From diagnosis to hope: A husband and wife’s journey through consecutive cancer diagnoses

A routine mammogram in 2012 saved Dena Malmos’ life, although at the time she almost didn’t go. Without insurance, she considered skipping the screening, until an old high school friend who had recently been diagnosed with breast cancer urged her to get screened. 

“I’d been checked before, and there wasn’t really any cancer in my family that I knew of at the time, so I didn’t think I had anything to worry about,” Dena said. “But my friend insisted that we all get mammograms and even joked that we couldn’t come to our high school reunion unless we did. So, I pulled from my fun money and went.”

That mammogram revealed a cancerous tumor. 

“I just couldn’t believe it,” said Dena, who was 48 at the time. “I kept thinking, ‘They must have the wrong data, a smudge on the camera.’ I couldn’t believe it was happening.” 

She quickly started treatment, which included surgery, chemotherapy and radiation, followed by seven years of endocrine therapy. 

Moving from patient to caregiver

In 2021, nearly a decade after her initial diagnosis, Dena, a professional video editor, found herself in a very different role. She was now accompanying her husband, Richard, to his oncology appointments at  UCLA Health Cancer Care in Pasadena with oncologist Dorcas Chi, MD, after he was diagnosed with early-stage lung adenocarcinoma, the most common type of lung cancer. 

After smoking for 45 years, he had finally quit and was feeling better than ever. Due to his smoking history, however, his doctor urged him to get screened for lung cancer, which is performed with a low-dose CT scan. After a bit of nudging, Richard went for a screening, which revealed a small tumor in his right lung.

“My mother, aunt and cousin died from lung cancer so as soon as I found out I had it too, I thought, ‘Oh Lord, this is going to take me,’” Richard said. 

Richard underwent surgery with thoracic surgeon Jay Lee, MD, the surgical director of the UCLA Thoracic Oncology Program and investigator at the UCLA Health Jonsson Comprehensive Cancer Center, who performed minimally invasive surgery to remove the tumor. 

Just a week later, Richard was back to work doing voiceovers for commercials.

An unexpected diagnosis and the start of a new clinical trial 

At this time, Dena and Richard thought they were putting cancer behind them. But just a few months later, Dena began experiencing persistent back pain, the kind that lingered no matter how much she stretched or rested.

Scans soon confirmed that her cancer had returned in her spine and liver. 

“I just thought it was because I was getting older, maybe arthritis,” said Dena. “I started getting a little discomfort in my hips and my back, and I started having trouble walking and climbing stairs. I never imagined it was cancer again.”

Dena and Richard immediately knew that she needed to be seen by Richard’s oncologist, Dr. Chi, whose specialty is breast cancer. 

“Dr. Chi is just a tremendous human being and a tremendous doctor,” said Richard. “So we knew she would be in good hands.”

Dena began standard first-line therapy for metastatic breast cancer, a combination of an aromatase inhibitor and a CDK4/6 inhibitor. She tolerated the treatment for nearly two years, despite side effects such as difficulty digesting dairy and certain foods and ongoing stomach discomfort, until a routine scan revealed that the tumor in her liver had grown. 

While discussing Dena’s next treatment options, Dr. Chi recommended Dena participate in a new phase 3 clinical trial called VIKTORIA-1. Led by UCLA’s Rena Callahan, MD, the trial is evaluating whether a combination of gedatolisib, a targeted therapy, and fulvestrant, a hormone therapy, with or without palbociclib, another targeted therapy, can help people with advanced HR-positive, HER2-negative breast cancer whose disease has progressed after standard treatments.

“There were no tears, no panic,” Dr. Chi said. “Dena looked at me and said, ‘Tell me what we do next.’ She has been a trooper since day one, incredibly positive, organized and ready to go.”

Promising results

So far, the results from the VIKTORIA-1 trial have been positive. The triplet arm, which Dena received, had been found to reduce the risk of disease progression or death by 76% compared to fulvestrant alone. Even the doublet arm reduced that risk by 67%.

Progression-free survival, which measures how long a treatment can keep cancer from growing or spreading, increased from two months in the control group to more than nine months with the triplet. 

“These results are potentially practice-changing,” said Dr. Callahan. “To see this level of benefit in patients who have already gone through standard therapy is remarkable. This is a novel targeted therapy for estrogen receptor-positive breast cancer. However, the great news is that there was no requirement for a specific mutation in the tumor to see a benefit; we could use this therapy in the largest subtype of breast cancer. It gives us a powerful new option for people facing advanced disease.” 

For Dena, she was finally starting to feel like herself again.

“This trial gave me my life back,” she says. “No pain, no nausea, just a little groggy. It feels like a miracle.”

Dr. Chi emphasizes how crucial patients such as Dena are to advancing cancer care.

“One of the most important messages is encouraging people to participate in clinical trials,” she says. “Because of patients like Dena, we now have data showing how effective this therapy can be.”

Dena agrees, and hopes her experience encourages others to ask about research options early in their care.

“Clinical trials aren’t scary,” she says. “They can give you hope, especially when you think you’re out of options.”

Now, three years after learning her cancer returned, Dena, 61, continues to thrive. 

“She’s living her life to the fullest,” Dr. Chi said. “If you saw her, you wouldn’t believe she has stage 4 disease.” 

Richard, who also continues to do follow-ups with Dr. Chi, will be celebrating five years of being cancer-free in January.

For Dena and Richard, UCLA Health is not just a medical team, it’s become family.

“Dr. Chi and the whole team are one in a million,” said Dena. “They helped save both of our lives.”