Published Jul 30, 2025

‘The Bachelor’ Star Katie Thurston Plans For a Double Mastectomy Amid Metastatic Breast Cancer Fight & Praises Humor For ‘Making Every Day Easier’

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Living With Metastatic Breast Cancer

“Bachelorette” alum Katie Thurston, who is battling stage 4, hormone-positive, HER-2 negative breast cancer, has opened up about her plan to get a double mastectomy three months after undergoing hormone-blocking therapy, which is causing her to go into medically-induced menopause. Despite the tough times she’s been through and what lies ahead, Thurston has used humor to make this time in her life feel “easier,” something she’s able to do alongside her comedian husband Jeff Arcuri.
Metastatic breast cancer also called “stage four” breast cancer means that the cancer has spread, or metastasized, beyond the breasts to other parts of the body. While treatment for metastatic breast cancer is not curative, it can improve your quality of life. You and your doctor will work together to develop a treatment plan that’s right for you.
For help finding a clinical trial that’s right for you, try our easy-to-use Clinical Trial Finder.
The medical community has a broad consensus that women have annual mammograms between the ages of 45 and 54. 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.

Reality TV star Katie Thurston, known for being on the Bachelor‘s 25th season and starring in The Bachelorette’s 17th season, has revealed she’s planning to get a double mastectomy [the surgical removal of both breasts] after three months of taking a hormone-blocking therapy in her battle against stage four breast cancer.

The 34-year-old star of “The Bachelor” spoke about her treatment plan during a recent episode, next to her comedian husband Jeff Arcuri, to her fellow “Bachelorette” Kaitlyn Bristowe on the “Off The Vine” podcast.

Thurston, who shared her stage 4 breast cancer diagnosis with the public in February 2025, also admitted that humor has helped make this arduous time “easier.”

She explained on the podcast, that she hopes in the near future to hear the words “there’s no evidence of disease … even though, technically, stage four is not curable.”

Thurston continued, “Technically, medically, I will have breast cancer forever … but with so much advancements happening, and the way that I caught it when I did, I’m being very optimistic.”

She then offered listeners some insight into what treatment she’s planning to get done, saying, We waited to see that the medicine is working.

“And it is. So we’re gonna basically give it three more months, and then I can do a double mastectomy, get a boob job if I want, which is, I think, the route I’m gonna go.”

After addressing how the decision of implants is a topic she needs to learn more about and how she’d be unsure what size breasts to get after having her’s removed, she added, “It’s been a challenge of like, I’ve worked my whole life to finally be confident in my breast era and then you’re telling me I gotta chop them off and get new ones?”

As for how she staying sane throughout the rollercoaster of emotions she’s feeling, she said, “I do spiral … I think you just have to allow yourself to spiral. You know, you can’t bottle it up.

“So, there’s certainly days where Jeff and I are just bopping around town, having a great day, laughing. And then there’s days where I’m just on the couch and he’s like, ‘What can I do for you? Are you okay?’ And I’m just like, ‘I need to cry today.’ So I just think you have to go through the highs and lows and know that that’s constant.”

Thurston, who doesn’t have a breast cancer in her family, then stressed the importance of understanding, “There’s no finish line in this healing journey. It’s just a constant flow.”

Recounting how she initially dismissed her symptom of a painful lump in her breast, she urged anyone listening to get checked.

“I want people to be proactive on checking their breasts, and push with their doctors on getting it explored further … I want people to take their health seriously and be confident enough to have these conversations with their doctor,” Thurston said.

“I think that will potentially save their life, versus waiting until their 40 for their first, ever, mammogram.”

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A post shared by Katie Thurston (@thekatiethurston)

Despite the dark side of a cancer diagnosis, Thurston has kept a positive outlook and has been able to turn to jokes with her husband, we shared “we laugh a lot.”

Thurston chimed in, “I think it makes it digestible … let’s have fun with this conversation, cancer sucks on it’s own. We don’t need more sadness around it.

“Using humor to kind of cope with it just makes every day easier.”

Thurston also hopes there will be a shift in the age women get checked for breast cancer in the future, as she was “technically 33” when she first had cancer.

She then suggested that any young women seeking a mammogram prior to the recommended age, should just “pay out of pocket” for “peace of mind.”

Katie Thurston’s Breast Cancer Journey

Back in 2021, Thurston disclosed how she decided to get a lumpectomy at just 20-years-old after discovering a lump in her breast during a self-exam.

In an Instagram story, Thurston told fans she experienced the breast cancer scare after giving herself a self breast exam. The lumpectomy, a surgery to remove a cancer or abnormal tissue from the breast by only removing the tumor as opposed to the whole breast, ultimately left her with a scar on her chest.

“I often get questions about my scar. It’s from a lumpectomy after finding a lump in my breast. Because I was only 20, I discovered this on my own,” she explained, at the time where she stressed how women should be their “biggest advocate” when it comes to their personal health.

Then, in February 2025, Thurston announced she had breast cancer recurrence.

She wrote, “Yesterday I saw all the couples post their Valentines Day celebrations. I felt envious if I’m being honest. Jeff took me to Hawaii and after, we were going to travel the world before planting roots together in NYC finally. But instead, my Vday was spent coordinating a place to live as I have to go back to LA for more testing and treatment.

“I used my morning to figure out insurance for NYC and laws on preexisting conditions. I scheduled appointments for another biopsy, fertility, mental health, surgery, as well as meeting with my team to discuss the overall treatment plan, which will include chemo.”

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Thurston is continuing to share her story with fans, whether that be through more interviews or Instagram posts, and we’re delighted to see her persistent smile and willingness to spread her breast cancer knowledge with others.

Further opening up about the type of breast cancer, Thursday said she was diagnosed with triple positive, a HER2-positive cancer. Breast cancer classified as HER2-positive tends to exhibit faster growth, increased likelihood of spreading (metastasis), and a higher chance of recurrence. Despite its aggressive nature, HER2-positive cancer responds well to treatments that specifically target HER2 proteins.

She captioned her post, “What this means is no chemo. Instead I’ll be on Letrozole + Kisqali + Zoladex as my first line of treatment. This is a custom plan based on being having HER2-negative, Luminal B, hormone-positive breast cancer. Letrozole to block estrogen, Kisqali to stop cancer cells from growing, and Zoladex to shut down my ovaries.

“Could I need chemo in the future? Maybe. If this treatment stops working or if the cancer grows again, it’s an option we’ll revisit. We will closely monitor the treatment plan and make sure it’s working for my body.”

Understanding Stage 4 (Metastatic) Breast Cancer

Stage 4, or metastatic breast cancer, means that the cancer has spread to distant areas of the body. Even though there is currently no cure for metastatic breast cancer, doctors have many options to treat this stage advanced stage of breast cancer.

Hormone therapy, chemotherapy and targeted drugs are all options to talk to her doctor about, depending on your individual needs. Sometimes surgery and/or radiation is considered as part of the treatment, but mainly it is important to focus on improving your quality of life.

The treatment plan for metastatic breast cancer patients depends on the specific needs of the woman, whether they need an aggressive chemotherapy or depending on the doctor’s assessment, they may benefit from another medication.

For hormone receptive positive cancer breast cancer patients, doctors try to see how long they can keep patients on oral therapies. Very often, newly diagnosed metastatic hormone receptive-positive breast cancers (where cells have either estrogen (ER) or progesterone (PR) receptors or both) respond best with different hormonal medications, and sometimes for many many years.

Dr. Erica Mayer, a medical oncologist at Dana-Farber Cancer Institute, says clinical trials have shown that hormone medicines are more effective when paired with targeted therapies. At some point, chemotherapy will be introduced. And according to Dr. Mayer, it’s delivered at a dose and schedule that’s as well-tolerated as possible.

“We are so lucky in breast cancer that we have so many effective and well-tolerated treatments,” Dr. Mayer tells SurvivorNet. I’m so gratified to see that patients are doing better and living longer today with metastatic breast cancer than they have ever done before.”

Bottom line, there are more and more options becoming available for patients to manage symptoms of advanced stage disease, and it’s best to talk about specific treatment plans and what is best for you with your own doctor.

Treating Metastatic Breast Cancer

With metastatic breast cancer, the primary goal of treatment is to control its spread. SurvivorNet offers information about what those options are from targeted therapies to chemotherapy and when these various treatment options can be used. We also provide information on new, exciting research that is currently being tested in clinical trials and information about when recently approved drugs, like immunotherapies, can be used.

For help finding a clinical trial that may be right for you or a loved one, try our easy-to-use Clinical Trial Finder.

While there have been many developments in recent years when it comes to treating late-stage breast cancer, which therapies can be used will depend on the characteristics of the patient’s cancer.

What are the Treatment Options for Late-Stage Breast Cancer?

Late-stage breast cancer is not one disease, but many different diseases so the options available to different patients vary a great deal. Which treatment doctors recommend will depend on several factors like a woman’s overall health, genetics, the biology of the tumor, and more.

Treatment for late-stage breast cancer 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

Treating Her2-positive Metastatic Breast Cancer

Can Metastatic Breast Cancer be Prevented?

While there’s no sure way to prevent metastatic breast cancer, researchers are working diligently to find ways you can prevent the first (or primary) breast cancer from returning or metastasizing.

Dr. Kenneth D. Miller, medical oncologist at the Alvin & Lois Lapidus Cancer Institute at Sinai Hospital of Baltimore, recommended, in an earlier interview with SurvivorNet, making lifestyle adjustments to reduce risk factors and improve cancer survivorship, including:

Eat a low-fat diet: Women who eat a low-fat diet tend to have lower levels of estrogen in their blood, which could help reduce risk.
Choose a colorful diet: Women who eat a varied diet of fruits and vegetables may have a lower risk of developing breast cancer.
Exercise for two or more hours weekly: Studies suggest that physical activity can lower breast cancer recurrence.
Maintain a healthy body weight: Women who are overweight after treatment for breast cancer may be at higher risk of recurrence
Limit alcohol intake: Heavy alcohol consumption has been linked to an increased risk of recurrence.

Maintaining Quality of Life With Metastatic Breast Cancer

“Metastatic breast cancer is a treatable disease,” explains Dr. Miller. “Fortunately, we have so many new treatments for women with recurrent breast cancer and for many women who look at this as a chronic disease that they can live with “often for many years.”

While treatment for metastatic breast cancer is not curative, it can improve your quality of life. You and your doctor will work together to develop a treatment plan that’s right for you.

“Quality of life typically involves many things including treating symptoms effectively and modifying lifestyle to allow time for treatment and to accommodate to living with a chronic disease. A positive attitude doesn’t cure cancer but also contributes to living well with cancer. Faith, spirituality, intimate relationships, friends, and families help as well.”

In some cases, you may need more aggressive therapies that can be lifesaving. Finding the right combination of treatments for your breast cancer and your body may take some time. Be patient and work with your doctor to arrive at the right treatment plan.

Remember, when you are fighting metastatic breast cancer, it can be hard to remember the good in life. No matter what treatments you are undergoing, it’s important to maintain a support system around you and an optimistic outlook.

If you are feeling overwhelmed and unable to go on, seek help. And talk to your physician. Your physician can recommend support groups or other professionals that can help make your journey easier.

Meanwhile, studies of new treatment options are called clinical trials, and they are an essential part of medicine for two reasons: Clinical trials help doctors better understand cancer and discover more effective treatment methods—and they also allow patients to try a treatment before it’s approved by the U.S. Food and Drug Administration (FDA), which can be life-changing.

WATCH: Clinical Trials Help Find New Treatment Options

Dr. Beth Karlan is a gynecologic oncologist at UCLA Health. She says the goal with clinical trials is to advance cancer research to a point where the disease becomes akin to diabetes, where it becomes a manageable condition.

“Clinical trials hopefully can benefit you, but is also providing very, very vital information to the whole scientific community about the effectiveness of these treatments,” Dr. Karlan said. “They can be lifesaving. In the last few years, we’ve seen many children and adults who have participated in trials and had miraculous results.”