour target while greatly reducing doses delivered to her heart, lungs, liver, kidneys and bowels," Poh said.
Crucially, Poh noted that Hasyima's prior surgeries were debulking procedures only, meaning "viable tumour cells were still left behind each round, hence it was not unexpected that the tumours recurred." She added: "Complete treatment should have involved radiation therapy after surgery."
Fertility preservation and treatment course
Before beginning treatment, Hasyima expressed concern that radiation might affect her chances of having children. Poh addressed these concerns and advised on fertility preservation options, including in-vitro fertilisation. Hasyima underwent egg retrieval and freezing, successfully preserving seven embryos.
She then commenced 28 sessions of proton therapy in July 2025. Despite experiencing fatigue and back pain during treatment, she remained active, attending weekly pilates classes. By the time she completed treatment in September 2025, her back pain had resolved, and she could mobilise with a walking stick. She gradually regained sensation in her legs and now demonstrates improved balance and coordination when walking.
In December 2025, Hasyima and her husband Jaime Cruz travelled to Guatemala, where she completed a four-hour hike up an ancient Maya pyramid using a walking stick. "Navigating the slopes and uneven, rocky terrain was a challenge so I had to take frequent breaks. But completing the hike gave me a great sense of achievement. I never imagined it was possible after my diagnosis," she said.
A follow-up MRI scan in January 2026 showed no active tumour growth, and she is awaiting her next routine scan in September. "I am looking forward to the next chapter of my life — being a mother and perhaps taking part in Hyrox," Hasyima said.
Poh emphasised that early diagnosis and timely treatment remain critical to preserving neurological function, preventing damage, and improving long-term outcomes for patients with spinal ependymomas. The case highlights the growing role of proton beam therapy (搜索) in managing complex, recurrent tumours adjacent to critical structures where conventional approaches have been exhausted.