The return of 'scanxiety'...

This September and October mark my 5-year anniversary of being told I have stage 4 head and neck cancer in 2021. I was trying to pinpoint a more exact date, but these things are never precise in the cancer world. While it was this week 5 years ago that I was told I had developed a new aggressive lung cancer with multiple tumours, it wasn’t until over a month later that further tests showed that the cancer was actually related to my original head and neck cancer caused by the HPV virus. That is, my original HPV-related head and neck cancer from 2020 had spread, or metastasized. I was now a stage 4 patient.

Even though I was put on cutting-edge immunotherapy, the predicted outcome was not good. A terminal diagnosis led me to make the decision to quit my job and make the most of the time left. But I was one of the lucky ones. I tolerated immunotherapy well, and gradually and progressively it helped my immune system fight the cancer I had, and in September 2024, 3 years from my original stage 4 diagnosis, I was told that my regular 3-monthly scans “remain clear of metastatic disease". Since then, my regular 3-monthly scans for head & neck, chest and abdomen, were scaled back to 4-monthly scans each coming back with no new evidence of disease.

At the start of 2026, it was decided to reduce my scans to every 6 months, but as luck would have it, the first of those scans revealed an increase in opacity in the region of my lower left lung. My oncologist was really reassuring, telling me that this is unlikely to be a new tumour, and most likely to be a side effect of an infection, but that I would need to have another scan within 3 months to check on whether there is any change or not.

And this is the point about this blog post; when you have stage 4 cancer, even when tests consistently come back good, uncertainty and anxiousness are never far away. I’ve had a few running buddies recently die from stage 4 cancer, and that has brought on a new bout of survivor’s guilt, which I first wrote about at the end of treatment in 2020 when I thought it was ‘curative’. But this time, being stage 4 myself, I know it only takes one ‘bad scan’, and sometimes I can’t stop feeling that there is an inevitability to this.

Lastly, to be on the safe side, I’ve also pulled out of doing an incredibly exciting and adventurous race at the start of October as my new scan is like to occur then. And to be honest, mentally I would have found it hard to give that adventure the true focus it needed. So even if the scan results come back as benign, ripples of uncertainty have already had their impact.