“Scan-xiety,” with Lidia Schapira, MD

December 2, 2014
Download MP3 (8.99 MB/9:49)

In this podcast, Dr. Lidia Schapira discusses ways to cope with feeling anxious about having scans for cancer and waiting for the results.

Transcript: 

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ASCO: You're listening to a podcast from Lineagotica. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the world's leading professional organization for doctors that care for people with cancer.

In this podcast, Dr. Lidia Schapira discusses ways to cope with feeling anxious about having scans for cancer and waiting for the results.

Dr. Schapira is a medical oncologist at the Massachusetts General Hospital and associate professor of Medicine at Harvard Medical School. Dr. Schapira is also an Associate Editor for Lineagotica.

ASCO would like to thank Dr. Schapira for discussing this topic.

Dr. Schapira: This is Dr. Lidia Schapira and I'd like to chat with you today about scanxiety. Maybe the term just makes you anxious. Scanxiety is a new term that we use to talk about all that anxiety, trepidation, almost craziness that surrounds the idea of having to have scans to check on a cancer. You may be somebody who is receiving treatment now or maybe a survivor of cancer. But for everybody, the need to have these scans, then waiting for results, then hearing the results is usually a time that's very, very difficult and that may be just putting it very mildly. For some, it's almost a period of craziness. By that, I mean that one could feel out of control. For people who like to know what comes next, for people who need to be in control or feel they're in control of their lives, this could be incredibly upsetting and distressing. Those of us who work with cancer patients, those of us who are clinicians or oncologists have come to recognize that this is really an important part of the cancer journey or experience.

First, I'd like to just reassure all of you who have experienced it, either yourselves or through perhaps a loved one shared journey that this is quite normal. It's appropriate. Then I'd like to just think with you about how we can possibly help each other or I can possibly give you some advice to help bear this a little bit more easily. It's probably not going to stop, but there may be some things that you can do or help somebody you love to think about or do that may make it a little less burdensome.

Again, scanxiety refers to all of those feelings that make one very upset, distressed, feel out of control or nervous that surround either the concept of having an appointment for a scan or actually going through the scans. I've heard patients say that they are fine until they have to go through the scans. Once the scans are done, what makes them most anxious is knowing that the pictures are taken and the information is there, somebody possibly has it and they don't. What's worse for them about this whole experience is waiting for results. For others, it may actually be the fact that the experience itself is unpleasant. There may be some disgusting liquids to drink or some needles that need to be inserting into veins or just the experience of being enclosed in a very tight space may be very upsetting. There may be different aspects to this experience that are upsetting to different people, it's just important to be aware.

Before your appointment, it's important to try to think about what it is that makes you perhaps the craziest or the most anxious. Reasonable advice is to surround yourself with people who will help you, who will reassure you, who will put you at ease. Perhaps planning the appointments early in the day may be helpful. There's less of a chance of having to wait when you get there. Some have compared it to a trip to the airport. The earlier in the day, perhaps the easier it is to just get there and the less chance that you'll have to sit and wait. Perhaps it's important to go with somebody, to take some music to listen to or something to do while you're waiting, that's reassuring. Make sure that pain is minimized if you need an IV inserted and that's a painful experience, prepare with the professionals on your team who can give you some good advice.

It may be helpful to distract yourself with music, or a film, or conversation. Sometimes it's even helpful to try some relaxation techniques. For instance, deep breathing or meditation. The kind of things we do to soothe ourselves. Everything that you can do to put yourself at ease. To take some control over the situation as you're entering into the scan is really going to be helpful. Then the important part of this and perhaps the part that I talk with my patients the most about is what to do between the time that you've had the scan and that you're waiting to get results. That period can feel like an eternity to some.

I know that I spoke with 4 of my patients yesterday who had just had scans. With each 1 of them, we almost have a contract, how we're going to negotiate the time between the scans being performed and then my giving them news. Should we do this over the phone? Should we do this by email? Should we schedule an in person face to face? How will they task those moments between knowing that the results are there, and receiving them, and then figuring out where that lands them? Are they safe? Do we just continue until another scan? Or does it mean that something has to change?

Of course, the importance of these scans depends very much on the individual and the individual situation. Sometimes the scans are done just as a part of a normal follow up and sometimes the scans are done because there is a problem and we need to know if a treatment is working or not. It's impossible for me to just anticipate the situations that perhaps resonate with each one of you, those of you who are listening, but some of the principles can apply to everybody. I would say that the best advice I can give you about that is to have a plan with your team. It could be your nurse practitioner, nurse in the office, or the oncologist to know when it is that you're going to get those results and how you're going to learn them.

There may very well be doctors who will not do this over the phone who insist on seeing you. Well, then it's really important to have the appointment really close to the time you had your test. Whether it's minutes, hours, or days, hopefully not weeks, between the time that you finish the test and the time that you sit with your doctor to talk about what that means and either change a treatment or give you the all clear, then those are the times that you also need to try to do what you can to calm yourself and soothe yourself.

I can't resist but use the expression that I honestly feel is the most helpful and that is to find a way to be compassionate towards yourself. Surround yourself with people who can assure you. Find ways of finding some inner calm. Find ways of reminding yourself of what matters the most to you and why you need to wake up the next day and try perhaps to minimize all of the other intrusions in your life that are unwelcome. Comforting meal, comforting presence, avoiding perhaps situations where you're in public, all of these things may help.

My final words are, it's really normal to be anxious. Often, these experiences or the anticipation of the scan will make you relive some of the trauma of having been diagnosed or an earlier experience. Have a good contract with your oncologist or oncology nurse practitioner so that you know how long you'll have to wait for results, who's going to give them to you and bring somebody who can support you. In the meantime, I would say, take small steps, take deep breaths, try to distract yourself, find people who can reassure you, maybe a little humor, maybe a little prayer or reflection and hopefully, you will get through this experience. This is Dr. Lidia Schapira and this is the end of the podcast.

ASCO: Thank you Dr. Schapira. More information on coping with anxiety can be found at lineagotica.info. Lineagotica is supported by the Conquer Cancer Foundation, which is working to create a world free from the fear of cancer by funding breakthrough research, sharing knowledge with physicians and patients worldwide, and supporting initiatives to ensure that all people have access to high quality cancer care. Thank you for listening to this Lineagotica podcast.

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