When Katie Thurston envisioned her 2025, she pictured herself planning a wedding, moving to New York City, and starting a family with her fiancé.
Cancer was never part of the plan—but it became her sole focus a few weeks ago after she was diagnosed with Stage 4 breast cancer at just 34 years old.
“I was not prepared for the 2025 that I’ve been having so far,” Thurston told Health in an exclusive interview.
Since then, the former Bachelorette has been vocal on social media about navigating life with breast cancer—a disease that is increasingly affecting young women like her at alarming rates.
“It’s not out in our faces the way it needs to be that breast cancer is happening for women under 40, women under 30,” Thurston said. “If I had someone last summer doing what I’m doing now that was within my circle, I would have gone to the doctor a lot sooner.”
In the summer of 2024, Thurston discovered a lump in her breast. It was pea-sized, felt like rubber, and hurt—which made her think it couldn’t be cancer.
“You think, ‘I’m a young woman. Breast cancer doesn’t hurt,’” she said. “I just didn’t take it seriously.”
Thurston was right, to an extent. Many sources—the American Cancer Society, the Breast Cancer Research Fund, even previous Health articles—say that pain is not commonly a sign of breast cancer. But cancerous lumps aren’t always pain-free.
Thurston also had a benign cyst removed from her breast in the past, so she assumed her new lump was also non-cancerous.
Those two things led Thurston to put off mentioning the lump to a doctor. So when she finally got an appointment in early 2025—just a “tune-up,” she said—it led to a cancer diagnosis she wasn’t expecting.
Katie Thurston
A cancer diagnosis at 34 meant Thurston and her then-fiancé, now-husband Jeff Arcuri would have to fast-track their family planning.
Cancer treatments can disrupt fertility, sometimes permanently. Because Thurston and Arcuri still wanted the option to have biological children, they decided to undergo in vitro fertilization (IVF) and harvest the embryos before starting treatment.
“IVF alone is such a hard thing. It’s a hard thing physically and mentally on its own. Anyone going through oncofertility, dealing with IVF and cancer at the same time—it’s a beast,” Thurston said. “You start off with these high hopes, and you see how quickly 17 eggs then turn into two embryos.”
IVF also took a physical toll on Thurston. She needed daily shots—which she hates—and it took two weeks to physically recover from the egg retrieval. But she didn’t express any regrets.
“As much as it’s crazy that we did it in the order that we did and under the circumstances that we did,” Thurston said, “it does feel a little bit reassuring that there’s hope that we have these two embryos that are just waiting for us when the time is right.”
When Thurston first learned of her breast cancer, her doctors in California gave her a Stage 3, triple-positive breast cancer diagnosis. But weeks later, when Thurston moved from California to New York City, she got a new cancer team—and a new diagnosis.
Thurston’s new care team determined she actually had Stage 4, hormone-positive, HER-2 negative breast cancer that had spread to her liver. Thurston learned this new diagnosis just 24 hours before starting treatment for her previous diagnosis, which would have included chemotherapy.
HER2-negative cancer grows more slowly than HER2-positive cancer, and it responds to different treatments. For Thurston, this meant no chemotherapy. Instead, she was prescribed two oral medications and a monthly injection.
“Chemo is a very heavy thing, and I think everyone can agree if they can bypass it, that’s going to be their preference,” Thurston said. “I felt hopeful. In a weird way, I felt religious.”
On her new treatment plan, Thurston will now wait for those three medications to shrink her tumor. Eventually, she’ll likely have a surgery called a double mastectomy to remove both breasts.
Thurston is aware of the fear surrounding Stage 4 cancer diagnoses, and she wants to use her platform, in part, to help combat the stigma.
“Stage 4 isn’t the end, as people view it to be,” Thurston said.
“Stage 4 is very much treated now as more like a chronic illness,” she added. “[It’s] something we just maintain forever, as opposed to a timer on our life.”
Thurston remains hopeful that she’ll one day be in remission, or as close to it as possible. In explaining her condition, she refers to her cancer as “little teenager punks” building an army of cancer cells.
“It’s very possible, on a scan in the future, that there’s no army. You can’t even see it—no evidence of disease,” Thurston said. “But we know medically it does exist in there somewhere.”
Along her journey, Thurston said she’s found support in breast cancer survivors. Having lived through the same disease, this community has been the “biggest wealth of information,” Thurston said.
“The community of people—they say, ‘Worst club, best members.’ And it’s so true,” she added.
But that hasn’t been her only form of support. Arcuri, a stand-up comedian who postponed his world tour following Thurston’s diagnosis, has been her rock.
“I don’t know how I could have done all these early steps without him,” Thurston said. “Those first beginning stages of discovering your cancer and all the tests that go with it are the most important times to have a support system.”
In her cancer journey so far—from finding a lump, to getting diagnosed (and re-diagnosed), and building a community—Thurston said she’s learned that being proactive and advocating for yourself is essential after a difficult diagnosis.
“I want to encourage people to be their biggest advocate and be brave,” Thurston said.
“I think we push it off as much as we can out of fear or not taking it seriously, but there is so much you can do for yourself by being proactive,” she said. “Cancer itself is curable the earlier you detect it.”
