Scanxiety

I don’t know who first coined the word “scanxiety,” but whoever did hit it spot on.  Wikipedia calls it a portmanteau, which is “a blend of words in which parts of multiple words are combined into a new word.”  In this case, it is a combination of “scan” and “anxiety.”  Scanxiety. Get it? According to Google, portmanteau words were pioneered by Lewis Carroll, who created “chortle” (chuckle and snort) and “galumph” (gallop and triumph), among others.  I think he’d approve of “scanxiety.”

Scanxiety is real. Like many others with MBC, I have scans scheduled at regular intervals.  My medical oncologist (MO) orders a computerized tomography (CT) and a nuclear medicine (NM) scan every three months. If the scans show that there has been little or no progression of the disease, then I will continue with my current treatment plan.  If, however, the scans show significant progression, then the plan will be modified.

During the days and weeks leading up to each set of scans, scanxiety lurks in the background.  Does that pain I’ve been having mean that the cancer has spread somewhere new?  Those headaches?  Is it brain metastasis? I know those things are eventually coming, but please, not yet.

My scan day typically goes like this:  I arrive at the clinic around 8 AM. The first stop is the radiology check-in desk for the NM injection. After I’m taken to the injection room, the nurse inserts a needle into my forearm and then a tiny catheter is placed in the vein. Next, she pulls out the “special silver box” containing a radioactive tracer and injects a (hopefully) small amount into the vein. Since I’m heading straight over to get my CT scan and that scan also requires an IV injection, the nurse leaves the IV line in place.

The tracer takes about two hours to make its journey through my system and into my bones, so I use that window to get my CT scan. This scan will look at the organs in my chest, abdomen, and pelvis. I lie face up on a long, narrow table and rest my arms above my head as I travel through a large, donut-like machine. A voice tells me when to hold my breath and when to breathe. Just in case I don’t understand the words, there are little cartoonish-looking faces on the machine demonstrating the holding and the breathing.

Halfway through the scan, a technician comes into the room and injects contrast dye into my vein using the IV line left in place by the NM nurse.  The tech is always grateful (as am I) not to have to start a new IV.  Once the injection is done, the IV line is removed. 

If you’ve never had CT contrast dye injected into you, it may come as a surprise when you start feeling very warm at the top of your head.  The warmth moves down your body and, as it reaches your pelvis, you get the sensation that you’ve wet yourself.  The tech reassures me that I haven’t.

I slide through the scanner once more, breathing and holding my breath as directed.  The techs then come to help me off the table.  I try not to read into their kindness by thinking they’re being super nice because they saw something super bad on the scan.  They hand me a big bottle of water and instruct me to “drink a lot” to flush the contrast out of my system.  Off I go, back to the check-in desk for the next part of the NM bone scan.

The NM bone scan can take up to an hour and, although not painful, lying still on the hard table becomes uncomfortable. The most nerve-wracking part of this scan is when the machine is being set up.  A large flat panel is lowered toward my face until it’s about an inch from my nose.  I keep thinking it’s not going to stop, but it always does before it touches me. 

The scanner is quiet and it’s hard to tell that I’m moving through it at all.  Ever so slowly, however, I start to move out from under the flat panel.  As I emerge, I can see the monitor which shows an image of my skeleton.  I probably shouldn’t, but it’s hard not to look.   I see “hot spots” that show up as bright white areas. I evaluate whether I see more of them than during my previous scan.  I’m not a radiologist and certainly no expert, but I know that more hot spots could mean that the disease is spreading.  It’s not what I want.

Once I’ve been scanned from head to toe, the nurse comes in to adjust the machine.  She says she needs “just a few more views.”  I wonder, “Why?  What are you seeing?”  I don’t ask, and she doesn’t tell.  When the “few more views” are completed, I’m helped off the table and reminded, again, to drink lots of water. I’m sent on my way, hoping that I hear quickly about the results.

The wait between the scans and hearing the results can seem like forever, but my MO is good about calling me once she sees the reports.  It may take anywhere from a few hours to a few days to hear from her, and I try not to interpret any delay as bad news.  I will continue to hope that I remain “essentially stable” and will refrain from checking with Dr. Google (he really is an alarmist) on all the possible outcomes of my scans.  

My next set of scans is about a week away.  I’m hoping for “stable” – another three-month reprieve.  Worry is lurking in a dark corner, waiting to creep into my mind, but for now I’ll look for the sunshine and find humor where I can.  And knit.  I have a lot of yarn just waiting to be made into scarves and such.

Carol

Cancer has progressed to my bones.  I pray that it never enters my soul.