After getting engaged, the only words journalist Mrinali Dhembla expected to hear was “I do.”
Instead, he was told, “You have cancer.”
“When I first heard the words, ‘You have cancer,’ obviously I was very scared because when you are in your 20s, you just think that a small disturbance in your intestines is not a big deal. You can live with it,” said Dhembla, 27.
Dhembla was diagnosed early last year with Stage 3 rectal cancer that had already spread to the spine, part of a worrying rise in colorectal cancer in adults under the age of 50.
Treatment will usually include surgery, radiation and chemotherapy. But Dhembla received a very special invitation – she became one of the first patients to receive the one-two punch of nivolumab and ipilimumab.
The Food and Drug Administration approved a dual-drug immunotherapy last year for advanced cancers such as melanoma, mesothelioma and colorectal cancer.
“We started these immunosuppressive drugs, and he had an amazing response,” said Dr. Nicholas Hornstein, assistant professor of medical oncology at Northwell Health Cancer Institute, speaking about Dhembla.
“I am confident that, for the right patients, these new treatments can provide significant benefits in a short period of time, something that was not possible five years ago.”
A shocking diagnosis
Genetic testing revealed that Dhembla has Lynch syndrome, a genetic condition caused by mutations in genes that correct DNA replication errors.
“Think of these genes as a spelling checker for your DNA,” Hornstein told The Post.
“When cells divide, small mistakes naturally occur, and these mismatch repair proteins have to find and correct those mistakes,” he added. “In people with Lynch syndrome, that spell-checking system is broken, so DNA errors accumulate over time, and that can lead to cancer.”
People who do not know they have Lynch syndrome should start getting a colonoscopy between the ages of 20 and 25, or two to five years before the age when a family member is diagnosed, whichever comes first.
People at average risk should start screening for colorectal cancer at 45.
Dhembla said she did not know she had Lynch syndrome. He was unsupervised before his diagnosis, which came after he dismissed symptoms such as wall bleeding, low-grade fever and constipation that turned chronic.
Inside Cutting-Edge therapy
The good news is that Lynch syndrome makes tumors more susceptible to immunotherapy.
The dual-immunotherapy drug – which won the 2018 Nobel Prize in Physiology or Medicine – especially for patients with “high MSI.”
“That means that the DNA repair machinery of the tumor is broken, which is exactly what we see in Lynch syndrome,” explains Hornstein.
“Only about 15 percent of all colorectal cancers are advanced MSI, although the number is higher in younger patients and in those with Lynch syndrome.”
Dual immunotherapy breaks down the tumor’s protective barriers and empowers the immune system to fight cancer cells.
After only three implants in four months, Dhembla’s scans and biopsies showed no evidence of disease.
His circulating tumor DNA – molecules released from the blood by cancer cells – dropped from 300 to zero. Dhembla was declared cancer free in July 2025.
“[Dhembla’s] the immune system does what surgery, chemotherapy and radiation may not have been able to do.” “It is a profound example of precision medicine, which combines appropriate treatment with biological science.”
A new trend
If Dhembla had followed the “standard playbook,” he would have faced complex spinal surgery with risks of nerve damage.
He could lose his rectum and be tied to a permanent colostomy bag to collect his waste.
Instead, side effects of the immunotherapy program are fatigue, thyroid dysfunction or inflammation of the GI tract and lungs.
“I take a pill for my hypothyroidism every morning, but it’s built into my routine now and doesn’t cause any daily problems,” Dhembla told The Post.
He sees Hornstein every three months for enhanced monitoring.
“We are looking closely at Mrinali to ensure that the cancer does not return, without surgery,” said Hornstein.
“Since he’s had a complete clinical response, meaning no detectable cancer, we’re using a combination of tools to monitor him.”
Those tools include visiting an oncologist, a colorectal surgeon, a GI specialist and an endocrinologist.
He recently had a colonoscopy – not for another two years – and gets his rectum checked every three months.
A long way to her wedding day
Dhembla moved from New Hampshire to New York to be closer to Hornstein, and is settling into life as a New Yorker.
She has resumed planning her wedding with her fiance, Chris.
They intended to get married next month, “but decided it was better to let cancer be a distant memory” before walking down the aisle.
“Although my cancer journey was short, it left a lasting impact. I need time to recover from it emotionally and mentally,” said Dhembla.
