Medical Mysteries

Singer’s rare benign spinal tumour kept at bay with proton beam therapy

Medical Mysteries is a series that spotlights rare diseases or unusual conditions.

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SINGAPORE – It all started with a fall onstage while singer and content creator Hasyima Yusof was competing in The Final 1, a local reality singing competition, in 2014.

She was 20 then.

The pain worsened over time, affecting her sleep, ability to walk and quality of life, prompting her to see a doctor two years later.

Hasyima underwent several scans at a private hospital, which revealed a 10cm tumour growing in her spine. She underwent surgery to remove it, and a biopsy confirmed that it was benign.

What she had was a spinal ependymoma, a very rare tumour that develops from the cells lining the spinal cord. While classified as benign, it can still cause serious neurological issues by pressing on the spinal cord.

It affects about one in 350,000 people, and fewer than five new cases are diagnosed in Singapore each year.

Sharon Poh, a radiation oncologist at the National Cancer Centre Singapore (NCCS), said that although ependymomas most commonly occur in childhood, these slow-growing tumours 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,” she said.

Poh added that early diagnosis and timely treatment are important to help preserve neurological function, prevent damage and improve long-term outcomes.

However, in 2020, a routine check-up showed that the tumour had returned and was larger than before – this time measuring about 17cm.

She was operated on a second time to remove the tumour, but this time, Hasyima experienced side effects after surgery. There was numbness from her hips to her toes that affected her mobility.

The former finalist in The New Paper New Face 2017 contest, who turns 32 in August, said: “I was not only devastated, but I was also feeling frustrated.”

“It seemed like every four years, my life had to be put on hold because the doctors had to ‘fix’ me all over again. It took up a lot of the time. I could have spent it doing what other 20-something-year-old women were doing – living life. Instead, I spent it learning to get on my feet all over again,” she added.

But with the support of her family, friends and then boyfriend Jaime Cruz, Hasyima managed to stay positive.

Cruz, now 41, became her “main pillar of support”, helping to prepare her meals, running errands, accompanying her for her medical appointments and providing emotional support when Hasyima was at her lowest during the loss of mobility.

The couple got married in December 2022.

A year later, the numbness in her legs persisted, and she started experiencing fatigue and frequent bouts of excruciating back pain.

“I could not lie down to sleep and often had to sit at the table, where I could rest my head. I also had to rely on a walking stick to get around,” Hasyima told The Straits Times.

It was during a routine check-up that scans showed the tumour had recurred for a third time.

“We were trying to get pregnant. The MRI showed the regrowth. Despite that, I was hesitant to go for another surgery,” she said, admitting that every time the tumour returned, it filled her with a sense of dread.

Turning to proton therapy after three recurrences

There was, however, an alternative treatment for Hasyima.

“My first neurosurgeon told me about using proton beam therapy to shrink the tumour, but at that time, the therapy was available only in Japan. To be treated, we would have had to uproot and move there. I was also concerned about the high cost, which would have depleted my family’s savings,” she said.

By 2025, her condition had worsened, making it increasingly difficult for her to walk or get out of bed. She even had to use a wheelchair to get around.

This time, MRI scans showed the tumour was 23cm long and intertwined with the spinal cord, making it hard to remove completely through surgery.

“Cost was a big deal, so we decided to seek a second opinion at NCCS. By then, it was offering proton beam therapy,” Hasyima said.

The Goh Cheng Liang Proton Therapy Centre at NCCS opened in 2023, supported by a $50 million gift from the Goh Foundation.

Poh said that unlike conventional radiotherapy, proton beams can be tailored to stop within the tumour without an exit dose, allowing radiation to be delivered more precisely to the tumour.

It also minimises radiation exposure to nearby healthy tissues and organs, resulting in fewer short- and long-term treatment-related side effects.

“This reduces treatment-related side effects, particularly for tumours located near sensitive structures such as the brain and spinal cord. This means it may allow higher radiation doses to be delivered to selected tumours while protecting surrounding healthy tissues, offering better tumour control in certain cases,” she said.

Poh told ST that proton beam therapy was recommended for Hasyima because, by the third recurrence, surgery was no longer a suitable option, as the 23cm tumour had become too extensive.

“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.

“This was especially important as she had a very long and extensive tumour extending from her mid-thorax to mid-lower back. With proton beam therapy, we were able to deliver high doses to the tumour target while greatly reducing (radiation) doses delivered to her heart, lungs, liver, kidneys and bowels,” Poh explained.

She said that the procedures Hasyima had before proton therapy were just for debulking, which meant that “viable tumour cells were still left behind each round, hence it was not unexpected that the tumours recurred”.

“Complete treatment should have involved radiation therapy after surgery,” she added.

However, Cruz said: “Still, it took a lot of convincing because it involved radiation, and Hasyima was worried that it would affect our chances of having children.”

Poh addressed her concerns and advised her on fertility preservation options like in-vitro fertilisation.

Hasyima underwent egg retrieval and freezing and managed to preserve seven embryos before starting 28 sessions of proton therapy in July 2025. Despite experiencing fatigue and back pain from the treatment, she remained active, attending weekly pilates classes.

Her back pain went away, and she could get around using a walking stick after completing treatment in September 2025.

She gradually regained sensation in her legs and now has better balance and coordination when walking.

In December that same year, Hasyima and Cruz travelled with his family to Guatemala, where she completed a four-hour hike up an ancient Maya pyramid using a walking stick. She still relies on one today.

“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, after she returned from her trip, 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 (an indoor fitness race combining an 8km run with eight functional workout stations),” she said, drawing protests from her parents and doctor.