Thirty-two percent of advanced cancer patients report trouble sleeping in the days before a scan. Twenty-nine percent describe a feeling of dread that settles over them like weather they cannot outrun. Twenty-six percent lose the ability to concentrate on basic tasks.
These numbers come from qualitative research with advanced cancer patients published in Supportive Care in Cancer (Bui et al., 2021), and they describe something that oncology waiting rooms have known for years but clinical language took a while to name: scanxiety.
The term itself first appeared in print in 2011, coined by Bruce Feiler in Time magazine. It has since entered clinical literature and patient vernacular alike, describing the anxiety that clusters around cancer-related imaging, from the moment a scan is scheduled to the moment results arrive. A 2023 scoping review in the journal Cancers (Derry-Vick et al.) analyzed 36 studies and found that scanxiety has two distinct dimensions: anxiety about the scan procedure itself (the enclosed space, the noise, the forced stillness) and anxiety about what the results might reveal.
That distinction matters because the tools that address procedural anxiety are not the same tools that address results anxiety. For patients navigating scan schedules at Emory Winship, Northside Hospital Cancer Institute, or Piedmont Cancer Institute across metro Atlanta, understanding which type of anxiety is dominant changes which coping approach is relevant.
What Scanxiety Actually Is (And What It Is Not)
Scanxiety is not a clinical diagnosis. You will not find it in the DSM-5. It is a recognized psychological experience, distinct from generalized anxiety disorder, though the two can overlap and compound each other.
The core mechanism is anticipatory anxiety, a forward-looking dread that fixates on an uncertain outcome. Your brain runs simulations of worst-case scenarios. It rehearses bad news. It maps out consequences that have not happened yet and may never happen, but your body responds as though they already have. Heart rate increases. Muscles tighten. Sleep fragments.
This is neurologically different from reactive anxiety, which fires in response to something that has already occurred. Anticipatory anxiety is cognitively heavier because your mind generates the threat. The scan has not happened. The results do not exist. But the emotional experience is fully real.
A 2024 study in Psycho-Oncology (Patel et al.) examined scanxiety among young adult cancer survivors and found that intolerance of uncertainty and bodily threat monitoring were linked to scan-related fears, sometimes persisting up to 10 years post-treatment. The research distinguished scanxiety from fear of cancer recurrence (FCR), suggesting these are related but distinct constructs that may require different intervention approaches.
The Two Faces of Scan Anxiety
Procedural Anxiety: The Machine, the Room, the Stillness
MRI machines produce noise levels between 65 and 130 decibels, depending on the sequence. CT scans require contrast dye injections that create a warm, sometimes uncomfortable flush. PET scans demand extended stillness in a confined tube.
For someone already under the physical and emotional strain of active treatment, whether at Emory Midtown, Grady Memorial, or one of Northside’s outpatient imaging centers, the sensory environment of a scan adds another layer. The institutional lighting. The temperature of the room. The technician’s scripted instructions that, however kind, remind you this is a medical event, not a routine appointment.
Sensory grounding techniques address this because the anxiety is anchored to immediate physical experience. Some patients report that controlling one element of the environment, the music playing through the headphones, the blanket on their legs, a practiced breathing pattern, reduces the sense of helplessness. During the scan, progressive muscle relaxation (tensing and releasing muscle groups in sequence) gives the body something purposeful to do besides wait.
Results Anxiety: The Space Between the Scan and the Call
The Derry-Vick et al. (2023) review found that six of the 36 studies identified the waiting period between scan and results as the most stressful phase. Not the scan itself. Not the moment of hearing news. The gap.
This gap is where catastrophizing gains traction. The mind does not tolerate informational voids well. When you do not know, your brain fills the space with prediction, and prediction under threat skews negative.
Cognitive reframing is often used here, but it needs to be honest. The goal is not to convince yourself that results will be good. The goal is to interrupt the assumption that results will be bad. A truthful reframe sounds something like: “I do not have information yet. My anxiety is generating conclusions from incomplete data. I can hold the uncertainty without treating it as evidence.”
Easier said than done. But clinicians who work with scanxiety patients report that honest reframes outperform false optimism consistently.
Building a Scan Day Routine
Routine creates predictability, and predictability counteracts the helplessness that fuels anticipatory anxiety. A scan day routine is not about distraction. It is about reclaiming agency over a day that otherwise belongs entirely to the medical system. Here is what patients and clinicians describe as effective.
The night before: Preparing everything logistical. Directions, parking, documents, insurance cards, a list of medications. Removing logistical uncertainty frees cognitive space for emotional management.
The morning of: Movement, even briefly. A ten-minute walk shifts the nervous system from freeze mode toward engagement. If weather or energy do not allow outdoor movement, stretching accomplishes the same neurological function.
At the facility: Something that anchors the person outside the medical context. A podcast episode saved for the occasion. A conversation with someone who makes them laugh. The function is not to forget where you are. It is to remind yourself that you are more than a patient waiting for results.
After the scan: The post-scan hours are when anxiety tends to spike because the scan is done but the results are not. Patients who plan something specific and low-stakes for this window report better outcomes than those who go home and sit. A walk through Piedmont Park. A coffee shop in Decatur with good lighting. A phone call with a friend who understands that “how did it go” means “how are you,” not “what did they find.” Atlanta has no shortage of places to be that are not a hospital waiting room, and using them deliberately on scan days is not indulgence, it is strategy.
When Scanxiety Becomes Something Else
Scanxiety, for most people, is a temporary intensification of anxiety that peaks around scan time and subsides once results arrive. For some people, it does not subside.
If scan-related anxiety persists for weeks after receiving results, disrupts daily functioning between appointments, or triggers avoidance of recommended scans, it may have crossed the threshold into clinical anxiety. Avoidance is the critical marker. When fear of the scan becomes stronger than fear of missing a scan, medical adherence suffers, and that has clinical consequences.
Health psychologists are trained to distinguish between normal scanxiety (uncomfortable but functional) and clinical anxiety (debilitating and self-reinforcing). The distinction matters because the interventions differ. Pre-scan anxiety sessions, which combine cognitive restructuring with relaxation training, are designed for the first category. For the second, a more sustained therapeutic approach is appropriate.
The Boundaries of Scan-Specific Anxiety
This discussion focuses on acute anxiety around scans during active treatment. If someone in remission is experiencing persistent worry about recurrence, that is a related but distinct experience called fear of cancer recurrence, and it involves different psychological mechanisms and treatment approaches. If someone is processing trauma from a previous medical experience that now surfaces every time they enter a hospital, that is medical trauma, and it benefits from different therapeutic tools such as EMDR.
Scanxiety lives in a specific window: the days before, the day of, and the days after a scan during active treatment. It is bounded by time. It has a beginning and an end.
The strategies described here apply to people whose anxiety spikes around scans but returns to a manageable baseline between appointments. If that baseline has shifted permanently upward since diagnosis, or if scan-related dread has started preventing someone from scheduling follow-up imaging, the situation is beyond self-guided coping and warrants professional evaluation.
This content is for educational purposes and does not replace professional medical or psychological advice. If you are experiencing scan-related anxiety that interferes with your treatment adherence, please consult a licensed health psychologist or your oncology care team.