How MSK Nurses Offer Relief From Scanxiety

The cancer may be gone, but for many patients the medical tests continue, and so do the fear and worry. 

Now, a group of radiology nurses at Memorial Sloan Kettering Cancer Center (MSK) say it’s time to bring awareness — and relief — to the countless patients and their caregivers across the country suffering from anxiety related to radiology scans, an experience that has been dubbed “scanxiety.” 

“Even our healthy patients have this,” says MSK radiology nurse practitioner Ashley Hole. “It stays with them even when they are in remission.” 

That’s certainly true for Stacey Kaminsky, who was diagnosed with stage 3 breast cancer eight years ago. “I have the same level of anxiety for follow-up care as I did back when I was diagnosed,” she says. “Every time I hear the word MRI, my stomach drops.” 

After surgery and dozens of rounds of chemotherapy and radiation, there is no evidence of disease. But Stacey still gets regular scans to check for cancer recurrence and to help diagnose the cause of painful side effects from treatment, including back pain, neuropathy, and fibrotic tissue in her arms. One PET scan found a noncancerous brain tumor that now also requires annual scans. 

“It’s petrifying, because you never know what they’re going to find,” she says. “Will they find a tumor? Is my fibrotic scarring worse? What’s wrong with my spine?” 

After one PET scan, her fear was so intense she left the room and vomited. “I have canceled appointments because I just couldn’t take it,” she says. 

Scanxiety Is Normal

Stacey’s anxiety was so debilitating, she sought help from MSK psychiatrist Michael Rosenthal, MD.

Dr. Rosenthal told her that scanxiety is not only common, it’s to be expected: “I would argue it’s a normal human response to a very scary life-threatening experience.” 

Dr. Rosenthal reassures patients who may still feel on edge years after showing no evidence of cancer. Just walking in the door for a scan can trigger a stress response. 

“Of course it feels like life and death, because at one point it was,” he says. “Your body still reacts that way, and that’s a normal emotion. It brings you back — your body remembers, and your mind remembers what it was like to get that bad news.” 

Help Starts Here 

Seeing so many patients and caregivers struggle with scanxiety, MSK radiology nurses formed a team and set out to find a solution. Diving into dozens of studies, they discovered that while scanxiety is widespread, it’s often not acknowledged. 

“Giving patients the term ‘scanxiety’ to succinctly express the feeling of distress they are experiencing has been critical,” wrote Hole and co-authors Jaclyn Adronico, Kelly Bonenfant, and Mary Elizabeth Davis in a report published in the Journal of Radiology Nursing. 

The nurses took their findings and developed training for professionals as well as a detailed brochure for patients and caregivers that offers a wide range of calming techniques for various situations. 

For some, the anxiety can be worse before a scan. For others, it’s during the procedure. For most, the hardest time is waiting for the results. The first coping technique is for patients to talk about how they are feeling. Videos to guide meditation are also helpful.

MSK Recommendations Shared Nationwide

The MSK team findings and recommendations are now being shared with radiology nurses and technologists around the country — even ones who don’t specialize in oncology. The brochure is also available in Spanish, simplified Chinese, and Russian. This project is a result of MSK nurses’ constant efforts to innovate and to share knowledge that improves patients’ experiences — it was one of the reasons MSK recently earned Magnet® designation, the highest honor in nursing.  

Stacey says having her feelings validated by her care team has been essential to getting through her MRI scans — the nurses and technicians talk her through every step. “Just having a reassuring voice through the machine is really helpful,” she says. 

Stacey now uses visualization techniques, imagining a car trip from her driveway to the hospital that will take as long the scan takes. If she arrives at her destination before the scan is over, she simply repeats empowering words to the beat of the machine’s banging. It’s her own healing mantra. 

“I turn the banging into a chant: Go away. Go away. I’m done. I’m done. I’m done.”