Coping with “Scanxiety” during and after Cancer Treatment

The anxiety surrounding having medical scans, such as a CT scan or MRI, can be overwhelming for many people.

The anxiety surrounding having medical scans, such as a CT scan or MRI, can be overwhelming for many people.

After a patient has endured rigorous cancer treatment such as chemotherapy, surgery, radiation therapy, or hormonal therapies, some people might assume that undergoing a follow-up test such as an x-ray, CT scan, or MRI would be an easy, uncomplicated part of the cancer treatment process.

However, the anxiety surrounding having scans – sometimes referred to as “scanxiety” – can be overwhelming for many people.

“The unpredictability of the outcome of a scan can be quite stressful,” says Laura Liberman, a breast imaging expert at Memorial Sloan Kettering and a cancer survivor. “Studies have actually shown that having a follow-up scan can trigger classic symptoms of posttraumatic stress disorder in breast cancer survivors.”

Posttraumatic Stress Disorder in Cancer Patients

Memorial Sloan Kettering psychiatrist Matthew N. Doolittle says that between 4 percent and 22 percent of cancer survivors have a risk of developing posttraumatic stress disorder (PTSD) at some point during their lifetimes. (1)

“People with more-advanced disease, more pain, or those who have suffered other types of trauma are at greater risk for developing PTSD symptoms during or after treatment,” Dr. Doolittle says.

PTSD symptoms such as intrusive thoughts, irritability, and sleeplessness can interfere with quality of life, social functioning, and work. Some symptoms, such as avoiding places or things that are reminders of traumatic events or experiences, may even cause patients to delay medical scans and other critical parts of their cancer treatment or post-treatment plan.

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Taking Control

Anxiety about having a medical procedure or an imaging test is completely normal. The key is to be able to take steps to prevent these emotions from taking over your life or affecting the quality of your care.

Cognitive behavioral therapy, which is available to Memorial Sloan Kettering patients through the Department of Psychiatry and Behavioral Sciences, can be an effective technique to help patients cope with anxiety caused by a cancer diagnosis and treatment. This approach focuses on redirecting the way patients think about experiences or things that trigger concern or anxiety. The key is to identify realistic statements that will help them cope with treatment or posttreatment concerns, and to discuss negative thoughts.

“One of my patients found it helpful to remind himself that ‘the past is the past,’ as he went for post-treatment scans and checkups,” says Memorial Sloan Kettering psychologist Katherine N. DuHamel. “Telling yourself that it’s only a matter of time before you relapse and other things that paint a worst-case scenario is not uncommon.”

Dr. DuHamel adds, “Such unhelpful thoughts can be identified during cognitive behavioral therapy and the evidence for, and against, these thoughts can be weighed. Patients are asked questions such as, ‘What else can you tell yourself?’ and ‘How else can the situation be interpreted?’“

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Tips for Reducing Stress

Dr. Liberman offers several other tips to reduce stress before having a follow-up scan:

  • Before your appointment, surround yourself with people who will help reassure you and put you at ease.
  • Pretend each appointment is a trip to the airport. That way you will be pleasantly surprised if you don’t have to wait, rather than disappointed if you do.
  • Schedule tests early in the day when possible to reduce waiting time.
  • If you are having a biopsy, ask your doctor about anesthetic (numbing medicine). For some procedures, topical anesthesia (cream or spray) available by prescription that can be applied on the skin before the biopsy may be helpful.
  • Distract yourself with music or by inviting a loved one to accompany you to your appointment.
  • Try relaxation techniques such as meditation or deep breathing. To learn these techniques, Memorial Sloan Kettering’s Integrative Medicine Service offers classes, a CD on self-hypnosis, and other resources. At-home tools are also available on our website.
  • After the scan, schedule an appointment with your doctor to discuss the test results.

“Knowing you have an appointment to speak with your doctor after the results are available can assuage a lot of anxiety about test results,” Dr. Liberman says.

To learn more, watch a video about managing scanxiety with Drs. Liberman, Doolittle, and DuHamel.

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  1. Andrykowski, Michael and Maria Kangas. “Posttraumatic Stress Disorder Associated with Cancer Diagnosis and Treatment.” In Holland, Breitbart, et. al, eds. Psycho-Oncology. New York: Oxford, 2010, p. 353.


Commenting is disabled for this blog post.

My biggest concern is for all of x-ray and cat scan tests ordered that may not be necessary especially after years of being cancer free. Isn't that risky?

Thank you for your comment! We spoke with Radiation Safety Manager Lawrence Dauer and Vice Chair of Radiology for Quality and Safety Raymond H. Thornton, and here is what they said: We know from our research that many cancer survivors have this question. X-rays, CT scans and other radiology tests that use radiation are commonly obtained after effective cancer treatment in order to verify that a patient¹s response to therapy is lasting. Additionally, early detection of a recurrence offers the potential for early re-treatment. The frequency and duration of follow-up scans are guided by the type and stage of cancer as well as an individual’s risk factors. We encourage patients to discuss the anticipated schedule for follow-up imaging with their doctors. When there is a medical indication to have tests like x-rays or CT scans, the potential benefits almost always exceed the small risks that may be associated with the low-level radiation from these tests. In some cases, MRI can substitute for CT scans, eliminating radiation exposure altogether. Ask your doctor if this might be an option for you. If you would like more information, you can call Dr. Dauer at 212-639-7391 or Dr. Thornton at 212-639-2463.

Wow! This came at a good time for me. I had a PET scan yesterday. The night before I had a dream that I was diagnosed with brain cancer and was told that I had a year to live. I have non-hodgkins lymphoma, diagnosed in 2002. I have been in remission for about 10 years. I had chemo and rituxin and now, for about 6 years, rituxin every 6 months with a PET scan. I usually have a little anxiety just before but this time, for some reason, it was stronger. I see my doctor tomorrow. Pray for good results! Thank you! Shirley

Thanks to Carrie at Sloan for pointing out this article to me. I think all cancer patients (or anyone needing to have a scan done) can relate to scanxiety! For 2+ years I've been getting scans and they always seem the worst around the anniversary of my diagnosis. It tends to show up as a blog topic for me all the time! This past December was the all-time WORST I've ever felt. So much so that I decided I needed to start doing things differently and utilizing the resources at Sloan better (acupuncture, pod-cast for self-hypnotism, etc).

Thanks for sharing this information.

Does one feel pressure when having a mammogram or does it hurt? I had a mammogram this morning and it hurt. Is that supposed to happen? I think that my tolerance for pain is fairly high, having had two children natural childbirth. The saving grace was that it didn't last too long but why does it hurt? The squeezing pressure was quite severe. I thought the new machines eliminated that.

We spoke with diagnostic radiologist Carol Lee, and she said that for most women, having a mammogram is uncomfortable because of the need for the breast to be squeezed in order to get a good picture. In some women, the mammogram is actually painful, though each picture only takes a few seconds. Even the newer digital machines require compressing the breasts.
There are a number of reasons why the breasts need to be squeezed in order to do the mammogram. First, compression minimizes overlapping tissue that could hide an abnormality. It also evens out the thickness of the breast so the exposure is uniform, so there are no areas that get too much exposure and others that don’t get enough. Finally, the thinner the thickness of the breast, the less radiation is needed to produce a clear picture. So, unfortunately, squeezing the breast is necessary, even with the newest equipment.
There a few things that might help. If you still have menstrual cycles and have increased tenderness during parts of the cycle, you can schedule the mammogram for a time when the breasts are least tender, usually the first week of the cycle. You can also try taking acetaminophen or ibuprofen about an hour before the mammogram.

My wife was diagnosed with breast cancer in january of 2013. It took over 7 weeks for her to start her treatment after the initial diagnosis. During that time, she had many diagnostic tests run and she was always waiting for results. Her levle of anxiety then, as she told me tonight, was far greater than it is while waiting for scans, although she is anxious about getting those results as well. Has any study been done on people during that initial phase to see what kinds of anxiety or what level of anxiety they are having?

I had breast cancer 2.5 years ago and getting scans is still terrifying because I'm afraid they will find something. Of course, realistically you want them to find anything if it's there, because we know it's so much easier to treat if it's caught earlier. But the signifcance of a recurrance isn't lost on me. My last scan I had to get a biopsy on some ultimately benign microcalcifications. Even though this time they told me they were pretty sure they were benign, 95% sure they were benign, it was still terrifying. I'm told this gets easier then longer you go with good scans, but still...

I'm currently waiting to hear back from my doctor after a recent CT scan. It's been 12 days, thought the doctor's office reported they got the images back from the scanning facility 6 days ago (having received the radiologist's report a few days before that).

I went to a new facility, closer to my home, so the scenario is different. However, my doctor has always scheduled an appointment to see him a few days after the scan. Repeated calls to his office still haven't resulted in any information.

I had the Whipple procedure in February 2012 (turned out to be ampullary rather than pancreatic cancer). So this is 27 months or so after the procedure, or around the time that a Stage I cancer that got out might show up on a scan.

Scanxiety might not be entirely related to the patient's approach, but also to callousness from doctors at times.

I'm getting my first scan in a few days after lung cancer treatment with chemo and proton therapy. Strangely the proton did not shringk my tumor beyond a 50% reduction by chemo. So I'm seriously stressed out. Additionally my esopahgus
was seriously damaged as a lymph node was close. There is concern over a possible fistula. Do you do fistula repair at Sloan Kettering?

Dear William, our doctors are skilled in managing the complications of cancer treatment. If you’d like to speak with someone about making an appointment, you can call 800-525-2225 during regular business hours.

I hope it's appropriate for me to ask this question on this site. I've never had cancer, but I'm terrified of getting it due to an article I read on CT scan safety. I had a CT scan of my head/brain in 1988 when I was 36 because of headaches. In 2007, at the age of 55, I had a CT parathyroid series for localization. I had failed surgery previously. This led to 2 more CT scans in 2008 due to an incidental mediastinal cyst finding of chest, abdomen and pelvis before and after contrast. In 2009, I fell down the stairs and had CT scan of my head/brain and then cervical spine in the emergency room because I hit my head. In 2014, I had another CT scan in the emergency room because of severe flank and back pain. My internist frightened me that all these CT scans could cause cancer down the road and then I read that frightening article. All the doctors said the CT scans were needed. Is my internist correct? How much have my chances of cancer been raised? There is a lot of cancer on both sides in my family. Thank you.

Sandra, we are not able to answer individual medical questions on our blog. However, we found a few articles about the safety of CT scans that you might find helpful.


and here:…

If you have questions, we recommend you contact the National Cancer Institute’s Cancer Information Service at 800-4CANCER.

Thank you for your comment.

I am an eight year breast cancer survivor, take anastrazole and see an oncologist as well as have a mammogram each year. I recently was having some bladder issues and felt like I was getting the run around from an immediate care facility and a primary care doctor I consulted. I decidec to see a urologist who had training in bladder cancer at Sloan Kettering. He has ordered a CT scan with contrast of the pelvis and follow up cystoscopy.

Concerned about additional radiationand contrast, I contacted my oncologist for his opinion. He would not offer me one, stating that I had chosen to consult someone else and that it was up to me whether to have it. I can't think of the word to describe how I felt. Let down? Disappointed?
I was really hoping for his advice.

Maybe some of you who have been through this scanning with contrast can advise me. Feeling lost. Thank you!

Scan clear doctor wants to restart chemo "just to be safe".

Stage II breast cancer dx in Aug 2015, one node involved (and removed), 33 rounds of radiation, and now anastrozole X 5 years. They say other than bi-annual mammograms, no other scans to check for mets will be authorized, and to just contact them if I have "symptoms" like bone pain. Is this the protocol, no scans to monitor for mets?

Dear Debbie, we are sorry to hear about your diagnosis. Your concerns about the possibility of recurrence and metastasis are certainly understandable. We asked one of our medical oncologists in the Breast Service and he confirmed that there is typically no additional special surveillance prescribed to monitor for breast cancer metastasis, as a standard protocol. We would recommend that you continue to “listen” to your body, report any unusual symptoms to your doctor, and focus on general wellness with regard to making healthy lifestyle choices.

Also, you may be interested in reading about ways to cope with fear of recurrence in this blog post:

If you are interested in communicating with other women who have had a similar diagnosis and treatment experience, you may also find it helpful to join our online community for patients and caregivers, called “Connections.” Here is the link to learn more and find out how to sign up:

We hope this is helpful and wish you all our best.

I was diagnosed with stage 3A invasive breast cancer in 2008 treated with BMX, chemo, radiation and still taking Letrazole.
I have some swelling and pain of my sternum scheduled for a full body CT and bone scan. I'm more anxious about these tests than I was with all of my previous treatments. How likely is recurrence while still taking oral chemo?

Judy, we are not able to answer medical questions on our blog. We recommend you discuss your concerns with your doctor. Thank you for your comment.

I was diagnosed with Grade 1 breast cancer 2015 and had a lumpectomy with clear margins then CT scan - clear and a radioactive scan - clear - my surgical oncologist said there was now 'no cause for concern' she discharged me for a year, (I also had radiotherapy) but my scar and breast are extremley anxious due to painful breast to have s mammogram+ my cancer was not detected with a mammogram but a CT scan - I would prefer a CT scan to a mammogram due to the pain from my healing breast and scars - is this a valid alternative? I always listen to the experts, always, but sometimes I feel I have to go with my gut decision, but I am open to advice - Thank you

Dear Pauline, we are sorry to hear about your diagnosis. We recommend that you consult with your physician to discuss your concerns and ask whether it’s possible to use a different imaging method to monitor for signs of a recurrence or a new breast cancer. Thank you for reaching out to us.

Great article! So many of the same issues and anxieties are faced by those of us with chronic UBD who have endured numerous surgeries and relentless testing due to flares of disease or secondary issues related to surgery, ostomies, etc. thank you for addressing this.

Dear Jeanne, we’re glad you found this article helpful. Thank you for your comment.

Do yo use wide-bore MRI machine at your Outpatient pavilion facility? Do patients go head-first or feet-first in your MRI machine?

Dear AC, the MRI systems at our Rockefeller Outpatient Pavilion are both wide-bore systems. The body part being scanned generally determines if the patient goes in the machine head first or feet first. Head and spine scans are generally done with the patient going in head first, while other body scans (chest, abdomen, pelvis, and lower extremities) are done with the patient going feet first. That said, we can do the reverse if patient is claustrophobic or makes a specific request. Thank you for your comment.

NBC News showed a program from MSKCC. for people to answer questions after treatment. People are helped and quality of life increased. Can you print more about this program.

I had radical surgery to remove my kidney in Oct 2016. My follow up scan in April 2017 revealed additional spots. Because of the recent surgery my Dr. at Sloan has scheduled me for an additional CT Scan but not until October of 2017. The Kidney cancer I have can only be removed surgically as radiation and chemo do not respond to it. In October he will determine if I am physically up to another surgery. All depends on my recovery since last October. The stress of knowing I have to go through this once again and the worry of it spreading further has taken a toll on me mentally. Does the new Sloan in Monmouth provide the services referred to in your email and does your doctor have to refer you?

Dear Kathy, we’re sorry to hear you’re going through this. Supportive care services, including social work, are available at MSK Monmouth. We recommend you discuss this with your MSK team.

You may also be interested in Connections, our online support group. You can learn more at…

Thank you for your comment, and best wishes to you.

I have read your blog it’s wonderful and interesting. thanks for sharing.

i have a full body scan tomorrow AM. Unfortunately i had knee replacement and am concerned that when my knee is immobile for around 30 minutes or more, it begins to throb. It happened during the Pet Scan that lasted about 35 minutes. Should i take an anxiety reducing medicine to calm me down or something else?

Dear Ike, we’re sorry to hear about your “scanxiety.” We recommend you discuss your concerns with the doctor who is doing the scan. Thank you for your comment, and best wishes to you.

December 28th 2015 I was diagnosed with triple negative breast cancer. I had a lumpectomy and did 4 rounds of chemotherapy and 33 rounds of radiation. I had a Pet scan April 2017 because of bone pain and generally not feeling well. It showed a reactive lymph node in my neck with an suv of 5. Had a second Pet scan in August; lymph node still reactive. Did a fine needle biopsy; from the samples showed negative for malignancy; however I still do not feel well and an ultrasound still shows this node enlarged but not growing nor is it getting smaller. I have my annual mammogram this Friday and I am having a bad time with it. I am extremely worried. any advice?

What is the usual amount of time between having a CT or Bone scan with bad results and hearing from the oncologist?

Dear Paula, this is something that can vary based on the particular situation. We recommend that you discuss what to expect with your doctor. Thank you for your comment, and best wishes to you.

My husband, not me, is the one with lung (small cell) cancer. Catching it early, surgery, chemo, immunotherapy, and radiation has kept it under control for 5 years. But every time he has to go for scans, I, not him go through PTSD after the scans are done and we get the results (positive, so far). With good news, I don't know why I get like this???

Dear Rita, we’re sorry to hear you’re going through this. Cancer affects entire families, and your reaction is not uncommon. You might find it helpful to speak with someone about your feelings.

You may also want to consider participating in Connections, MSK’s online support group for people with cancer patients and their family members. You can learn more at…

Thank you for your comment, and best wishes to both of you.

Just got diagnosed with B cell non-hodgkins Lymphoma. How will I know if the treatments won't make it mestastisize? I have an appt with an Oncologist who specializes in Lymphoma but I am still fearful of this getting worse....I am 81

I'm not anxious about the results; I'm anxious that they WON'T give me scans to check at 6 months if it has spread. I had ovarian, stage 1, but I'm on Femara to keep the cells from "spreading." Also, I was told at 47 to keep my ovaries when I had a hysterectomy and that no pelvic exams were needed, so I went for 3 years without those. Back pain drove me to get an MRI, which said I had an enlarged uterus - which of course could not be true - and when I called, they had me come in for CT scan with contrast which identified the mass. I was lucky. Through a FLUKE it was discovered and I had surgery. My pcp had palpated my abdomen to check ovaries the week before and gave me the "all clear."

So you can understand why I'm a bit skeptical of doctors always knowing what's best. I want those scans, and I want them of my brain, thorax, and pelvis. I want them to catch it early. But my doc said he wouldn't order unless I "felt bad."

I don't think I'm being overanxious. I'm being PROACTIVE in my care because someone has to be! That CT w/contrast was the test needed to diagnose the mass. Thank God for the radiologist, but had I not read my report, they wouldn't have called me back. I had on my PSH that I'd had a hysterectomy, but no one checked that.

ADVOCATE FOR YOURSELVES! I'm not ashamed of my views and I'll keep on speaking up!