“Bachelor” alum Katie Thurston, 35, is navigating life with metastatic breast cancer — an advanced stage of the disease that has spread beyond the breast. With that comes one of the hardest parts of being an advanced cancer patient: the constant stream of decisions that shape treatment, quality of life, and the future.

“When I was diagnosed, I had so many questions and so many possibilities… I feel like I’ve lived many lives at this point,” Thurston shared on Instagram.

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A post shared by Katie Thurston (@thekatiethurston)

“Where should I be treated?”

“Do I want to become a mom?”

“Should I enroll in a clinical trial?”

These were just a few of the questions that flooded her mind in the early days of her diagnosis — questions that countless patients face but often struggle to articulate.

WATCH: See How SurvivorNet’s ‘My Health Questions’ Is Another Valuable Tool for Your Journey

As those questions mount, SurvivorNet is working to make the path clearer. Our patient‑friendly tool, My Health Questions, helps people understand their diagnosis, prepare meaningful questions for their doctors, and feel more confident in making treatment decisions.

Embedded throughout the SurvivorNet site, it delivers structured, clinically grounded answers based on guidelines and expert‑reviewed research. Patients can type or speak their questions and receive responses tailored to their individual profiles, with suggested prompts available for anyone unsure where to begin.

Thurston has been remarkably open about her journey — emotionally, romantically, and physically — bringing her audience along in real time. After posting about her experience, she even responded to followers’ breast cancer questions based on what she’s learned.

“Making these decisions is one of the hardest things about a diagnosis and most people don’t realize the things we have to think about,” one user wrote. Thurston replied, “…and always hoping we made the right decision.”

Another follower asked about reconstruction after a double mastectomy. Thurston answered candidly: “Overall, I love my implants… but at some point I’ll likely do some fat grafting to add a little ‘filling’ to help with rippling.”

Her willingness to engage in conversations that go beyond treatment side effects — touching on identity, relationships, and the emotional reshaping that comes with survivorship — helps patients and caregivers feel seen. And her broad platform creates a gateway for people seeking guidance, community, and resources they may not otherwise know how to find.

Katie’s Ongoing Treatment

Thurston previously shared that her 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.
  
  Courtesy of Instagram/@thekatiethurston

Earlier this year, Thurston received a double mastectomy, which is a procedure that removes both breasts.

Before breast cancer surgery, patients typically weigh several factors, including which procedure is most appropriate based on their cancer type and stage. For Thurston, the decision also involves coordinating around medications that are already playing a key role in her treatment.

“As a breast surgeon, my job is to help patients understand that their long‑term survival with a mastectomy is equivalent to that with a lumpectomy followed by radiation,” says Dr. Sarah Cate, Chief of Breast Surgery at Stamford Hospital.

WATCH: What Type of Breast Cancer Surgery Is the Right Choice?

Many women request the removal of both breasts, believing it offers the best protection against recurrence, but that isn’t always true. The most appropriate surgery depends on several factors, including tumor size, genetic markers, and the patient’s family history.

“Because of the timing of my medication break and liver recovery and the date of my surgery, which also requires pausing Kisqali, I’ll continue to pause treatment,” Thurston said at the time.

She added that her hormone‑suppression therapies, such as Lupron and letrozole, “do a lot of the heavy lifting” in her treatment and continued without interruption.

 

Treatment Options for Advanced Breast Cancer

Metastatic breast cancer (also called stage 4) means cancer cells have spread from the breast to other parts of the body, which may include the bones, liver, lungs, brain, and beyond.

Breast cancer spreads through the bloodstream or lymphatic system. The blood carries cancer cells to different body parts, where they grow as new tumors.

As the cancer spreads to other body parts, patients may experience additional symptoms depending on where the cancer has spread. Examples include:

• Bones: Severe bone pain or fractures
• Lungs: Difficulty breathing, chest pain, new cough
• Liver: Yellowing of the skin (jaundice), abdominal pain, nausea, and/or vomiting
• Brain: Headaches, memory loss, changes in vision, seizures

WATCH: Treatment options for metastatic breast cancer

Although stage 4 breast cancer is not curable, several treatment options exist that can extend the life of patients. 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.

Questions to Ask Your Doctor

If you’re considering a mastectomy, it can be helpful to go into the conversation with your doctor prepared. Here are some key questions to ask as you weigh your options. SurvivorNet’s proprietary AI tool, “My Health Questions,” can also support you along the way by providing evidence‑based answers aligned with cancer treatment guidelines and informed by oncologists across multiple specialties.

• What can I do to prepare for a double mastectomy?
• What happens before and after the procedure?
• For reconstruction, what are the benefits of using implants over my own tissue and vice versa?
• What should I know about implants?
• What will recovery look like after the procedure?

Learn more about SurvivorNet's rigorous medical review process.

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