What is Scanxiety? How Cancer Patients Can Manage the Stress of Uncertainty

In an interview with SurvivorNet, Dr. Samantha Boardman offered practical tips on how to manage scanxiety. Dr. Boardman is a psychiatrist and the author of a new book called Everyday Vitality. Here are her two top recommendations:

• Confront uncertainty
• Seek out the experience of flow

How To Manage Uncertainty

"We know that uncertainty is an unbelievably uncomfortable place to be psychologically," said Dr. Boardman. In fact, according to Dr. Boardman, studies have shown that people would often rather receive an electric shock than have to wait long periods of time to get information. "We’ll go to many lengths to try to get information at all costs," she said.

Stress and anxiety are common emotions that are experienced after a cancer diagnosis, and the ongoing pandemic can exacerbate those feelings.

What strategies does Dr. Boardman recommend for alleviating the stress of uncertainty?

One is a simple exercise that starts with drawing four columns on a piece of paper. "I'll ask patients to…write down what I don't know, what I do know, what I can't control, and what I can control," she said. From there, "a helpful way to dial down their anxiety" involves "trying to move as many items as possible into what they do know and what they can control."

Visually mapping this process out on a piece of paper can also make patients feel more in-control of their circumstances. By taking the anxieties bouncing around in a person's brain and putting them down in writing, patients are encouraged to feel like they have power over the challenges they're up against.

Clinical Psychologist Dr. Marianna Strongin talks to SurvivorNet about how cancer survivors can self-soothe during the coronavirus, and reassures them they’re more resilient than they think.

Fighting Anxiety with Flow

A second strategy that Dr. Boardman endorses is seeking out the experience of flow. "Scan anxiety is unbelievably stressful," said Dr. Boardman. "And probably one of the best antidotes that I think psychology can offer patients is to experience flow." Dr. Boardman defines flow as "that experience when you are so lost in an activity that you lose a sense of time."

Not sure what that feels like? "Probably the easiest way to think about it is an athlete or an artist when they are so embroiled in what they’re doing…that hours pass," Dr. Boardman explained. She encourages patients to embrace a hobby" something that we just do because we love doing it." Finding flow can look different for everybody. "It might be baking. It might be gardening. It might be even doing some housework," said Dr. Boardman.

The goal is for patients to find an activity that they can be so immersed in that they're not thinking of anything else. "We know there’s data that shows that flow is a very good antidote for dealing with that anxiety and uncertainty," said Dr. Boardman, "And especially, I think, patients can apply that to waiting for their scan results."

Anxiety in the Time of the Pandemic

Dr. Dianne Shumay is a psychologist who works exclusively with cancer patients at The University of California, San Francisco (UCSF) Cancer Center. In a previous conversation with SurvivorNet, Dr. Shumay shared some ways she's been helping patients cope not only with their battle with cancer, but also with increased stress due to Covid-19. According to Shumay, the perception that coronavirus only seriously impacts older adults is misleading, seeing as vulnerable people of any age are equally at risk.

"The perceptions of the coronavirus are that it affects older adults only, but in reality if affects vulnerable people no matter what your age," Dr. Shumay tells SurvivorNet.

Dr. Shumay encourages cancer patients to be open about their feelings with peers and other loved ones as a way to ease concerns and fears they might have. During this time, Dr. Shumay says that cancer psychologists have been using the Acceptance and Commitment Therapy technique, which helps patients stay positive and mindful during stressful times.

"This technique allows us to use mindfulness and values-based living to really focus on living the best possible life, even at times we're under extreme anxiety," Dr. Shumay says.

Areas To Focus On, According To Dr. Shumay

• Treat yourself with kindness
• Seek social support
• Give to Others
• Allow yourself to receive kindness

Like Dr. Shumay, Dr. Strongin has also emphasized the challenges that cancer patients face to their mental health because of COVID. In an earlier interview, she told SurvivorNet that the general public's anxiety over coronavirus is connecting them to the reality of cancer patients through shared worries and fears. There are ways to deal with anxiety, which includes breathing techniques, prioritizing your own mental health, or medication in some cases, Dr. Strongin says.

According to Anxiety and Depression Association of America (ADAA), anxiety affects 40 million adults in the United States from 18 years old and up making it the most common mental illness in the U.S. Furthermore, nearly 50% of cancer survivors experience symptoms of anxiety. So, when it comes to feelings of stress and nerves, no one is that different.

"Anxiety is a part of all of us," Dr. Strongin says. "It's important to have a healthy relationship with your anxiety and get to know it rather than fear it, avoid it or push it away."

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