Scan-Related Anxiety In Pancreatic Cancer

Susan Winebrenner, MSN, APRN, OCN - University of Louisville, School of Nursing

 In recent years, there has been a dramatic increase in diagnostic
imaging performed for screening, diagnosis and follow-up of disease.
 Although advancements in medical technologies have significantly
improved rates of survival, the exams themselves can provoke fear
and anxiety that often lead to emotional impairment and a reduced
quality of life.
 Scan-related anxiety has been well documented in the literature among
healthy patients undergoing cancer screenings, but few investigations
have studied the psychological impact of routine surveillance scans in
individuals with cancer.
 Design: A mixed methods, repeated measures design will recruit participants over a 6-12 month period.
 Sample: A non-probability, convenience sample of 40 participants who have undergone surgical resection for
pancreatic cancer and are receiving routine CT or MRI scans for disease surveillance.
 Setting: Participants will be recruited from a large, university-based hospital research facility specializing in
hepatobiliary cancers.
 RQ1: Are there significant differences in anxiety scores among
pancreatic cancer patients at three distinct time points (pre-scan, post-
scan and pre-results, post-results)?
 RQ2: Are there significant differences in quality of life scores among
pancreatic cancer patients at three specific time points (Pre-scan; Post-
scan and Pre-results; Post-results)?
 RQ3: What is the lived experience of undergoing surveillance scan
imaging in the context of a pancreatic cancer diagnosis?

 Individuals with pancreatic cancer are known to have increased

anxiety and fears of cancer recurrence, primarily because pancreatic
cancer is largely considered an incurable disease.
 Surgical resection remains the only curative option and even after
surgery, pancreatic cancer will recur in over 70% of patients.
 Current guidelines recommend routine surveillance scans every 3-6
months after curative surgery to monitor the disease; however, with
such high rates of recurrence, pancreatic cancer patients are a
particularly high risk for scan-related fears and anxiety which can
significantly impair overall quality of life.
 To date, no study has explored the psychological impact of
surveillance scan imaging in patients with pancreatic cancer.
Qualitative Methods: A subsample of participants will be purposively selected to describe their experiences of
 American Cancer Society, (2018). Survival rates for pancreatic cancer. Retrieved from
undergoing surveillance scans in the context of a pancreatic cancer diagnosis. https://www.cancer.org/cancer/pancreatic-cancer/detection-diagnosis-staging/survival-rates.html

Hermeneutical phenomenology will guide qualitative research  Bauml, J. M., Troxel A., Epperson C.N., et al. Scan-associated distress in lung cancer: Quantifying the impact of
“scanxiety.” Lung Cancer, 100(8), 110-113. doi: 10.1016/j.lungcan.2016.08.002
The specific aims of this study are as follows: NVivo ® qualitative software, V12  Lo Re, G., De Luca, R., Muscarneri, F., Dorangricchia, P., Picone, D., Vernuccio, F., . . . Cicero, G. (2016).
Relationship between anxiety level and radiological investigation. Comparison among different diagnostic imaging
• Aim 1). To measure the anxiety levels of pancreatic cancer exams in a prospective single-center study. La Radiologia Medica, 121(10), 763-768. doi:10.1007/s11547-016-0664-z

patients undergoing surveillance scan imaging. Human Subjects Protection: The protocol and any amendments will be approved through University of Louisville  National Comprehensive Cancer Network (2019). Pancreatic Adenocarcinoma (Version 2.2019). Retrieved from
https://www.nccn.org/professionals/physician_gls/pdf/pancreatic.pdf
Institutional Review Board (IRB).
• Aim 2.) To explore the relationship between scan-related anxiety  Mutsaers, B., Jones, G., Rutkowski, N., Tomei, C., Séguin Leclair, C., Petricone-Westwood, D.,

and quality of life. Subjects written consent will be obtained on IRB-approved informed consents  … Lebel, S. (2016). When fear of cancer recurrence becomes a clinical issue: a qualitative analysis of features
associated with clinical fear of cancer recurrence. Supportive Care in Cancer, 24(10), 4207–4218. https://doi-

• Aim 3.) To gain a deeper understanding of the lived experiences Ethical guidelines observed to maintain participant’s confidentiality throughout the study org.echo.louisville.edu/10.1007/s00520-016-3248-5
 Rasmussen, J. F., Siersma, V., Pedersen, J. H., & Brodersen, J. (2015). Psychosocial consequences in the Danish
of pancreatic cancer patients who are undergoing surveillance randomised controlled lung
doi:10.1016/j.lungcan.2014.11.003
cancer screening trial (DLCST). Lung Cancer, 87(1), 65-72.

scan imaging.

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