Former “Bachelorette” Katie Thurston confirmed Friday on Instagram that her breast cancer is Stage 4 and has spread to her liver. In a candid update to viewers, set 43 days after she received a cancer diagnosis, Thurston shared that she has not started treatment yet due to testing and her decision to “focus on fertility” beforehand.

Katie Thurston called out those “judging” celebrities pursuing surrogacy — because she likely will turn to that alternative to start a family, too, given her cancer diagnosis. The “Bachelorette” alum was asked in a Q&A via her Instagram Stories Friday if doctors had informed her whether she would “have to” go the surrogacy route to expand her family with husband Jeff Arcuri.