Grappling with Survivorship and Scanxiety Amid Recurring Cancer Scans
- Isabella Strahan, 21, is in remission after treatment for medulloblastoma (a type of malignant brain tumor) but continues to grapple with anxiousness (scanxiety), describing her latest MRI as overwhelming and emotionally triggering despite the reassuring results that there is no new tumor growth.
- Her diagnosis and treatment were intense—brain surgeries, radiation, and multiple rounds of chemotherapy—aimed at eliminating a rare, fast‑growing grade IV brain tumor.
Many survivors experience “scanxiety,” a normal surge of fear around follow-up scans, which experts describe as the mind searching for answers it can’t yet access. - Coping strategies include talking openly with trusted people, immersing in grounding activities, and using tools like Dr. Samantha Boardman’s four-column exercise to focus on what is known and within one’s control.
- Experts note that some brain tumors respond especially well to radiation and chemotherapy; as Dr. Ganesh Shankar explains, certain tumors are so interwoven with healthy tissue that aggressive surgery could cause “pretty significant neurologic deficits,” making these therapies essential.
- Chemotherapy options vary by tumor type, and genetics explains that neuro‑oncologist Dr. Howard Colman prefers temozolomide, often for its tolerability, though side effects like fatigue, nausea, low blood counts, and hair thinning remain common and closely monitored.
However, she’s still living with the emotional aftershocks of battling cancer, admitting that a recent routine MRI sent her spiraling into a whirlwind filled with heightened nerves and fear — a reminder that the farther she gets from her diagnosis, the more she worries each scan could pull her back into another grueling round of treatment.
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Her treatment was intensive and grueling. Isabella underwent three brain surgeries to remove the tumor, followed by weeks of radiation and multiple rounds of chemotherapy. The goal: eliminate any remaining cancer cells and prevent recurrence.
WATCH: What You Think You Know About Chemotherapy Side Effects May Be Wrong
Chemotherapy, while powerful, comes with its own challenges. It works by circulating through the bloodstream to kill fast-dividing cancer cells—but it also affects healthy cells, leading to side effects like fatigue and nausea.
“Patients almost universally experience fatigue,” explains Dr. Renata Urban, a gynecologic oncologist at the University of Washington. “But mitigating that fatigue often depends on the patient.”
“Scanxiety” is a feeling of anxiousness patients tend to experience leading up to or following a cancer scan or test. While Strahan didn’t use the term explicitly, it’s a sensation many cancer patients easily identify with going into check-ups to monitor the progress of their treatment.
“I just got really nauseous and thought I was going to throw up, but I didn’t actually throw up,” Strahan explained.
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“It was really getting hot in there. Usually, I can [get through the MRI]…But it was definitely a hard MRI today. I don’t know, I feel like the longer you go from your diagnosis, it’s almost been like two and a half years for me. It’s like, I don’t know if there’s going to be any changes. But there was not, everything was good. If anything, they’re just monitoring a spot near my fourth ventricle to make sure it’s not getting compressed with fluid. So we’re good for today. No new tumor growth.”
Last year, Strahan celebrated her “cancerversary,” marking a milestone in her cancer journey.
In a TikTok video marking her “cancerversary,” Isabella shared a moving montage of her journey—from shaving her head and relearning how to walk, to soaking in the outdoors and flashing the smile that’s become a beacon of hope across her social media. Her caption says it all.
@isabellastrahan Living the life I fought for ❤️🩹 #recovery #cancer #fyp ♬ The Journey – H.E.R.
“Living the life I fought for,” she wrote, pairing the video with H.E.R.’s soulful anthem The Journey.
Expert Resources for Glioma Patients
- Biopsy or Surgery First? How Surgeons Decide With Glioma Patients
- Brain Imaging Options for Glioma: What To Expect With MRI & CT Scan
- Chemotherapy For Glioma: What Are The Side Effects And How Can I Manage Them?
- Choosing the Right Chemotherapy: Balancing Effectiveness and Quality of Life in Glioma Treatment
- Coping with Glioma: Managing the Emotional and Psychological Impact
- Diagnosing Gliomas — Resections and the Grading System
Coping With Added Anxiety
It’s not uncommon for cancer survivors to experience heightened levels of anxiety after cancer. This notably appears while receiving regular scans to ensure the cancer has not returned. This type of anxiety (also called scanxiety) is normal, and some helpful tips exist to help deal with it.
“The way that I define anxiety is that it’s an internal question that we simply can’t find the answers to,” Dr. Marianna Strongin, a clinical psychologist and founder of Strong In Therapy, previously told SurvivorNet.
WATCH: Learning to Cope With Anxiety
Survivors are encouraged to be open with their feelings, not just to themselves but to people they trust.
Survivors are also encouraged to find an activity they love and can become so immersed in that they forget about the anxieties associated with cancer.
Psychiatrist Dr. Samantha Boardman suggests that survivors draw four columns on a sheet of paper. Then, they are asked to write down what they know, what they don’t know, and what they can and cannot control.
“It’s a helpful way to dial down their anxiety. It involves trying to move as many items as possible into what they do know and what they can control,” Dr. Boardman said.
Better Understanding Isabella’s Brain Cancer Treatments
To treat the four‑centimeter medulloblastoma discovered at the back of her brain—a tumor larger than a golf ball—Isabella underwent emergency surgery just one day before her 19th birthday. As is common with this type of cancer, she then received proton therapy and chemotherapy to target any remaining cells that surgery couldn’t safely remove.
Proton therapy is often recommended when the cancer hasn’t spread because it delivers radiation with remarkable precision.
Unlike traditional X‑rays, protons stop at the tumor instead of passing through the body, helping protect healthy tissue.
WATCH: Radiation Therapy in the Treatment of Glioma
As neurosurgeon Dr. Randy Jensen explains, “The radiation we use for gliomas tends to be something that’s a little bit smaller dose spread out over a longer period of time… so that the normal brain can be spared and not be injured by the treatment, but at the same time, killing the tumor cells.”
Radiation is typically delivered in small daily doses—called fractions—five days a week over about six weeks. This schedule allows healthy cells time to repair while cancer cells, which divide more quickly, struggle to recover. Each session lasts only a few minutes and is painless.
Some brain tumors respond especially well to radiation and chemotherapy.
“Some tumors and growths that occur in the brain are very sensitive to chemotherapy and radiation,” says Dr. Ganesh Shankar of Massachusetts General Hospital.
He notes that when tumors are deeply interwoven with normal brain tissue, doctors may rely more heavily on these treatments because “pretty significant neurologic deficits” could occur if surgeons attempt a more aggressive resection.
Chemotherapy remains a key part of treatment, and options vary depending on the tumor’s type, grade, and genetic features.
WATCH: Exploring Chemotherapy Options and New Therapies For Glioma
“Chemotherapy options depend a lot on the specific type and grade of tumor,” explains neuro‑oncologist Dr. Howard Colman, adding that newer targeted therapies are emerging for tumors with certain DNA‑level mutations.
For many patients with high‑grade gliomas, the most commonly used drug is temozolomide (TMZ), an oral chemotherapy that can cross the blood‑brain barrier. Other options include lomustine (CCNU) and the PCV regimen—procarbazine, lomustine, and vincristine—often used for tumors with specific genetic markers.
“In my practice, I tell patients that the temozolomide is my preference… it’s much better tolerated,” says Dr. Herbert Newton of UH Seidman Cancer Center. “Most patients are interested in trying the temozolomide first and seeing how it goes, knowing that the PCV is there… if they need to ramp it up and be a little more aggressive.”
While radiation and chemotherapy are effective, they can bring side effects such as fatigue, nausea, low blood counts, appetite loss, headaches, and hair thinning. Doctors monitor patients closely and adjust treatment plans to help manage these challenges.
Better Understanding Brain Tumors
Brain tumors can impact a person’s cognitive function and overall well-being, depending largely on the tumor’s size, type, and specific location within the brain. When large enough, tumors may interfere with the central nervous system, pressing on nearby nerves, blood vessels, or tissues. This disruption may result in difficulties with coordination, balance, or mobility.
According to the American Society of Clinical Oncology (ASCO), brain tumors make up 85–90% of all primary central nervous system (CNS) tumors. They can be benign or malignant, with treatment and symptoms varying based on tumor type and location.
“The goal is to remove as much of the tumor as we can while keeping the patient well neurologically,” Dr. Reid Thompson, Chair of Neurosurgery at Vanderbilt University Medical Center, tells SurvivorNet. In other words, to remove as much of the tumor as possible without causing harm to the patient.
Even though surgery can remove a large part of the tumor, any remaining cancer cells can continue to grow over time, leading to the tumor’s return. For this reason, surgery is often followed by other treatments, like radiation or chemotherapy, to try to eliminate any remaining cells.
WATCH: Hope for Glioblastoma Research
While some brain tumors cause noticeable symptoms, others can go unnoticed for long periods. When symptoms do occur, they might include:
- Persistent headaches
- Difficulty speaking or processing thoughts
- Muscle weakness
- Behavioral or personality changes
- Vision disturbances
- Seizures
- Hearing loss
- Confusion
- Memory issues
Treatment Options for Brain Tumors
Treatment strategies for brain cancer depend on several variables, including the tumor’s size, type, grade, and location. Doctors may recommend:
- Surgery
- Radiation therapy
- Chemotherapy
Your medical team will help guide you based on your individual diagnosis. The prognosis—or outlook—depends on:
- Tumor type and growth rate
- Tumor location in the brain
- Presence of genetic mutations or abnormalities
- Whether the entire tumor can be removed
- The patient’s overall health
Types of Brain Tumors: Cancerous and Non-Cancerous
According to the National Cancer Institute, brain tumors can vary greatly in behavior. Some common non-cancerous (benign) types include:
- Chordomas: Slow-growing, often found near the spine’s base or where it meets the skull
- Craniopharyngiomas: Develop near the pituitary gland; rare and slow-growing
- Gangliocytomas: Form in the temporal lobe and affect the central nervous system
- Glomus jugulare: Rare and slow-growing
- Meningiomas: Typically grow on the brain’s outer protective layer (dura mater)
- Pineocytomas: Arise from the pineal gland near the brain’s center
- Pituitary adenomas: Located in the pituitary gland; generally slow-growing
- Schwannomas: Originate in Schwann cells, which insulate nerve fibers
- Acoustic neuromas (vestibular schwannomas): Impact on hearing and balance nerves
Common malignant (cancerous) brain tumors include:
- Gliomas: The most frequent and aggressive form of primary brain cancer
- Astrocytomas: Derived from star-shaped brain cells, with four growth grades
- Ependymomas: Graded based on aggressiveness
- Oligodendrogliomas: Can grow slowly (Grade 2) or aggressively (Grade 3)
- Medulloblastomas: Fast-growing and often found in children
- Glioblastomas: The most common and aggressive brain tumor in adults
Questions to Ask Your Doctor
If you or a loved one has been diagnosed with a glioma, be sure to discuss molecular testing with your treating team. Here are some questions to ask:
- Do you need both the tissue sample and blood samples for molecular testing?
- What specific mutations will you be testing for in my tumor?
- Do I have any genetic mutation that would change the course of my treatment?
- Am I eligible to receive targeted therapy? What about immunotherapy?
- Is there a clinical trial that would be relevant for me?
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