When a thymoma spread near the spine, a young engineer from Egypt chose proton therapy at Fred Hutch.

But it was more than that.

His father, an orthopedic surgeon, was having lunch with colleagues around the same time when one of them noticed that people with myasthenia gravis also often had thymoma. So Heddaya went to get a chest x-ray, which confirmed the diagnosis of thymoma.

“I was not scared by the diagnosis, the doctors gave me confidence, and I was raised to be an optimist,” Heddaya said. “They said the tumor was ‘good but still cancerous’ and thought it was unlikely to spread throughout my body.”

Even though Heddai’s father worked in health care in Egypt, he wanted his son to go to the United States, where he could find more treatment options. The family also had ties to Seattle, so in early 2015, Heddaya went to UW Medical Center at Montlake for surgery with Douglas Wood, MD, FACS, FRCS.

“The tumor was the size of a small football and had probably been growing since puberty,” Heddaya said. “I was hoping that surgery would solve the problem, but they saw some cancer cells in the pleura (the lining around the lungs and chest area) and predicted that the thymoma would slowly grow back.”

Unfortunately, they were right. After surgery and chemotherapy, the tumor returned, and in 2019 it became so large that UW doctors scheduled another surgery.

This time, surgeons entered through his back and removed a rib along with the tumor and part of the pleura on the left side, near the spine. He also had to continue chemotherapy to slow the growth of the tumor because his team knew it would come back.

As the tumor continued to grow, Heddaya and his family came to Fred Hutch Cancer Center – Proton Therapy in early 2022 to explore more options. He consulted with John Kang, MD.who reviewed his scans and suspected that the tumor had spread to the spinal cord. Kang ordered an MRI, which confirmed this.

“Meeting Dr. Kang was a miracle,” Heddaya said. “He found a new tumor, recommended immediate robotic surgery and put me on proton therapy. He also told me that we noticed it early. I didn’t even have any symptoms.”

“The MRI confirmed that Yousef’s tumor in the upper thoracic spine is adjacent to his spinal cord,” Kang said. “I referred him to spinal tumor specialist Dr. Anubhav Amin to perform minimally invasive surgery to create a small separation between the tumor and the spinal cord, which allowed me to increase the proton dose to the tumor to maximize local control. Cancer treatment is multidisciplinary, and I am fortunate to work with colleagues such as Dr. Wood, (Yousefa’s) oncologist Dr. Rafael Santana-Davila and Dr. Amin.”

“Proton therapy was so simple,” Heddaya said. “I wasn’t afraid of it because I read other people’s stories and they made me feel safe. I realized that proton therapy minimizes harm to a healthy body. I saw people finishing treatment and they looked happy.”

Heddaya moved to Seattle for several months while she underwent proton therapy. Since the pandemic has made it difficult to meet people, he adopted a toy poodle, which he named Dahab, after his favorite diving and hiking town on the Red Sea. The couple walked daily along Green Lake and became a famous duo.

During this time, Heddai’s doctors also changed Heddai’s chemotherapy regimen, and the tumor began to shrink for the first time.

He continued chemotherapy until April 2024, when doctors ordered a temporary break. Even though the cancer is slow growing, the cancer will be treated as a chronic disease: Heddaya will start and stop chemotherapy as needed, and his team will monitor tumor growth with MRI scans every three months.

When a site becomes critical, proton therapy can be used at that site.

“If Yusef benefits from radiation in the future, I am willing to treat him,” Kang said. “As a radiation oncologist at Fred Hutch and UW Medicine, I have access to protons, photons, neutrons and electrons. I think about which type of radiation is best to use in each case as they have their own unique advantages and disadvantages. I am honored to have access to so many treatment options for Youssef and patients like him.”

Today, Heddaya runs his grandfather’s farm near the Nile River, where he grows wheat, rice and potatoes. He leads an active lifestyle and often heads to the Red Sea or Mediterranean Sea to surf and kayak.

“My advice to others is to calm down,” Heddaya said. “Trust the process, don’t be intimidated, especially when it comes to protons. Thanks to my care at Fred Hutch and UW Medicine, I can do whatever I want, even sports and exercise.”