Many—including her team of doctors—would call Olivia Munn's experience with fighting breast cancer “aggressive.” She uses the word, too. In fact, it comes up 12 times during the afternoon I spend with her in upstate New York. “Doctors kept telling me I have an aggressive cancer,” the 43-year-old actor says of the diagnosis: luminal B breast cancer found in both of her breasts. “Aggressive cancers need aggressive treatments.”
When she picks me up at the Metro North train station, we’re both bearing gifts: Mine, hot pink peonies, yet to bloom; her, two homemade vanilla chai lattes. Behind the wheel of the black SUV, she’s casual in jeans and a chambray top, her long hair wavy, and wearing large round reading glasses. During our drive to the family’s temporary East Coast home, we keep it light and chat about our nails (neutral pink and turquoise sparkles, respectively) and the books we’ve recently read. This is Munn’s home base with partner John Mulaney, 41, and their two-year-old son Malcolm while she films Apple TV's Your Friends and Neighbors through the summer (otherwise Los Angeles is home). The day I visit, Mulaney, with whom she has been partnered since 2021, is in the family’s hometown filming Everybody’s in LA for Netflix, but Malcolm can be heard playing with a nanny in the kitchen.
Everything is so casual about the experience, from Munn carrying in wood from the pile outside and building us a fire in the beige-decorated living room to sitting down in overstuffed chairs with our legs curled beneath (we’re both barefoot, having ditched our shoes at the door), that it almost feels unnatural to pull out my recorder and launch in with: How are you feeling?
“Better, finally,” she says. It’s time to discuss everything that’s happened to Munn in the past year. In April of 2023, she received an incredibly unexpected diagnosis: after genetic testing came back negative for the breast cancer gene (BRCA), as well as a series of clear mammograms and an ultrasound (a necessary precaution if you have dense breasts, like Munn), she was diagnosed with luminal B breast cancer in both breasts because her ob-gyn calculated her Breast Cancer Risk Assessment score at 37%, which was high enough to merit an MRI. Masses were detected, and once a biopsy was done, her doctor, Thaïs Aliabadi, MD, called with her professional opinion. “I couldn't take any risks with Olivia's life,” she tells Vogue. “To minimize the chance of any abnormal cells remaining, I suggested a double mastectomy, giving Olivia the best opportunity to beat her cancer.”
Instead of leaving for a new film project, Munn went all in on treatment. “You start thinking about your mortality differently once you have a baby,” Munn says. The boys were there by her side every step of the way in Los Angeles. “Olivia and I have been through a lot of things together in the past couple years,” Mulaney says, speaking for the first time days later over the phone. “Just side-by-side, supporting each other through anything. And as her guy, I felt both scared and protective. Even with Malcolm in her lap and me there holding her hand, she was going to be physically fighting this disease alone.”
Munn recruited a team of doctors and created an intensive treatment plan that included undergoing four surgeries in a total of ten months: a full double mastectomy where all the tissue in her breasts was removed, a lymph node dissection, reconstructive surgery, and an innovative procedure called a nipple delay. “I knew there was cancer happening inside of me, which was already giving me a panic,” she says of why she elected to try the nipple-saving procedure (Angelina Jolie did the same thing during her mastectomy a decade ago), versus opting for photorealistic nipple tattoos. “And I knew that they were going to take everything out of my breasts, but that was all on the inside. When I realized things were going to change in ways people could see, too, I really realized things were going to be different.”
Phase two began in November of 2023 and involved purposefully sending her body into menopause. Dr Aliabadi describes luminal B breast cancer as a hormone receptor-positive type that feeds and grows in the presence of estrogen. The standard course of action is a prescription of the estrogen-suppressing drug Lupron, which simultaneously halted Munn’s ovaries from producing estrogen and zapped her of all her energy. “The side effects of the medication hit me almost immediately,” she admits. “It was next-level, debilitating exhaustion. I would wake up in the morning and almost immediately need to get back into bed. If you asked Malcolm, ‘Where does daddy work?’ He'd run to his [Mulaney’s] desk, and if you asked him, ‘Where does mommy work?’ He'd point to my bed. It was so sweet. But at the same time, it was breaking my heart because this is his image of me.”
So she asked her doctors if there was any alternative to the drug, which was what led to the fifth significant surgery in her cancer journey, which she’s ready to talk about today: “I have now had an oophorectomy and hysterectomy. I took out my uterus, fallopian tubes, and ovaries.” It happened just last month.
This wasn’t a choice Munn made lightly, as it meant she could never carry any future children—but it was the obvious one, given her options: She needed to remove the hormones from her body to keep her cancer from returning, so it was either stay on Lupron and remain bedridden or rid her body of the reason the hormones existed in the first place.
“It was a big decision to make, but it was the best decision for me because I needed to be present for my family. I had friends try to cheer me up by saying, ‘Malcolm’s not going to remember this. Don't worry.’ But I just kept thinking to myself, ‘I'm going to remember this, that I missed all these things.’ It's his childhood, but it's my motherhood, and I don't want to miss any of these parts if I don't have to.”
The days after surgery were painful, Munn says, but in less than a week she was on her way to feeling back to normal. “I did have one real moment of panic,” she reflects. “A real breakdown. Because it’s just so strange when you’ve been with this body your entire life, had your period for so long, feel when you’re ovulating, and all of a sudden it’s gone.” She’s telling me about the relief, too, for her returned ability to get (and stay) out of bed when we’re interrupted by a little boy with a bowl cut at the door—Malcolm. He’s in search of a sparkling blue bouncy ball, which we find together, stored away in a bag of toys.
After he leaves the room, Munn beats me to the topic of kids, asking if I want them. I tell her about my beloved niece, named after my late mother, and how I do want kids but am crippled by the anxiety of passing along family genetic illnesses. We discuss recent breakthroughs in genetic testing, in-vitro fertilization, and egg freezing and Munn steps into big-sister mode, sharing that she has frozen her eggs three times in her life: at ages 33, 39, and recently at 42, in response to her diagnosis and how treatment can negatively impact or make it impossible to have children.
“It's interesting because my 33-year-old eggs were great. My 39-year-old eggs? None of them worked. As you get older, one month can have great eggs, the other not so much. Clearly, the month we did at 39 was not a good month. After my diagnosis, we decided to try one more round of egg retrievals and hoped it was a good month. John and I talked about it a lot and we don't feel like we're done growing our family, but didn't know if I would have to do chemotherapy or radiation.” Both of those treatments can dramatically affect a woman's fertility.
Her doctor put her on a special cancer protocol for egg retrieval—she couldn’t pump herself full of hormones in an attempt to hyper-ovulate, because even post-mastectomy, there was a risk she could be encouraging nascent cancer cells to grow. Instead, Munn’s course of treatment involved lower doses of hormones. “We just wanted a few more eggs,” she said. “At my age, one in every 10 eggs are healthy, and we were hoping to make one embryo from this retrieval.” But because of the cautious cancer protocol, the doctors were only able to get seven—down three from the goal, but still okay—to try to turn into embryos. from there, the hope was to get one single, healthy embryo.
While she and Mulaney waited to hear back, Munn leveled with her partner: For her to feel comfortable going through with any fertility-halting treatment, she needed to know the future of her family was viable, and it all rested on these embryos. If they didn’t come back healthy, she wanted to try for another egg retrieval round, even though she understood the risks.
“A few hours later, we got the call from my doctor,” she says. “He shared that we had two healthy embryos. John and I just started crying. It was just so exciting because not only did we get it in one retrieval, but it also meant that I didn't have to keep putting myself at risk. It was just amazing.”
With this reassurance, Munn began the process that's led her to today—and now, she's focused on the present. “We are very protective of our little life, but I knew from the day she was diagnosed that the risk assessment test her doctor had done open-and-shut saved her life,” Mulaney says. “So, while we like to lead our life privately, I was completely supportive of Olivia sharing her story.” On March 13th of this year, she shared her diagnosis on Instagram, encouraging women to use the tool to calculate their own lifetime risk score and schedule doctor appointments (and the call to action worked, with over 23,000 people sharing their stories). When it comes to the future of their embryos, Munn is cautiously optimistic.
“When you're pregnant with your own baby, it’s like teamwork—you and the baby working together to make their little life come true,” she says. “You’re doing all this work to eat well, try to not have anxiety, just do all the right things during the pregnancy. With a surrogate, you have to try to go find a version of yourself somewhere out in the world. Somebody that you trust as much as yourself to live their life as a pregnant woman the same way that you would. But a surrogate isn’t a scary prospect to me anymore because there’s nothing I can do. I don’t have the ability to carry a baby anymore, so if we want to build our family, this is our option. This journey has made me realize how grateful I am to have options for not only fighting cancer, but also having more children if we want, because I know a lot of people don’t have those options.”
For Munn, this time of physical healing is one for mental and emotional healing as well.
“A friend-of-a-friend who went through breast cancer has become a sort of guide for me,” Munn says, talking about fellow actor Jessica St. Clair, who has been in remission from estrogen-positive breast cancer for nine years. “I appreciate how direct she is, she doesn’t sugarcoat anything—I just need somebody to tell me what an experience will be like.”
Both women recount a story from the first conversation they had: “I told her something that a fellow breast cancer survivor once told me when I was crying,” St. Clair says. “The woman told me, ‘You won’t believe me now, but you’re going to be happy you went through this one day.’” It’s been a little over a year since that conversation, which feels like a great time to look back and ask, was St. Clair right?
“I’m not there yet,” Munn admits. “But I’m on my way.”
In this story: Hair, Gonn Kinoshita; Makeup, Daniel Martin; Visual Editor, Olivia Horner; Photo Assistants, Geoffrey Leung and Nuvany David; Fashion Assistant, Patti Creamer; Production: Fujio Emura.
