How to Deal With “Scanxiety”
If you’re living with lung cancer and you have a scan coming up, you’re probably already bracing yourself for the date. Scans have been well documented to trigger stress; in fact, the term “scanxiety” was coined by a cancer patient who wrote about his experience in Time magazine in 2011. Navigating the days before a lung scan—a procedure that looks for pulmonary nodules—can be challenging, so we asked those with experience on both sides of the PET machine for advice on maintaining sanity before and after the big day.
Why Do Scans Trigger Us?
Receiving health news of any sort is anxiety-provoking, says Shanthi Gowrinathan, M.D., a psychiatrist who specializes in psycho-oncology at Saint John’s Cancer Institute at Providence Saint John’s Health Center in Santa Monica, CA. Then there’s the process itself, which happens between every three months to once a year and can be frightening: “PET, CT, and MRI machines are not the friendliest places,” she points out. “They make loud noises and are confining.” And of course, the biggest trigger is that a scan is likely how you got your cancer diagnosis in the first place, and how you’ll know if it’s back.
Feeling anxious before a scan is a normal human reaction, Dr. Gowrinathan says, but calling it “scanxiety” may not be helpful. “It’s hard enough going through cancer treatment; it’s not useful to pathologize things you have to go through,” she says. Instead, acknowledge that a scan can trigger some scary feelings, says Ivy Elkins, a 54-year-old from Buffalo Grove, IL. The seven-year lung cancer survivor and Lung Cancer Foundation of America speakers bureau member gets a neck and chest scan every three months, and a brain MRI every six months. “Over the years, there have been times when it’s been easier and more difficult,” she recalls.
Realizing how much anxiety the waiting period causes, Elkins schedules her scans and appointments to review the results for the same day. That way, she reduces the period of intense waiting to just a few hours. Most doctors and oncologists understand the added stress of dragging out the process and can often accommodate same-day or next-day reviews—so be sure to ask. Another tip: Unsubscribe from appointment reminders on your smartphone calendar. That way, a simple MyChart notification on your phone won’t trigger your anxiety a day early, Elkins says.
Connect With Community
Chances are there’s a built-in support network (check out lungevity.org) with your type of cancer who will understand what a scan date means without any explanation. As supportive as her immediate family is, including her husband of 25 years and two young adult sons, Elkins finds that before scans, it’s more comforting to turn to people who’ve been there themselves and speak the same “cancer language.” Routines are helpful, too, she says, and in non-pandemic times she likes to meet a lung cancer friend for breakfast the day before her scan.
Like many cancer patients, Elkins has learned to shift her thinking to focus on the present and “on what matters right now as opposed to planning too far in the future.” Of course, that’s easier said than done. For Elkins, delving into research advocacy for lung cancer has been “better than therapy.” She co-founded the research advocacy group EGFR Resisters in 2017, and has helped the group expand to more than 75 countries. But when she has a scan date approaching, she also finds a good book or Netflix series to get lost in (the only prerequisite is that none of the characters have cancer, she says).
Find a Stress Reducing Technique That Works for You
“I wish I could tell you there’s some secret sauce,” says Anil Vachani, M.D., a pulmonologist and co-director of the Lung Cancer Screening Program at the University of Pennsylvania's Perelman School of Medicine in Philadelphia. But, as he tells his patients, use whatever works for you to reduce other sorts of stress, whether it be yoga, exercise, good sleep, or meditation. Research has shown that even one hour of mindful meditation can reduce anxiety. For Elkins, that means sticking to a routine, which includes logging daily miles on her treadmill.
Remember, Feelings Are Temporary
As a psycho-oncologist, Dr. Gowrinathan advises patients to keep this concept front and center: “Understand that your feelings in the moment are powerful, but they will pass,” she says. That’s not always easy, of course. But if this isn’t your first scan, draw on your experience of having done it before and feeling differently on the other side, she suggests. “In the moment it feels like it is unbearable,” she acknowledges. “But the way you’re feeling now is not how it’s actually going to be.”
Tap the Care Team
Some patients will need more than positive self-talk (as powerful as it can be). Most hospitals and cancer centers have psycho-oncologists—like Dr. Gowrinathan—on staff to help manage more extreme anxiety. In some cases, that can include short-term anti-anxiety medication. “As a psychiatrist, I can offer patients medications they can take as needed, particularly for longer scans where you need to stay still,” she says. “When someone has claustrophobia or panic around scans, we can use medications to help them tolerate that process.”
Know When to Stop
For those who don’t have a lung cancer diagnosis, screens create anxiety despite the relatively low risk of finding cancer, Dr. Vachani says. Fortunately, unlike some cancers, lung cancer has clear guidelines about when screens should stop, he says. If the lesions under scrutiny are solid (obscuring the underlying lung structures), they only need to be scanned regularly for two years. A small subset that appear fuzzier may need a close eye for two to five years. So, when your care team recommends an end to the checks, take a big breath of relief and agree.
- Scanxiety: Time Magazine. (2011.) “Scanxiety.” content.time.com/time/specials/packages/article/0,28804,2075133_2075127_2075107,00.html
- Meditation Study: Experimental Biology. (2018.) “Single Session Mindfulness Meditation Reduces Aortic Pulsatile Load and Anxiety in Mild to Moderately Anxious Adults.” faseb.onlinelibrary.wiley.com/doi/10.1096/fasebj.2018.32.1_supplement.714.19
- Lung Cancer Screening Guidelines: Centers for Disease Control and Prevention. (n.d.) “Who Should Be Screened for Lung Cancer?” cdc.gov/cancer/lung/basic_info/screening.htm