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.)
That means, among other things, Thurston is dealing with hot flashes, body aches, and—the one she says people don’t talk about enough—vaginal dryness. She’s candid about how this can make sex very painful and the way it’s challenged her sex life with her new husband, comedian Jeff Arcuri; after all, this is the same Thurston who was at one point best-known for flashing a vibrator during her entrance on Matt James’s season of The Bachelor. “I’m going to be so blunt,” she says, “but the time that Jeff and I finally decided to be intimate, we really had to go so slowly, make sure there was lubricant, and pause and be like, ‘Wait, wait, wait’ a bunch of different times.” She credits her “open dialogue” with Arcuri and his patience and kindness for helping them navigate the “shifts in my sexual health.”
Another not-so-obvious bump in the road is “the loss of cognitive function so many of us [with breast cancer] experience,” she says. “People may think, ‘Well, you’re done with treatment,’ or, ‘You seem to be fine, so why can’t you keep working as normal?’” she says. But the “hard truth” is, “there are so many things that are impacting our memory and our sharpness,” she explains, pointing to her medications and being thrust into menopause. (Not to mention the sheer emotional and mental burden of managing life while dealing with a serious illness.) Thurston says she’s been able to keep working only because of the freedom she has to work from home and at her own pace. “There’s no way I could have ever gone back to the bank I used to work at and handle money and numbers,” she says.
Alongside the mental fogginess comes a tiredness that would’ve been incomprehensible to a previous version of her. “Old me used to be able to really show up for people, to put other people before myself all the time, to be energetic, and that’s just not my reality now,” Thurston says. Where she may have once felt a pang of guilt for what she calls “playing the cancer card”—declining an event or hangout last-minute, letting certain tasks go undone—she’s since made peace with her new norm and the ways in which it requires her to put herself first, regardless of whether others can see or understand why.
The experience has taught her a big lesson, she says: You truly never know what’s going on in someone else’s life. A person who’s annoying you by, for instance, opening a door too slowly or acting grumpy or asking you to repeat yourself might look young and healthy, but you just have no idea, she says. These days, she could very well be that stranger in another person’s life. “It’s given me this new sense of patience and understanding, and a desire to offer the benefit of the doubt to people who might seem like an inconvenience,” she says.
And for those who have loved ones with breast cancer, Thurston shares some words of wisdom: It’s never a bad time to check in—no matter what phase they’re in of their, well, journey. “Even if it feels like old news to you,” she says, “it’s never going to be old news to us.”
Related:
- Breast Cancer Is Rising in Young Women—Here Are 5 Signs You May Need a Mammogram Before 40
- 9 Things No One Tells You About Having Breast Cancer
- What Is a Breast Cancer Risk Assessment Score—And Should I Get One?
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