Active Surveillance: Living With Uncertainty and Managing Anxiety

For many people living with chronic skin cancers or a history of advanced or high-risk skin cancer, active surveillance becomes an ongoing part of life. Active surveillance refers to close medical monitoring for new or recurring skin cancers through regular dermatology appointments, biopsies, and imaging.

While this approach plays a critical role in early detection and long-term outcomes, it can also introduce a lesser-discussed challenge: persistent anxiety.

Many patients describe a familiar emotional cycle. Anxiety builds in the days or weeks leading up to an appointment, intensifies during the visit itself, and lingers while waiting for biopsy or imaging results. Over time, this can create a constant sense of vigilance that is both mentally and physically exhausting.

The Emotional Side of Active Surveillance

Living with active surveillance often means living in an in-between state. Treatment may feel ongoing, even when no immediate intervention is happening. For some, this can trigger feelings of hypervigilance, fear of recurrence, or a sense that the cancer journey never truly ends.

In recent years, healthcare providers and researchers have begun to acknowledge this experience more openly. Terms like scanxiety have emerged to describe the stress surrounding scans and test results, giving language to what many patients already know firsthand.

Despite this growing awareness, many people navigating active surveillance still feel they are managing these fears largely on their own.

Tools to Support Mental Well-Being During Surveillance

Managing anxiety during active surveillance does not mean eliminating fear entirely. Instead, it often involves building practical routines and tools to help reduce stress before appointments, stay grounded during visits, and cope with the waiting period afterward.

These strategies can include:

• Preparing questions and concerns ahead of appointments

• Setting limits on symptom checking and rumination

• Using grounding or breathing techniques during procedures

• Creating healthier ways to manage the waiting period for results

Support for the emotional side of surveillance is an essential, and often overlooked, part of survivorship care.

A Deeper Resource for Patients and Caregivers

We’ve created a comprehensive guide that explores the emotional realities of active surveillance and shares patient-informed strategies to help manage anxiety at each stage of the process.

This guide lives in our Education Hub, where we house our full library of medically reviewed resources for people affected by skin cancer.

Read the full guide here.