When we connect to chat, former Bachelorette Katie Thurston has just passed the six-month mark of living with stage 4 breast cancer, and she’s on the cusp of a pivot—one of who-knows-how-many she’s had to make since her diagnosis. This time, she’s postponing the double mastectomy she had planned for November. (Ahead of the surgery, she’ll have to stop the medication she’s been taking to shrink her tumor, and based on her progress on it so far, she and her doctor feel it’s too soon to take that risk.) As Thurston has quickly learned, being agile is a necessary skill for navigating any breast cancer…“dare I say, journey,” she says, cheekily, plucking a word of Bachelorette lingo.
A winding path filled with twists and turns is a more apt description for having breast cancer, particularly stage 4, than many people realize, Thurston tells SELF. There are some who, upon hearing the stage of her diagnosis, presume it’s a swift death sentence. “They get very sad and uncomfortable…and rightfully so, but medicine has come such a long way that you really can’t give yourself a countdown on your life,” she says. “Never once have I been told [by a doctor] how long I have to live, nor would I want to know that.”
Others, like those who’ve witnessed loved ones with cancer be treated or enter remission, suspect that “cancer has a beginning, middle, and end,” Thurston says. But that’s also a misconception for a few different reasons. Stage 4 breast cancer (which refers to cancer that has spread to distant organs), is considered incurable. So while treatment can shrivel up tumors and knock out cancer cells to the point that they’re no longer visible on scans (a.k.a. “no evidence of disease,” or NED), undetectable cancer cells can still remain throughout the body, threatening recurrence. (Thurston will be on medication and getting routine imaging for the rest of her life.) And even for those with breast cancer of a potentially curable stage, Thurston says, “it’s really a forever experience, because every new pain, every new feeling, every headache provokes this fear of, ‘Is it coming back? Is it now spreading?’”
The reality of living with breast cancer can, then, feel a lot murkier than you might anticipate, Thurston says—not barreling toward death nor a clear-cut “I beat this!” date, either. Piling onto this messy middle are all the uncomfortable and often invisible symptoms of treatment, like in Thurston’s case, the experience of medical menopause caused by the hormone-blocking medications she’s taking. (Her cancer is hormone-receptive, meaning hormones like estrogen fuel the growth of it, and cutting them out can help.)
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