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.

Was dismayed to be told she had cancer but did not need treatment, which her friends found hard…

Age at interview 64

Gender Female

Age at diagnosis 53

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Had been geared up to have treatment so was shocked to be told he would be put on watch and wait…

Age at interview 44

Gender Male

Age at diagnosis 33

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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’).

Explains how often he saw his specialist during ‘watch and wait’ and what happened at those…

Age at interview 58

Gender Male

Age at diagnosis 51

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Needed regular reassurance that he didn’t need treatment and could forget about his illness by…

Age at interview 58

Gender Male

Age at diagnosis 51

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Was concerned during watch and wait that his lumps were growing bigger and with hindsight feels…

Age at interview 44

Gender Male

Age at diagnosis 33

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Sometimes worries about her illness but reassures herself that it is being dealt with; having…

Age at interview 61

Gender Female

Age at diagnosis 60

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When lymphoma comes back

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Radiotherapy

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