Scanxiety—A Nearly Universal Experience Among Cancer Patients

After navigating cancer treatments such as radiation, chemotherapy, even surgery, you might think a standard follow-up scan would be a breeze.

But for the vast majority of cancer patients—upwards of 80 percent, according to a study in the journal Lung Cancer—these scans cause stress and anxiety, which can wreak havoc on patients’ ability to sleep, eat, even function in their daily lives.

There is even a name for the anxiety and worry that accompanies the period of time before undergoing or receiving the results of a medical examination (such as an MRI or CT scan): scanxiety.

When Worry Takes Over

“Scanxiety” may not be accepted medical terminology, at least not yet, but fear and worry about imaging, both before a scan and after while waiting for the results, is pervasive among cancer patients. Studies suggest that having a follow-up scan after cancer treatment can trigger symptoms of post-traumatic stress disorder (PTSD), including intrusive thoughts, irritability, and insomnia.

“The anxiety can begin even weeks before a scan,” says Lauren Shaffer, a licensed clinical social worker who works with cancer patients and facilitates a support group at New York Presbyterian–Weill Cornell Medical Center. “During the pre- and post-scan period patients may have trouble eating and sleeping. They may begin arguing with their spouse or falling down on the job. Some patients may seem preoccupied or withdrawn.” And for good reason: there’s a lot riding on each and every scan.

During treatment, patients worry about their regimen working. After remission, they worry about a recurrence. It’s like emotional roulette. The wheel spins patients around for days or even weeks before spitting out an answer: A cancer sentence or freedom from cancer-related drama—at least for another few months.

Techniques to Manage Scanxiety

So how do you prevent a scan from hijacking your very existence? Shaffer suggests trying these seven strategies:

1. Plan ahead. Since many scans occur at specific intervals throughout the year, you have a planning advantage. Consider which parts of the process make you anxious and devise a plan of action to make the experience easier. Too much time to ruminate before an afternoon scan? “Book the first appointment of the day, even if means waiting a few more days before you get the test,” says Shaffer. Bored in the waiting room? Ask a friend to join you. Fretting about the results? Book an appointment with a counselor for the period between the scan and your follow-up appointment. Knowing you have an appointment already on the books can ease anxiety about receiving test results.
2. Identify your go-to people. Cancer is a deeply personal experience, so it’s critical to identify a few people you can rely on during your weakest moments. “If you call your friend and tell her you’re worried about your scan and she launches into her own troubles, she’s probably not the best person to call,” says Shaffer. “Think about who won’t be negative, who will listen and hold you up. Then call them.”
3. Get some sleep. If you’re not sleeping, you’re more vulnerable to stress and anxiety. Plus, your immune system takes a hit. More than “rest and recharge,” sleep actually rejuvenates your body’s cells and tissues. Aim for seven to nine hours each night—especially in the days before a scan—and engage in a soothing bedtime routine an hour before turning in. Take a warm bath, meditate, or read a meditation or prayer book.
4. Shift your thinking. Rather than preparing to receive bad news, visualize the best possible scenario. Draw a picture in your mind of what you want the scan to show. Ground yourself there. There’s no point worrying about the future until you know there’s something to worry about. Remember, if something does show up your doctor and medical team will be there to help you address it.
5. Create a comforting ritual. Most cancer patients get scans at least annually, so it makes sense to come up with a soothing routine to help normalize the experience. It doesn’t matter which set of behaviors you do to mark the experience, just that you do them before every scan in the same sequence. Researchers speculate rituals act almost like mindfulness. They anchor you in the moment, providing stability during times of crisis. Perhaps that’s why clergy, attorneys, even Wall Street executives frequently engage in rituals to weather the storms that come their way.
6. Talk to your doctor. Not only can your doctor prescribe medications to help relieve anxiety and depression, but they can also connect you with a team of professionals, such as social workers and chaplains, who can help you better manage your emotions.
7. Zone out. If you spend a lot of time worrying in the days before your scan, schedule time to meditate, go for a walk, do some gentle yoga, or listen to a favorite podcast, suggests Shaffer. “Some patients create a ‘feel-good’ playlist to listen to in the waiting room.” Any healthy activity that takes your mind off the scan is something you should indulge in.

“The longer people live with cancer, the more they have to learn to cope with this recurring anxiety and find ways to manage it,” says Shaffer. “You can’t deny that scans make you anxious, but you can find ways to acknowledge it and comfort yourself through the process.”