Katie Thurston shed light on the emotional side of living with stage 4 cancer, her mental health journey.
Thurston, 35, shared on Instagram Stories that she is on her second month of taking Wellbutrin (bupropion), an antidepressant commonly prescribed to treat major depressive disorder.
“Having a mental health glow up this summer. On month 2 of Wellbutrin. Next on the list, a therapist that I like.” Thurston wrote.
The Bachelorette alum first announced her breast cancer diagnosis in February 2025 and underwent a double mastectomy in April this year.
She also acknowledged the realities of metastatic breast cancer, noting that surgery alone cannot eliminate stage 4 disease.
“It is impossible to completely remove cancer via DMX [double mastectomy] as someone who is stage 4,” she wrote. “Managing stage 4 as a ‘chronic illness’ long-term is possible. And I believe in the future of medicine.”
Emotional Distress Is Common After a Cancer Diagnosis
Mental health challenges are among the most common yet underrecognized effects of cancer.
Patients may experience anxiety, depression, fear, uncertainty and emotional distress throughout diagnosis, treatment and survivorship. While many people adjust over time, others develop persistent psychological symptoms that can interfere with treatment decisions, daily functioning and overall quality of life.
Depression affects approximately 15% to 25% of people with cancer, although rates may be even higher among those living with advanced or metastatic disease. Anxiety is also common, particularly while waiting for scan results or facing uncertainty about disease progression.
Why Mental Health Is Becoming Part of Standard Cancer Care
Increasingly, oncologists and cancer centers are recognizing that emotional well-being is closely tied to physical health.
Organizations, including the American Society of Clinical Oncology (ASCO) recommend routinely screening cancer patients for anxiety, depression and psychological distress, with referrals for counseling, psychiatric care or support groups when needed.
Untreated mental health conditions can reduce adherence to treatment, increase symptom burden and make it harder for patients to communicate with their care teams. Conversely, psychological support may improve coping skills, treatment engagement and quality of life.
Support can take many forms, including psychotherapy, peer support programs, mindfulness-based interventions and, when appropriate, antidepressant medications prescribed under medical supervision.
While antidepressants are not appropriate for everyone, they may help manage persistent depression or anxiety that develops during cancer treatment, particularly when combined with therapy.
Stage 4 Cancer Is Increasingly Viewed as a Chronic Illness
Historically, stage 4 cancer was often viewed primarily through the lens of end-of-life care. Advances in targeted therapies, immunotherapy and precision medicine, however, have changed expectations for many patients.
Today, some metastatic cancers, including certain forms of breast cancer, can be managed for years with ongoing treatment, allowing patients to maintain active lives while receiving therapy.
The National Cancer Institute notes that although metastatic cancer generally cannot be cured, treatment aims to control disease progression, reduce symptoms and preserve quality of life for as long as possible.
Rather than focusing solely on tumor response, clinicians increasingly emphasize helping patients manage fatigue, pain, sleep disturbances, financial stress and emotional health throughout long-term treatment.
Looking Beyond Survival
As more people live longer with advanced cancer, experts say success is no longer measured only in months or years of survival.
Mental health, emotional resilience and quality of life are becoming equally important outcomes.
Thurston’s openness about taking antidepressants while navigating stage 4 breast cancer reflects a growing recognition that seeking psychological support is not a sign of weakness but part of living as fully as possible during treatment.
