Scanxiety: What is it and what does it mean to radiology technicians?
I’ve recently come across the #scanxiety hashtag on social media, and it has opened me up to a whole new perspective as a healthcare professional.
Before I go any further, do yourself a favour and check out this amazing person’s Instagram profile - she is really doing some great things: Magdalena Bujalski
And before you leave, be sure to check out the transcript from our Q&A session at the end of this blog for a true insight into a patient's scanxiety, and what we as healthcare professionals can do to help.
So, what is Scanxiety? According to Mags, it is the stress and anxiety that cancer patients (and others) feel when waiting for scans and the results of those scans.
Pretty simple, hey? We could all imagine that having a staging scan would be a nerve-racking time. But do we truly understand the level of emotional and mental drain that patients go through?
At a fundamental level, one may be thinking: “am I going to live or die?”
Just try to imagine what being in that state-of-mind would do to your mental health and emotional wellbeing. Now imagine being in that state-of-mind for six months - the time for most patients between getting the results of the previous scan and waiting for the next one. This is the reality for a lot of cancer survivors.
Scanxiety is ultimately the fear of the unknown. The constant niggling in the back of the mind - has the cancer shrunk or grown? The amplification of anxiety with every new pain or bodily function that seems out of the ordinary. The unsettling calm when everything is actually feeling ok - is this too good to be true? The unpredictable nature of cancer means that patients cannot truly trust their own body, and therefore they need to wait for their scan results to get a real gauge on their progress.
So let’s imagine you are a person undergoing cancer treatment. You’ve waited out the six (or three, or twelve) months by keeping busy. You might have gone back to work, gone travelling, reconnected with long lost family or friends. And now the time has come to book your next staging CT scan.
Let’s explore two possible scenarios at the booking stage of the scan, shall we?
Scenario 1: You are treated like a number, the receptionist sounds like they are reading the instructions from a script, and you are left feeling like an insignificant patient who shall now be identified as the “11:30am CT Chest/Abdomen scan”.
Scenario 2: You are greeted with a friendly, personalised hello… “hello again Tristan, has it been six months already? Now I’m sure you already know all of the preparation, but I’ll just go through it again with you to refresh your memory.”
I know which scenario I would prefer if I were this patient.
Fast forward to the scan day. Remember, most patients having their staging scan have been through this multiple times, so there are no real surprises in terms of the scan process. This isn’t where the scanxiety arises. The scan signifies the moment where their data is captured and processed, and their entire future will be dictated on what this reveals. This is scanxiety. And it all comes to a head whilst lying on the scan table.
Obviously every patient is unique in their treatment journey and personality. How they process scanxiety, how it manifests into physical and emotional responses, how much significance they are placing on the results of this particular scan - everyone is going to be different. So it would be useless (and misleading) if I told you “follow these three things and you will relieve scanxiety for all your patients”.
The truth is that radiology technicians (and all other healthcare professionals) will have little-to-no impact on the underlying causes of scanxiety, which is the fear of the unknown, the nervous wait for the scan results. This is something that each patient will have to go through. But there is one crucial quality that a radiology tech can have that will make the scan process sooooo much easier for the patient, and that is EMPATHY.
I’ve always thought of empathy as simply “putting yourself in someone else’s shoes”, and this has done me and my patients a real disservice. Ultimately because this is only one side of the empathy coin. It’s not enough to simply say to yourself “this patient is anxious”. Empathy involves CONNECTING with someone, recognising what they are feeling and experiencing and then meeting them in a space that you are both comfortable with.
I will be the first to admit that I am not the best with small talk. I prefer to get to the point of a conversation, and keep things on a need-to-know basis. So for most of my career I have used this as an excuse to shut myself off from my patients, and the majority of our conversations have been formalities regarding the scan. And to be honest, a lot of patients still appreciate this much! Having their technician talk them through the scan, what to expect, how long it will take, can relieve a lot of anxiety. It takes away some of that fear of the unknown, especially if it is their first scan.
But thankfully I have been working on the way I connect and interact with people lately, and I have found that my patients are so much more appreciative now that my interaction isn’t purely clinical and mandatory. Simply asking them how their treatment is going, complementing them on how well they are looking, asking if they need a blanket or anything to make them more comfortable. It doesn’t have to be a deep and meaningful therapy session. And ultimately it has to be something that both you and the patient are comfortable with. Remember, each patient has a different personality and will be in a unique situation in their life, so you need to meet them in a place that reflects this.
If a patient feels like they are just another number, this can really add to their scanxiety levels. Knowing that they are being seen, looked after and recognised as a real person with real emotions and feelings can go a long way in their treatment journey.
I have worked with radiology techs in the past who seriously sound like robots. They go through the checklist without expression or interest, rush the patient in and tell them what to do with no regard to how they are feeling. Not only does this make the patient feel like a burden, but I can’t imagine a radiology tech with this attitude would be fulfilled or satisfied with their job. Doing the exact same thing day in, day out, without meaning or motivation is enough to make anyone unsatisfied and even depressed. By seeing patients as individuals, each interaction is more unique and fulfilling, and our overall job satisfaction rises.
So remember, while you may see 20 or 30 patients per day, for each individual patient this scan can be a huge deal for them. Be empathetic: recognise the situation the patient is in, how it is making them feel, what is going through their mind. See them as a human being and then connect with them in a way that you both feel comfortable with. And ultimately, love the job you do and celebrate the impact you have on people’s lives.
Q&A with Magdalena Bujalski, Cancer survivor
1. What does scanxiety mean to you?
To me, scanxiety is the fear of finding out what actually is going on inside of your body. I think that after a diagnosis as intense as cancer, or even other severe medical conditions, you never trust what is happening inside of your body. You may feel great, but find out that your tumour is growing, or you feel very sick, but there is no evidence that the cancer is back. Another reason why scanxiety is such a big deal for cancer patients is because there have been so many changes in our lives recently, and we don’t know when we will be able to go back to “normal” again. Cancer is so unpredictable. When you’re waiting for your scan, a.k.a. waiting for an update on your medical condition, your life is on standby. You’re afraid to make plans for the future, whether that be near or far, because you have no idea what is coming next. You don’t know whether you will need more treatment, whether you’ll need a different type of treatment, or whether you’ll be able to slowly start going back to normal life.
2. Do you notice it more during certain times? e.g. while you are having the scan, the days, weeks or months leading up to the next scan, waiting for scan results
I find that I have been pretty good with keeping my mind off of my health since I found out that I was in remission in August. It still creeps up on me here and there, but for the most part, I am able to focus on enjoying my day-to-day life without letting cancer consume my brain. However, once I get that letter in the mail in regard to the date of my scan (my hospital sends appointment letters in the mail), I begin to feel uneasy. But, for me, it is particularly bad the week leading up to the scan. That is when it is on my mind constantly. Will I get to keep enjoying my life in remission? Did the cancer come back and I need to do more treatment? Waiting for scan result is also very very difficult and that is also when my scanxiety is at an all-time high.
3. What are some things you do to cope with it?
To cope with scanxiety, I just try to keep myself occupied. If my mind is busy thinking about other things, then it is not focusing on the scan. Luckily, I am now back at work; therefore, most of my day is spent thinking about work-related things. In the evenings, I also tend to fill up my time with activities so I don’t have time to sit there and think about the upcoming scan. And, by night time, I am already so tired from my busy day that I fall asleep right away. Sometimes, I find that talking it out is also very helpful, especially with someone else who understand what I am going through.
4. Have you had any bad experiences during a scan?
No, I have been very fortunate and have only ever had positive experiences during my scans.
5. Have you had any positive experiences during a scan?
All of my scans to date have been positive. What really helps is when the staff is very happy and positive. If they are kind and take the time to genuinely make conversation while they are preparing you for the scan, that can make a world of a difference to someone who is very nervous. Staff that are very bossy and make it seem like they are only there because they have to be can add to the patient's stress. If the patient is new, or this is one of their first scans, walking them through it and explaining everything slowly really helps as well.
6. Has there been anything specifically that a doctor, technician or receptionist has done that has impacted you either positively or negatively?
I really appreciate it when medical staff share their insight and their knowledge. I know that this can only go to a certain extent as you don’t want to say the wrong thing, or give false information. For example: I once had a technician who asked me what cancer I had and told me that her friend had a similar cancer and did this treatment in the United States. This made me happy because I had looked into that specific treatment as plan B, but was not aware that it was available in the US. I have also had other technicians and doctors make suggestions as to how to deal with certain side effects of chemo or of the scans. They will share hacks that other patients have shared with them.
Compliments are also really nice. I have had technicians who have told me that my wig looked very real and very nice. There have also been technicians who have told me that I am looking great, despite being on a strong chemo regimen. Nothing excites cancer patients more than when someone points out their post-chemo hair growth progress. Small compliments like that can really help make the patient feel happier and more at ease.
Even something as small as offering a warm blanket to the patient to help them feel more comfortable can really go a long way.
7. Do you feel that the technicians who have done your scans have had real empathy to your situation and emotional state?
Yes, I have been very fortunate in that regard. Every technician that I have met during my cancer journey has been very kind and empathetic toward me.
8. What are some things the technicians could do to make your scan less anxious?
I think that explaining what is going on and how the scan process works, along with being positive and talking to the patient.