Katie Thurston's Breast Cancer Journey
- “The Bachelorette” alum Katie Thurston is sharing how medically induced menopause during metastatic breast cancer treatment has affected her brain health, bone health, and sex life, hoping to raise awareness about the challenges of hormone suppression.
- Thurston is undergoing treatment for HR+/HER2- metastatic breast cancer, which includes a recent double mastectomy and ongoing therapy with Kisqali (ribociclib), Lupron (leuprolide), and letrozole to help slow cancer growth and manage hormone-driven disease. She has also started taking Wellbutrin, an antidepressant medication, for her mental health.
- Menopause is when a woman has gone 12 consecutive months without a menstrual period, but it is vastly more complex than its simple definition. The average age at which a woman starts menopause is around 51. However, certain medical treatments — such as chemotherapy, radiation, surgical removal of the ovaries, or hormone-suppressing drugs used in some cancer treatments — can also induce menopause.
- If you or someone you love is navigating menopause or cancer, you don’t have to face every question alone. SurvivorNet’s My Health Questions, an AI-powered tool, can help you find answers to everyday cancer questions, better understand treatment options, and feel more informed along the way.
Thurston, who is undergoing treatment for HER2-negative, hormone-positive metastatic breast cancer, which includes hormone suppression medication and a double mastectomy [removal of both breasts], recently took to Instagram to address how medically induced menopause has changed her body.
Read MoreView this post on Instagram
Thurston continued, “First of all, hormones play more of a role than I think people realize until you no longer have them. One of them is your brain health. This includes your mood regulation, this includes your memory, your motivation, all the things that make you feel like ready to tackle life.
“We don’t get that anymore. We have brain fog, we have mood swings, we are sad. We are sad to be going through what we are going through, rightfully so. I actually started an antidepressant for the first time this year to assist with that. We actually have to get a bone scan to measure the density of our bones because once we stop allowing our bodies to have hormones, we are at risk for osteoporosis. That means our bones will break easier.”
The 35-year-old former reality star, who is married to comedian Jeff Arcuri, then highlighted the intimate side effects women may experience during menopause, including vaginal dryness, urinary tract infections, painful sex, and a lower sex drive.
“I’m gonna be honest with you, the amount of times I’ve been intimate with my partner this year is less than five. And thankfully, he is a supportive partner because once you are in medically induced menopause, sex no longer gets to be fun and spontaneous and easy,” she explained.
“It becomes a process of communication and patience and training and confidence building because nothing is the same down there. In order to combat that, weekly, I have an estradiol [which replaces or supplements the body’s natural estrogen] tablet that is inserted twice a week, as well as creams that I can use to kind of offset it.”
Thurston explained that while treatments help manage her symptoms, her sex life has undeniably changed, and she continues to cope with the loss of being able to carry a pregnancy as she navigates the lasting effects of breast cancer treatment.
She concluded, “Being in medically induced menopause sucks.”
View this post on Instagram
Katie’s Ongoing Breast Cancer Treatment Journey
When it comes to Thurston’s ongoing battle with HR+/HER2‑ metastatic breast cancer, she recently underwent a double mastectomy, and her ongoing treatment regimen includes three key medications:
- Kisqali (ribociclib): Approved by the FDA in 2017, this targeted therapy is used in combination with endocrine therapy to treat HR+/HER2- breast cancer. It works by slowing the progression of cancer, offering a more tolerable alternative to traditional chemotherapy.
- Lupron (leuprolide): A hormone therapy injection that lowers estrogen levels in the body, helping to prevent the cancer from growing.
- Letrozole: An aromatase inhibitor that reduces the body’s estrogen production, commonly used in postmenopausal women with hormone-sensitive breast cancer.
Remember, although stage 4 breast cancer is not curable, several treatment options exist that can extend the life of patients.
RELATED: Early Menopause Comes as a Shock to Cancer Survivor Araceli Rubi
Treatment options depend on the stage, type of primary breast cancer, and whether hormone receptors are positive.
Treatment can include a combination of:
- Chemotherapy: Oral or IV medications that are toxic to tumor cells
- Hormonal therapies: Drugs that lower estrogen levels or block estrogen receptors from allowing the cancer cells to grow
- Targeted therapies: Drugs that target your tumor’s specific gene mutations
- Immunotherapy: Medications that stimulate your immune system to recognize and attack cancer cells
- Radiation: The use of high-energy rays to kill tumor cells and shrink tumors
- Surgery: To remove a cancerous tumor or lymph nodes (uncommon with stage IV; more common in stages I, II, and III)
- Clinical trials: Studies of new medications, treatments, and other therapies offer hope for better outcomes.
View this post on Instagram
Understanding Menopause & How It Affects The Body
Menopause is when a woman has gone 12 consecutive months without a menstrual period, but it is vastly more complex than its simple definition. The average age at which a woman starts menopause is around 51. However, certain medical treatments — such as chemotherapy, radiation, surgical removal of the ovaries, or hormone-suppressing drugs used in some cancer treatments — can also induce menopause.
According to leading experts in menopausal care, menopause is a major life and health transition that can affect much more than reproductive health. Symptoms extend far beyond hot flashes and can affect nearly every aspect of a woman’s physical, emotional, and cognitive life. It can influence sleep, mood, cognition, sexual health, heart health, bone health, and overall well-being.
Dr. Sarah Richina, Director of UPMC Magee-Womens Midlife Health Center in Pittsburgh, who advocates for personalized, interdisciplinary care to improve women’s long-term health and well-being, recently spoke with SN Health on how menopause can leave women feeling like they’re struggling to keep up.
“What we see and hear a lot is patients coming in and saying, ‘I don’t feel like myself,’” Dr. Richina told SN Health, noting that menopausal changes can bring a “period of vulnerability.”
“It also comes at a time when there are a lot of responsibilities. You might be caretaking for your parents who are aging, or your children are growing and leaving home. And so, there are a lot of transitions happening in people’s lives at this point.”
SN & You: Discussing Sex and Sexuality After Cancer
SurvivorNet also spoke with Dr. Yuan Yuan, breast medical oncologist and medical director for breast cancer research at Cedars-Sinai Medical Center, and asked how they tackle the topic of sexual health with breast cancer patients.
“I think it’s important,” she says on the overall subject, but explains that during the visit with a provider, you only have so much time. “You’re focused on chemo side effects, labs, imaging, you know, a lot of things … it’s taken up all the time,” Dr. Yuan Yuan explained. “So sex has become being pushed to the corner.”
RELATED: Hormones & Mood Swings: Why Anxiety & Emotional Changes Intensify In Perimenopause
Dr. Stephanie McNally, Medical Director for Katz Institute of Health at Northwell Health, also spoke with SN Health and validated the emotional symptoms many women experience as they enter menopause, adding that they aren’t imagined or exaggerated.
“There’s very good data to show that there is an increase in depression and anxiety diagnoses in the perimenopausal transition,” Dr. McNally said.
The reasons are both biological and situational:
- Shifts in estrogen and progesterone
- Life stressors are common in midlife, which may include caring for aging parents, career pressures, caregiving, or relationship changes.
- Elevated stress hormones like epinephrine and cortisol
These forces interact in ways that can destabilize mood, energy, and sleep.
More On Menopause
- A Doctor’s Top Tips to Staying Strong Through Menopause Involves Fitness: ‘Get a Glow Going’
- Balancing Menopause, Caregiving and Career Pressures — Women Need More Support During This Transition
- Managing Menopause: Proper Nutrition Is Essential For Easing Symptoms
- Not Just Hot Flashes: Why Menopause Can Bring Changes to Your Skin, Hair and Waistline
- What’s the Difference Between Menopause and Perimenopause? A Leading OB/GYN Explains
Dr. McNally described these symptoms as a tightly linked system:
“If you break it down into a physiological hormonal perspective… these stress hormones could negatively impact many other factors of your life,” Dr. McNally explains.
“If you’re not sleeping as a root, your other mood function fatigue is all connected. Think of it as a triangle. Sleep, mood, and energy are very, very connected.”
Understanding Hormone Therapy For Breast Cancer
Hormone therapy for breast cancer is one line of defense in the vast tool kit for treatment.
It’s used for hormone receptor-positive cancers, which are actually the most common types of breast cancers. When a tumor is “hormone receptor-positive,” it means that a pathologist has run special tests on the cancer to determine that it is positive for either the estrogen and/or progesterone receptor.
WATCH: Understanding hormone therapy for breast cancer.
When a certain type of cancer tests positive for being hormone-receptive, it means that the cancer needs the hormones estrogen and/or progesterone to grow.
Your doctor will then determine what type of treatment is best for your type of cancer.
It’s important to note that approximately half of early-stage hormone receptor-positive breast cancers stop responding to hormone therapy.
These cancers can be compared to a room with a light switch. Initially, the breast cancer has just one light switch that you need to hit to turn off the lights. But as the breast cancer mutates, it grows an additional light switch, so now you must hit both at the same time if you want to kill the cell.
Hormone Therapies for Breast Cancer: mTOR Inhibitors
Almost all advanced-stage, hormone receptor-positive cancers eventually become resistant to hormone therapy. But by combining hormone therapy with a new class of drugs called mTOR inhibitors, doctors can hit both switches at once. The mTOR inhibitors act on proteins called kinases, slowing down the cancer’s growth.
Helpful Information About Breast Cancer Screening
It’s important to understand when women should begin screening for breast cancer.
The medical community has a consensus that women between 45 and 54 have annual mammograms. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should start getting mammograms every other year at the age of 40, suggesting that this lowered the age for breast cancer screening could save 19% more lives. For women aged 55 and older, the American Cancer Society recommends getting a mammogram every other year. However, women in this age group who want added reassurance can still get annual mammograms.
Women with a strong family history of breast cancer, have dense breasts, have a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before age 30, are considered at higher risk for breast cancer.
WATCH: Understanding the BRCA gene mutation
Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk for developing breast cancer, you should begin screening earlier.
Breast density is determined through mammograms. However, women with dense breasts are at a higher risk for developing breast cancer because dense breast tissue can mask potential cancer during screening. 3D mammograms, breast ultrasound, breast MRI, and molecular breast imaging are options for women with dense breasts for a more precise screening. It is important to ask your doctor about your breast density and cancer risk.
Family History & Breast Cancer Risk
Although breast cancer can happen to anyone, certain factors can increase a person’s risk of getting the disease. The known risk factors for breast cancer include:
- Older age
- Having a gene mutation such as the BRCA1 or BRCA2
- Added exposure to estrogen
- Having children after the age of 30
- Exposure to radiation early in life
- Family history of the disease
Different types of genetic testing can help people with a family history of cancer better ascertain their cancer risks.
Your doctor will discuss your family history of cancer with you in the context of your type of tumor and your age at diagnosis. Hereditary genetic testing is usually done with a blood or saliva test.
About ten percent of breast cancers are hereditary, says Dr. Ophira Ginsburg, Director of the High-Risk Cancer Program at NYU Langone’s Perlmutter Cancer Center.
“We encourage only those with a family history to get [genetic testing],” Dr. Ginsburg previously told SurvivorNet. “I would say that if you have anyone in your family diagnosed with a rare cancer. Or if you have a strong family history of one or two kinds of cancer, particularly breast and ovarian, but also colon, rectal, uterine, and ovarian cancer, that goes together in another cancer syndrome called the Lynch Syndrome.
The second test involves the genetic sequencing of your tumor if you’ve been diagnosed with cancer by this point. These genetic changes can be inherited, but most arise during a person’s lifetime. This process usually involves examining a biopsy or surgical specimen of your tumor. This testing can lead to decisions on drugs that might work against your cancer.
“Digital mammography, it turns out, significantly improves the quality of the mammogram… It’s 3D or tomosynthesis mammography,” Dr. Connie Lehman, the chief of the Breast Imaging Division at Massachusetts General Hospital, explains.
“This allows us to find more cancers and significantly reduce our false-positive rate. With digital mammography 3D tomosynthesis, we’re taking thin slices through that breast tissue, like slices of a loaf of bread. We can look at each slice independently rather than trying to see through the entire thickness of the entire loaf of bread. So those thin slices help us find things that were hidden in all the multiple layers,” Dr. Lehman adds.
Additional testing can be considered for dense breasts, depending on a woman’s personal history, preferences, and her physician’s guidance.
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
