Actress Olivia Munn's Breast Cancer Journey
- Actress Olivia Munn has revealed the hormone suppression therapy she underwent has put her into medically induced menopause.
- Menopause, which the National Institute on Aging describes as a normal part of aging, typically begins in women between the ages of 45 and 55. Symptoms of menopause include body changes, hot flashes, and aches and pains.
- Munn was diagnosed with Luminal B breast cancer. Her treatment involved a lymph node dissection, a nipple delay procedure (a surgery that spares nipples before breast reconstruction), and a double mastectomy (surgical removal of both breasts)—all within 30 days of her diagnosis.
- The actress’ recent Breast Cancer Risk Assessment score, which was at 37%, ultimately led to her undergoing an MRI, ultrasound, and a biopsy, which confirmed her breast cancer.
- According to research in “Breast Cancer,” luminal B tumors are of a “higher grade” and tend to have a worse prognosis. This type of breast cancer is estrogen-positive (ER), meaning it is fueled by the hormone estrogen. It can also be progestogen (PR) negative, meaning it is not fueled by progestogen. This type of breast also tends to have a higher expression of the Ki67 protein, making it grow quickly. Hormonal therapy and chemotherapy are often used to treat this type of cancer.
Speaking to People, for a magazine cover story published this week, Munn said her treatment for Luminal B breast cancer involved a lymph node dissection, a nipple delay procedure (a surgery which spares nipples prior to breast reconstruction), and a double mastectomy (surgical removal of both breasts)—all within 30 days of her diagnosis.
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Munn, a 43-year-old mom of one, explained her menopause symptoms to People, saying “I’m constantly thinking it’s hot, my hair is thinning, and I’m tired a lot.”
In regard to her nipple delay procedure, she said, “I had amazing doctors, but it was still a negotiation sometimes on what we are doing. But I’m glad I did. I want to give myself the best shot of keeping the parts of me that I can keep.”
And as for the support she’s had throughout her cancer journey, Munn credits her partner John Mulaney for all that his done and continues to do.
She told People, “It would’ve felt like climbing an iceberg without him. I don’t think he had a moment to himself, between being an incredibly hands-on father and going to and from the hospital.
“Taking Malcolm to the park, putting him to nap, driving to Cedars-Sinai, hanging out with me, going home, putting Malcolm to bed, coming back to me. And he did it all happily.”
Munn is sharing her story to inspire others to understand cancer risk, adding, “I feel grateful that I was given the opportunity to fight. When I’m with him [her son], it’s the only time my brain doesn’t think about being sick. I’m just so happy with him.
“And it puts a lot of stuff into perspective. Because if my body changes, I’m still his mom. If I have hot flashes, I’m still his mom. If I lose my hair, I’m still his mom. That’s really what matters the most to me. I get to be here for him.”
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Olivia Munn’s Breast Cancer Diagnosis
Munn, an award-winning actress known for hits like “Perfect Couples,” “X-Men: Apocalypse,” and numerous voice acting roles, was diagnosed with breast cancer after undergoing The Breast Cancer Risk Assessment.
The actress’ Breast Cancer Risk Assessment score was at 37%, which led to her undergoing an MRI, ultrasound, and a biopsy, which confirmed her breast cancer.
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The assessment is a “statistical model that allows healthcare professionals to calculate the probability of a woman developing breast cancer over the course of their lifetime,” Dr. Ruth Oratz, breast medical oncologist, NYU Langone Health’s Perlmutter Cancer Center; clinical professor of medicine, NYU Grossman School of Medicine previously told SurvivorNet.
She underwent genetic testing last February, and two months later she was diagnosed with Luminal B breast cancer in both of her breasts.
According to research in “Breast Cancer,” luminal B tumors are of a “higher grade” and tend to have a worse prognosis. This type of breast cancer is estrogen-positive (ER), meaning it is fueled by the hormone estrogen. It can also be progestogen (PR) negative, meaning it is not fueled by progestogen. This type of breast also tends to have a higher expression of the Ki67 protein, making it grow quickly. Hormonal therapy and chemotherapy are often used to treat this type of cancer.
Luminal is one of several types and is distinguished by its molecular makeup. Other types of breast cancer types include: Luminal A breast cancer, Luminal B breast cancer, Luminal B-like breast cancer, HER2-enriched breast cancer, and Triple-negative or basal-like breast cancer.E ach type has a specific, individualized molecular structure. The different types of the molecular structure of breast cancer may inform the treatment path.
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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.
Understanding Hormone Replacement Therapy
Hormone replacement therapy (HRT) is prescribed to help women manage menopausal symptoms. However, it’s also known to increase your risk of certain cancers.
Women are diagnosed with menopause after they’ve gone one year, or 12 months, without a period, according to the U.S. Department of Health & Human Services. Menopause is diagnosed when a woman is in her 40s or 50s. However, the average age of menopause in the United States is 51 years old.
Some women experience intense symptoms during menopause:
- Hot flashes
- Problems with sleeping
- Bone thinning
- Pain during sex
As a result, doctors may prescribe hormone replacement therapy, which controls the levels of estrogen and progesterone in a woman’s body.
HRT Related Cancer Risks
A 2019 analysis of 26 studies that include more than 4 million women found a correlation between HRT and ovarian cancer incidence for women in the United States and Europe.
The correlation was highest in two subtypes (epithelial-stromal and endometrioid ovarian tumors). However, the association couldn’t be reproduced in women in other parts of the world.
A 2017 study found that women on HRT had a 32% increased chance of developing serous borderline ovarian tumors. It’s also been determined that most types of HRT increase a woman’s risk of developing breast cancer.
It’s important to note that HRT is sometimes part of ovarian cancer treatment after a woman has removed her ovaries.
“There is actually some data that suggests improved survival with HRT given to ovarian cancer patients after diagnosis,” Dr. Rimel previously told SurvivorNet.
RELATED: Hormone Therapies for Breast Cancer: Aromatase Inhibitor
In 2012, a randomized control trial showed significantly improved survival in women with epithelial ovarian cancer who received HRT (estrogen) and standard cancer treatment.
However, routine hormone replacement therapy is also debated, as it minimizes the risk of osteoporosis, cardiovascular problems, and sexual dysfunction. Still, the evidence is considered “too limited” to support it being used routinely.
WATCH: The Importance of Listening to Your Body.
Understanding Double Mastectomies
Olivia Munn underwent a double mastectomy to treat her cancer.
When a woman decides to have a mastectomy, several factors go into that decision. Among things to consider is whether to have breast-conserving surgery such as a lumpectomy. These decisions should be made alongside your doctor by openly and candidly discussing risks vs. benefits.
“A double mastectomy typically takes about two hours for the cancer part of the operation, the removing of the tissue,” Dr. Elisa Port, Chief of Breast Surgery at Mount Sinai Health System, tells SurvivorNet. “The real length, the total length of the surgery, can often depend on what type of reconstruction [a patient] has.”
WATCH: What Happens During a Double Mastectomy
Other factors that weigh into the decision to get a mastectomy are the size and features of the tumor and your family history. However, the gravity of your decision comes into full view, especially if you choose to get a mastectomy and remove both of your breasts.
Some women decide to have their breasts reconstructed and have implants put in right after the mastectomy, while others don’t have reconstruction at all.
Dr. Port added that most women opt to have some reconstruction. The length of these surgeries can vary greatly. When implants are used, the procedure can take two to three hours (so the total surgery time would be around five hours). There is also the option to take one’s own tissue (usually from the belly area) and transfer it into the breast area during reconstruction.
What To Ask Your Doctor
If you have been diagnosed with breast cancer, you may have questions about keeping your strength through treatment. Here are a few questions to help you begin the conversation with your doctor:
- What treatment will I be receiving?
- What side effects are associated with this treatment?
- Are there steps I can take daily to help minimize these side effects?
- What physical activity routine do you recommend for me during treatment?
- Do you have recommendations for someone who doesn’t particularly enjoy exercise?
- Can you recommend a dietician who can help me with healthy eating tips and weight maintenance?
- I’ve been having trouble sleeping. Do you have any treatment recommendations?
Contributing: SurvivorNet Staff
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