Scanxiety and Breast Cancer
It’s natural to feel anxiety before, during, and after a cancer imaging scan. This type of worry even has its own name: scanxiety.
“With scans, there’s a loss of control,” says Lisa Sevanick, LCSW, a breast cancer social worker at NYU Langone Health in New York City. “You may or may not know what’s going on in your body, and that can bring up anxiety.”
Wanting to postpone or cancel a test due to these fears is understandable, but doing so can delay important results that may negatively impact your health. Complying with your scan schedule ensures you get appropriate care — and that could save your life.
Scanxiety can affect people who were just diagnosed, have been through many scans, and/or are living with early-stage or metastatic disease. It can look different depending on your diagnosis. For people with early-stage breast cancer, the many unknowns about what lies ahead can lead to fear. For people with metastatic breast cancer, scanxiety may be more intense, as they navigate more frequent scans. However, prior knowledge and experience can be helpful for developing strategies for receiving results, Sevanick says.
Signs of scanxiety
Many people diagnosed with breast cancer feel fear and worry about the future. The main difference between general anxiety about breast cancer and scanxiety is that scanxiety is tied to upcoming scans. Once the scans are over, the anxiety usually settles.
Be on the lookout for any of these symptoms of scanxiety:
worrisome and constant thoughts: thinking about the what-ifs of recurrence or progression or remembering past scans
racing heartbeat
shallow breathing
difficulty concentrating
trouble sleeping
Stages of scanxiety
Scanxiety symptoms can start as soon as you schedule your next imaging test and last through when the results of the test come in. It can show up in a number of ways, such as the fear of a new finding, worries about whether treatment is working, or anxiety about a change in disease status. It can even affect people without cancer who go in for routine screening, particularly those at a higher risk for cancer. “It depends on where the person is and their mindframe,” Sevanick says.
How to manage scanxiety
Each person copes with scanxiety differently. Sevanick offers the following suggestions.
Check in with yourself
Before your scan, it’s important to acknowledge your feelings, Sevanick says. “Validate that it’s appropriate to be a little nervous,” she says. Ask yourself: What part of the process makes you the most nervous? Getting to the source of your worries can provide some clarity.
Talk with your healthcare team
If you’re feeling worried about what to expect, prepare questions to ask your healthcare team beforehand. Are you unclear about how you’ll get your results? Ask your doctor what to do if they come in on your patient portal before you hear from them. That can help you feel prepared, Sevanick says.
Reach out to a friend or family member
Opening up to a familiar person can bring comfort when you’re feeling worried. You might find the person is quick to respond with “you’ll be fine,” or a similar comment. That’s natural, Sevanick says: We don’t like to see our loved ones uncomfortable or nervous. You might preface your talk with “I’m just looking for someone to listen.”
Bring someone, if it helps
Some people like to have a friend or family member go with them to their appointment on the day of the scan. Others prefer to go alone so they can get in and out. Do what feels best for you.
Talk to a mental health professional
There’s nothing wrong with seeking some extra help if you need it. A therapist and/or medication can be valuable tools in your toolbox for coping. As kaynotrealname shared in the BreastCancer.org Community, “If you need some medication in order to help you function while undergoing the stress of the wait, don't hesitate to ask for that.”
Tell the technologist you are nervous
If you’re feeling anxious when you arrive for your scan, let the tech know, as he or she can help support you through the experience. “It may help the tech take their time or explain things as they are happening,” Sevanick says. Even just stating out loud that you’re nervous can ease some of your tension.
Focus on your breath
It sounds cliché, but it really does work. Try box breathing (also known as square breathing):
Inhale through your nose for a count of four.
Hold your breath for a count of four.
Exhale through your mouth for a count of four.
Hold your breath for a count of four.
Repeat 3-5 times.
If that’s too much, even just taking one or two deep breaths before or during a scan can be grounding. But be aware that for some types of scans, deep breathing could blur an image, so ask the technologist if it’s OK for you to do so.
Try guided visualization
During the scan, you can also try picturing yourself in a peaceful place like a beach or in nature, Sevanick suggests. Research shows that this activates the parasympathetic nervous system and engages your senses, shifting your focus away from the anxiety.
Know how you’ll receive your results
After the scan, be sure to ask how you’ll receive the test results. Ask about any flexibility you have: For example, you may be able to request that results aren’t sent directly to your patient portal. You could also set up an appointment with your physician to discuss the results, instead of just reading them on your chart. This gives you some control, Sevanick says.
Have something to look forward to
Make a plan to do something fun after the scan, like get a manicure or meet a friend for coffee. It’s completely normal if it takes time for symptoms of scanxiety to resolve, so distracting yourself with something you enjoy can help you find some peace.
Find support in community
Connecting with others who are dealing with scanxiety can also help you process how you’re feeling. Sevanick, who leads support groups for people with breast cancer, says that hearing your experience reflected back is validating.
“It’s a camaraderie of being in a community of people going through the same feelings at the same time,” she says. “It’s the spirit of walking the same path and connecting with others in a safe, supportive space.”
Vocalizing your experience is a big part of it, she adds. “When you hear yourself telling your own story, you may even learn some new things about it. It’s a way to hear your own thoughts that you hadn’t caught up with in your own mind. Or you might say something that really helps another person.”
A support group isn’t the only way to find community, though. If you’re feeling especially anxious, hearing stories in a group setting might be triggering. Sevanick suggests one-to-one peer support, offered at many hospitals and medical centers, which matches patients to trained volunteers who often have lived experience.
Tips from the Community
The Breastcancer.org Community is another place where you can connect with others about scanxiety. They offered these tips:
“I try to keep busy and continue to do normal work and household tasks in the weeks leading up to scan day. In the few days before and the day and night before I listen to a lot of music and playlists that I have created to keep me in a good headspace.” —Susan Rahn
“Meditation works for me (usually). One step, one moment at a time.” —casey714
“Can you try to think of mammograms and other scans as routine maintenance? I have to get both mammograms and CTs, now just annually, and I've found it really helps to think of it as taking the old car… in for a routine oil change. If they find a problem, it's caught early before it becomes a big problem. Or think of scans as our robot friends, who exist to help us.” —alicebastable
“Lately, what’s helping me most is the thought ‘I am not alone.’ So many people around me are facing, or have faced, scary medical things, and those that won’t probably will if they live long enough. I haven’t been singled out for the universe for some kind of special persecution here, it’s just my turn.’”—purplecat
“Scanxiety SUCKS! I do look at my patient portal, remind myself I don't have a medical degree, and do NOT let myself talk with Dr. Google.” —kotchaj
“Something that's helped people I know with getting rid of anxious thoughts and emotions is doing something with your body that is in your current ability to do.” —supportforamy12