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The Whole Picture

April 2023 Vol 9 No 2
Lillie D. Shockney, RN, BS, MAS, HON-ONN-CG
University Distinguished Service Professor of Breast Cancer,
Professor of Surgery, Johns Hopkins University School of Medicine
Co-Developer of Work Stride—Managing Cancer at Work
Johns Hopkins Healthcare Solutions

Imaging tests are an important tool in providing a full and complete picture (literally) of your unique situation. There are several types of imaging tests—also called “scans”—each with a specific purpose. Scans are necessary and extremely helpful to your oncology care team, but being on the receiving end of that scan can cause tremendous anxiety—or “scanxiety,” as many have come to call it. This is a very common and normal feeling. In hope of alleviating some of that anxiety, let’s take a look at the types of imaging tests, how they are used, and strategies for coping with scanxiety.

Common Oncology Imaging Tests


MRI stands for magnetic resonance imaging. This scan uses powerful magnets to take detailed pictures of the inside of the body. These pictures allow your oncology care team to see “cross sections” of the body, almost like slices in a load of bread.

CT or CAT Scan

CT stands for computed tomography and is sometimes also called a CAT scan. This scan creates a 3-dimensional picture of the body using x-rays to take pictures from different angles. A CT scan may be used to view several organs or 1 organ in particular. CT is also used for bone scans—a look at the skeletal system from head to toe.

PET Scan

PET stands for positron emission tomography. This type of scan is widely used to detect cancer because it can potentially identify cancer cells before they would show up on MRI or CT scans. This scan is unique in that it uses a radioactive substance usually made from sugar. This substance is commonly referred to as a tracer, which is injected into your body to find and measure the spread of cancer in your body. The tracer causes cancer cells to appear brighter than healthy cells on the pictures produced by the scanner.


A PET/CT combines a PET scan with a CT scan to show in great detail the exact location of tumors.


Ultrasound, also known as sonography, is a medical imaging test that uses high-frequency sound waves to capture live images from the inside of the body. Unlike other imaging techniques, ultrasound does not use radiation. Your care team may use ultrasound to provide a more detailed picture of a suspicious lump; examine specific organs, blood vessels, or tissues; or it may be used as an aid when collecting tissue for biopsy.


Most people are familiar with x-rays because they are used for so many purposes—from broken bones to lingering coughs. X-rays are less commonly used today for cancer detection with the exception of mammography, which is an x-ray of the breast.

Coping Strategies

Whether your scan is for routine screening, diagnostic purposes, treatment planning purposes, or follow-up after treatment, many people experience stress and worry over the test itself as well as the impending results. The thought of going in for a scan can create sleepless nights, feelings of dread over what might be found, fear that the treatments aren’t working, or fear that the cancer has come back.

Prepare for the Scan

It is important to take steps to reduce your anxiety whenever possible. One strategy to reduce anxiety is to be as prepared as possible for your appointment:

  • Make sure you know the location of the imaging facility and details about parking
  • Know in advance what you should (or shouldn’t) wear
  • Ask about eating/drinking before the scan
  • Ask about the timing of results
  • Consider bringing a friend or loved one for support

When Should Imaging Tests Be Ordered?

Your treatment team may order scans for:

  • Routine cancer screening, such as a mammogram
  • Diagnostic purposes, such as identifying a suspicious mass
  • Determining the stage of the disease
  • Determining the effectiveness of treatment; assessing tumor size
  • Regular surveillance after treatment is completed to check for recurrence

Calming Your Mind

Fear of the unknown is a powerful emotion; that fear can easily cause us to assume the worst and allow our minds to go to dark places. I want to encourage you to try to avoid those dark places. Until you have all the facts, worry will not help. I know, the waiting is just so difficult. One way I’ve found to occupy my mind and distract from negative thoughts is meditation. There are several meditation websites and apps that serve as a good starting point for those to whom meditation is a new technique. One site I’ve come across is, but there are many others. Filling your mind with calming music, nature sounds, and positive messages may help you to get through some of the waiting and may relieve your anxiety—even if it’s just a little bit.

My Wish

Imaging tests are a necessary and crucial part of this journey. Although they can be the source of anxiety, I hope you can find peace in the process. And of course, my wish for you is that your scan results show NED: No Evidence of Disease.

About the Author

Lillie D. Shockney is Editor-in-Chief Emeritus of Conquer magazine, a University Distinguished Service Professor of Breast Cancer and Professor of Surgery at Johns Hopkins University School of Medicine, and a 2-time cancer survivor.

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