The Power of Looking "Normal" While Battling Metastatic Breast Cancer
"Do you feel guilty for appearing healthy when you have stage four breast cancer?" This profound question, posed by Katie Thurston, a former Bachelorette star, on her Instagram channel, Boobie Broadcast, struck a chord with many. With over 60,000 members, including survivors, medical experts, and supporters, her platform has become a safe space to discuss the often-overlooked reality of living with metastatic breast cancer.
Thurston's honest response was eye-opening: "I'm exhausted, my body aches, my hair is thinning, my hormones are disrupted, my memory fails me, my intimacy suffers, my hands and feet feel restricted, and I've had to make difficult choices about my fertility and future. So, no, I don't feel guilty for looking normal. I want others in my position to know they shouldn't either."
Her words resonated deeply with me, as I, too, am a metastatic breast cancer survivor. It's a powerful reminder that appearances can be deceiving.
Metastatic breast cancer, or stage four, is a silent struggle for many. It's a disease that can lurk beneath a smile, a secret carried by those who continue to move forward, even as time ticks on.
Dr. Devika Gajria, a breast medical oncologist at Memorial Sloan Kettering Cancer Center, emphasizes the variability of the experience: "The biology of the cancer itself plays a significant role. Some undergo weekly chemo, while others manage with monthly injections. The treatment journey is unique for each person."
A concerning trend is the rise in young women receiving stage four diagnoses. According to the Breast Cancer Research Foundation, an estimated 200,000 women in the U.S. are living with metastatic breast cancer as of 2024, with the steepest increase seen in women aged 20-39, at nearly 3% annually.
But there's hope. Dr. Gajria highlights the advancements: "We've made significant progress in the last decade, with more treatment options, improved medication delivery, and better management of side effects. For some, it's becoming a chronic disease rather than an immediate life-threatening one."
The approval of novel therapies in the last ten years has led to improved survival rates, offering a sense of normalcy to more patients.
Thurston shares, "Some days, I forget I have cancer. But there's no finish line. It's a constant decision-making process: ovaries, breasts—it's all on the table."
The heartbreak of metastatic disease lies in the loss of control. Dr. Gajria explains, "When a malignancy takes over, requiring constant management, it changes our life narrative. We know it's there, quiet now, but it could become more aggressive. It's a destabilizing force."
Uncertainty is a constant companion. While no one knows what tomorrow holds, a metastatic diagnosis amplifies this uncertainty. What's visible on the outside often belies the internal battle.
I've undergone a bilateral mastectomy, and my right femur, where the cancer spread years ago, now has a metal rod. My body is a map of survival, marked by scars, tattoos from radiation, and numbness—reminders of my journey.
Dr. Gajria adds, "It's challenging when people don't see the impact on your face, skin, or hair. We often associate cancer with a gaunt appearance and hair loss. But many patients are on different journeys, still fighting."
Thurston emphasizes the non-linear nature of healing: "You'll have highs and lows."
Metastatic breast cancer teaches us about perspective and the fragility of life. Each day becomes a celebration of the ordinary, a reminder to cherish time.
Thurston believes cancer can make us better: "I've embraced my body. I'm grateful to be alive. Cellulite, rolls—who cares? I'm just happy to be here, to have a body. Wrinkles? It's a blessing to age."
The night before our interview, I saw Thurston at The Pink Agenda's Annual Gala, looking radiant. Cancer was not the topic of our brief chat.
That's the beauty of it—you never truly know what someone is going through.
Less than 24 hours later, we discussed her scanxiety before her six-month checkup. It's a rollercoaster we ride together, oscillating between hope and fear, living fully yet waiting quietly.
Thurston believes in the power of support and funding: "Stage four is not the end. We're active members of society, and we need help."
Metastatic breast cancer may be invisible to some, but those living with it are not. We are here, alive, and moving forward.
