Watch and wait

People who have indolent or low grade (slow-growing) non-Hodgkin lymphoma may not need immediate treatment. Those who are well, have no symptoms such as weight loss, night sweats or fevers, whose lymph nodes are not obviously enlarging rapidly or threatening major organ function, will be regularly monitored by their specialist for months or years until the illness changes and treatment is considered necessary. This is known as 'active surveillance', 'watchful waiting' or 'watch and wait'. Research has shown that people who are monitored in this way do just as well as those who are immediately given chemotherapy, plus they are spared the unwanted effects of treatment. Some may even avoid treatment altogether.

Some people in this situation feel relief that they will not have to undergo immediate chemotherapy. However, it can be unsettling to be told you have cancer but that you don't need treatment. One man we spoke to said he was 'amazed'. As well as trying to understand this situation for themselves, the person has to explain it to friends and family who may find it even harder to believe.

Being on 'watch and wait' means seeing a specialist every few months for various tests to check on the illness and possible symptoms. These appointments can be an unwelcome reminder of the diagnosis - some mentioned that sitting in the waiting room was hard - but between appointments life can be normal. Some people occasionally had concerns about whether they needed treatment, or worried that their doctors might be mistaken. Reassurance from the consultant helped. A woman in her early 60s wondered if maybe 'observing rather than treating cancer' was more common in older people than we realise. One man who was anxious to do something to help his illness decided to try a Chinese herbal medicine, but he stopped before his chemotherapy began (see 'Complementary approaches').

Last reviewed February 2016.
Last updated February 2016.

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