Managing “Scanxiety”
Written by: Rebecca L. Marshall, Ph.D.
The term “scanxiety” commonly refers to the anxiety, worry, and fear associated with post-treatment follow-up imaging. A follow-up MRI or CT scan months to years after enduring cancer treatment can lead to overwhelming feelings of anxiety in anticipation of the imaging results. One of the reasons for such anxiety is that parents and children who have undergone cancer treatment have learned, in profound ways, how unpredictable cancer and its treatment can be.
Managing one’s own “scanxiety” is complicated enough for an adult cancer survivor who undergoes routine follow-up imaging; it becomes even more complicated for the parent who is guiding his or her child through the process of follow-up scanning. Parents often must manage their own anxiety while navigating how to best help their children deal with their feelings.
Given the potentially overwhelming nature of such anxiety, it can be helpful for both parents and children to follow anxiety prevention and reduction techniques during the weeks, days, and even minutes before the imaging takes place. Here are some ideas for reducing the stress associated with follow-up scanning.
Positive Self-Talk: When worry or rumination begin to creep into your – or your child’s – mind, remember that checking for recurrence does not mean re-experiencing past trauma associated with the original cancer diagnosis and treatment. Remind yourself to take each moment as it comes, knowing that you and your child will process new information if needed, when needed. Try to turn negative thoughts into positive ones by imagining yourself and your child facing any new problems with courage, and resolving them successfully, one day at a time.
A Celebration of Self-Care and Wellness: Checking for cancer recurrence may naturally lend itself to worrying about the future. Refocusing your own thoughts and your child’s thoughts on the fact that together you have overcome important past struggles can become a moment of triumph and celebration. Follow-up scanning can be a reminder of victory rather than a trigger for excessive worry. Turn the experience into a moment of positive affirmation of your past resilience in the face of adversity.
Laughter – and Smiles – Are the Best Medicine: Before the scan, plan an event or outing that brings laughter and joy to you and your child. Sharing a special meal together or scheduling a “field trip” to a museum, mall, or sports event can help redirect your mind and your child’s mind away from future scan results and toward present, happy moments that you share together. Creating joyful and meaningful memories before the follow-up scan may later serve as a focus and source of comfort to ease worry and fear during the actual imaging process. Reminding yourself and your child to smile periodically in the face of tension and stress can itself also have powerful calming effects.
Practice Mindful Awareness: Despite your best efforts to refocus your thoughts from negative to positive ones, and to lighten your mood through laughter and creating happy memories, “scanxiety” may still take hold – in the waiting room, during the scan, or any time before or after the appointment. When managing your worry or racing thoughts becomes overwhelming, practicing mindful awareness by centering your attention on breathing exercises (taking slow, deep breaths while closing your eyes, relaxing your muscles, and centering your thoughts on how inhaling and exhaling feels) can help shift your attentional focus away from future test results and toward your own control of physical experiences and sensations. Centering your attention on those things within your control, including your awareness of your own breathing and intentional muscle relaxation, can help you to regain a sense of calm in the midst of potentially difficult circumstances.
Create an Action Plan: Create an action plan with your son or daughter to manage possible anxiety surrounding a scan. Talk about your worries and fears ahead of time, and agree together on a plan to reduce stress. The plan may include practicing healthy habits, like eating and sleeping well in the days leading up to the appointment, as well as specific plans when anxiety may become prominent. You and your child may want to decide in advance what kinds of happy memories to focus on while in the waiting room, what prayers you may want to say, or how you will refocus attention away from automatic negative thoughts and toward positive ones. You may want to practice deep breathing exercises and mindful awareness of your physical state prior to the appointment so that you have a go-to tool for calming yourself and keeping anxiety at bay. Having a plan of what to do in the face of stress will help you and your child feel prepared if you experience expected, or unexpected, “scanxiety.”
Rebecca L. Marshall, Ph.D. is a licensed psychologist and staff therapist at The Summit Counseling Center in Johns Creek, GA. She completed her post-doctoral fellowship at U.T. M.D. Anderson Cancer Center (Division of Pediatrics, Children’s Cancer Hospital, 2000-2002), and has over 15 years of clinical and research experience working with children and adolescents, and their parents.