Finding Deeper Joy in the Holidays After Cancer
- For Olivia Munn, holidays after cancer are about savoring small, imperfect moments—like misspelled Santa letters and leftover cookies—that make time with family even more meaningful.
- Munn was diagnosed with breast cancer in April 2023 even though her mammogram appeared normal and she tested negative for the BRCA gene mutation, which is linked to a higher risk of breast and ovarian cancers. At her OBGYN’s recommendation, she completed a Breast Cancer Risk Assessment, and further screening prompted by the results ultimately revealed her cancer.
- According to Dr. Ruth Oratz, a breast medical oncologist at NYU Langone, a Breast Cancer Risk Assessment is a statistical tool that helps doctors estimate a woman’s likelihood of developing breast cancer over her lifetime. The assessment takes into account factors such as age, family history of breast cancer, the age at which she first had her period, and her reproductive history to evaluate her overall risk.
- Licensed clinical psychologist Dr. Marianna Strongin shared helpful tips for patients through the holiday season. She said, “When talking to loved ones about your preferences and discussing your cancer journey during the holidays, it’s important that you be your authentic self.”
- “If you aren’t feeling comfortable talking about your cancer and you don’t want it to be a part of the holiday season, tell them why that is. Tell them why talking about it would be so distressing for you.” The added authenticity will improve the communication between you and your loved ones.
Munn, along with her husband John Mulaney and their children—four-year-old Malcolm and one-year-old Méi—has shared a glimpse of what she described as the “best” Christmas day on her Instagram story, celebrating the small, imperfect moments that made it special.
Read MoreRELATED: How to Help Friends or Family Battling Cancer During the Holidays
“It’s been the best day,” Munn wrote, sharing a photo of a leftover sugar cookie topped with soft pastel sprinkles.
The other photo, featuring Santa’s letter, was accompanied by Munn writing, “Hmm … Santa spells Claus with an ‘E’ now.”
It appears that either Munn or her husband made the mix-up, but no matter who was responsible, the way she called attention to it was undeniably charming.
The note, dated December 25, 2005, thanked Malcolm for the cookies left out on Christmas Eve and complimented them on how delicious they were.
The note also expressed appreciation for the “special milk” left out with the cookies.
Munn hasn’t yet shared any more photos from this holiday week, but we’re happy to hear she had a wonderful day.
Last holiday season, Munn shared adorable photos and videos capturing the chaos after gift-opening, writing, “The house is a mess, Malcolm got safety glasses personally from the penguins of Madagascar and Méi is 100 days old today. All my Christmas wishes came true.”
Now that her daughter is walking and her son Malcolm is four, it’s easy to imagine she and her husband are having a busy holiday week.
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Munn also recently celebrated Malcom’s 4th birthday on November 24, a milestone event she also took to Instagram to share with fans.
She captioned a celebratory post, showing a poolside photo of Munn and her two children, “He’s been asking for it to be a Ghostbusters theme ever since John showed him the movie and cartoons this past summer.
“I made the mistake of getting large inflatables of the Stay Puft Marshmallow Man and the Ecto-1 because after a long negotiation (which I lost) they came back home with us and are now fully inflated in our living room. How lucky am I that I get to be Malcolm’s mom everyday for the rest of my life.”
Helping You Cope During the Holidays
Although Munn has beaten cancer, we’d like to share what licensed clinical psychologist Dr. Marianna Strongin, who founded Strong In Therapy Psychology, previously shared when it comes to tips for coping during the holidays.
“When talking to loved ones about your preferences and discussing your cancer journey during the holidays, it’s important that you be your authentic self,” Dr. Strongin said. “So, rather than telling people exactly what you want, it’s important to share why you want that.”
Strong continued, “When we are our most authentic selves and disclose our true feelings, the people around us feel us. So, if you aren’t feeling comfortable talking about your cancer and you don’t want it to be a part of the holiday season, tell them why that is. Tell them why talking about it would be so distressing for you.”
Everyone deals with their diagnosis differently. Some people want to discuss it, while others don’t, and the decision should be respected.
Sarah Paul of CancerCare says there’s no shame in playing the cancer card this holiday season.
“For patients going through a difficult moment, it becomes a real lens into what’s happening for them because they can remember the holidays the year before or even the year before,” Dr. Strongin continued. “It becomes a sense of reality when they know that this is going to be the year that’s marked by this (a cancer battle or diagnosis).”
She suggests patients try to find a bit of joy as the season becomes more festive. Take advantage of loved ones sharing the holidays with you and do things that make you happy.
“I really challenged (cancer patients) to kind of take this holiday as it is, to find the joy in it, to find ways to accept the reality of where they are in this time and space,” Strongin said.
Olivia’s Breast Cancer Journey
Olivia Munn’s breast cancer diagnosis emerged despite receiving a “normal” mammogram and testing negative for the BRCA-gene mutation, which increases your risk for breast and ovarian cancer.
At the suggestion of her OBGYN, the actress underwent a Breast Cancer Risk Assessment, which helps determine a woman’s probability of getting breast cancer. Her results called for additional screening, which revealed she had an aggressive form of cancer in both of her breasts.
“I wouldn’t have found my cancer for another year – at my next scheduled mammogram – except that my OBGYN…decided to calculate my Breast Cancer Risk Assessment Score. The fact that she did save my life,” Munn said in an Instagram post, shared in March 2024.
The Breast Cancer Risk Assessment she credits for catching her breast cancer 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 tells SurvivorNet.
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Munn underwent genetic testing to better understand her cancer risk. Genetic tests can be as simple as a simple saliva swab or blood sample. The results help your care team determine if you have a specific mutation that puts you at higher risk for cancer. The results help doctors tailor your treatment and are helpful for breast cancer patients.
“I tested negative for all (different cancer genes), including BRCA,” Munn said.
The BRCA1 and BRCA2 gene mutations are among the most important genes to look for in breast cancer. Together, they are responsible for about half of all hereditary breast cancers. These genes prevent cells from dividing haphazardly and uncontrollably in a person without mutations. Mutations prevent these genes from doing their job and can allow unchecked growth of breast, ovarian, and other tissues.
Two months after undergoing genetic testing, Munn 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.
What Are the Options if You Have a High Risk of Developing Breast Cancer?
Learning More About Breast Risk Assessment & Genetic Testing
The Breast Cancer Risk Assessment Munn credits for catching her breast cancer 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 explained to SurvivorNet.
Genetic Testing for Breast Cancer: What is This Type of Test? And What Do My Results Mean?
As for genetic testing, it can be as simple as a simple saliva swab or blood sample. The results help your care team determine if you have a specific mutation that puts you at higher risk for cancer. Additionally, genetic testing aids doctors in tailoring your specific treatment, therefore very helpful for breast cancer patients.
BRCA Gene Mutations
When Olivia Munn said she “tested negative for all [different cancer genes], including BRCA,” she was referring to the BRCA1 and BRCA2 gene mutations, which are among the most important genes to look for in breast cancer.
How Testing For BRCA In Breast Cancer Works
Together, they are responsible for about half of all hereditary breast cancers. These genes prevent cells from dividing haphazardly and uncontrollably in a person without mutations. Mutations prevent these genes from doing their job and can allow unchecked growth of breast, ovarian, and other tissues.
Dr. Oratz says if the Breast Cancer Risk Assessment finds that a woman is at higher risk of getting breast cancer, she should expect further testing and screening. However, if a woman is positive for the BRCA gene mutation, a Breast Cancer Risk Assessment “is not really accurate.”
“Having information empowers patients,” Dr. Oratz added. “It is very important for people to be aware of the health risks, their family history, and their own personal medical conditions. All of these things can affect the risk of developing cancer.”
According to the National Cancer Institute, about “13% of women” in the general population will develop breast cancer sometime during their lives. By contrast, 55% to 72% of women who inherit a harmful BRCA1 or BRACA2 variant will develop breast cancer by 70 to 80 years of age.
Between 5% and 10% of breast cancer cases are thought to be hereditary. And about 10% of patients who undergo genetic testing will test positive for the BRCA1 or BRCA2 gene, Dr. Julie Rani Nangia, an assistant professor at Baylor College of Medicine, previously told SurvivorNet.
“The genetic BRCA1 and (BRCA)2 mutations, if a woman has one of these mutations … it puts her at basically the highest quantifiable risk for getting breast cancer,” Dr. Elisa Port, a surgical oncologist at Mount Sinai, also told SurvivorNet in an earlier interview.
“We typically say between the 60 (percent) and 80 percent range. Having a BRCA1 and (BRCA)2 mutation also means that that person is at higher risk of getting breast cancer at an earlier age, and also maybe at risk for other cancers like ovarian cancer, like pancreatic cancer for men, prostate cancer and male breast cancer may be a concern.”
Since the discovery of the BRCA mutations in the 1990s, doctors have gone on to identify many other gene mutations that put people at a higher risk of developing breast cancer.
“There’s actually eight to 10 genes that also can put someone at a higher risk for breast cancer,” Dr. Port says, adding that usually that risk isn’t as high as the BRCA mutations. These additional gene mutations include PALB2, ATM, TP53, CHEK2, PTEN, CDH1 and STK11.
Should I Get Genetic Testing to Assess My Risk for Breast Cancer?
“We call them more moderate penetrance genes and those genes, the risk of breast cancer associated with them can be anywhere from say 20 percent to 50 percent. … so still very high, but lower than the BRCA genes that were the ones we originally described.”
The PALB2 gene is a “moderate penetrance gene, and the risk of getting breast cancer with PALB2 can be a pretty broad range,” Dr. Port says. “And unlike the BRCA genes where we don’t really use the family history of who got breast cancer to affect the risk estimates, with PALB2, you really can dial up risk or dial down risk depending on how many relatives and the age of the relatives in the family got breast cancer.”
Limitations of Genetic Testing
Like anything in life, there are limitations to genetic testing for breast cancer, specifically the commercially available tests women can take. One of the most common types of commercially available tests is from 23andMe, a genomics and biotechnology company, as well as tellmeGen and MyHeritage genetic tests.
“There’s only a cadre of them that are approved and accurate and there can be both false positives and false negatives, so it really depends,” Dr. Port says. “If someone is suspicious of having one of these genes (mutations) and gets tested through one of what we call the direct to consumer type tests, it is important that those testing results may need to be verified before doing something irreversible based on those results.”
In other words, if you take one of these tests without your doctor’s knowledge, and you receive some concerning results, make sure you discuss those results with your doctor before taking your next steps.
The other limitation to genetic testing is genetic counseling. Dr. Port says this is the most critical part of genetic testing. What does genetic counseling mean? Well, if you get a positive result back, how are you going to cope with that news?
“If someone gets a genetic test result back, it’s really important for them to know what is this? (What does this) mean for them? Put it into context.”
“What does it mean for their family members? For their relatives? Genetic counseling to follow up genetic testing is a really, really important part of the whole process and is not always available in the direct to consumer type avenue.”
Based on your personal and family health history, your doctor can refer you for genetic counseling, according to the U.S. Centers for Disease Control and Prevention.
What to Know About 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 who have 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.
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.
Screening For Breast Cancer
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.
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
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 who have a family history to really get [genetic testing],” Dr. Ginsburg previously told SurvivorNet.
“I would say that if you have anyone in your family who was diagnosed with a very 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,” Dr. Ginsburg adds.
Contributing: SurvivorNet Staff
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