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Watchful Waiting Treatment for Non-Hodgkin Lymphoma Patients

Watchful waiting is a form of active surveillance that can be used for people with non-Hodgkin lymphoma (NHL) when there is no immediate threat to their health. Watchful waiting is recommended for people with NHL who have low tumor burden. Research studies have demonstrated that delaying treatment for as long as 3 years had similar overall survival rates as immediate initiation of chemotherapy.1

Watchful waiting can be challenging

Results of the National Lympho Care Study suggest that watchful waiting is an acceptable treatment option for select patients and it may maintain quality of life and reduce medical costs.1

The study included 1754 people, of which 22 percent were assigned watchful waiting, 17 percent received the medicine rituximab alone, and 61 percent received chemoimmunotherapy. The long-term follow-up survival data from this study revealed no significant difference in overall survival.1

Therefore, it seems that people with less aggressive features and with low tumor burden may have no survival benefit with immediate treatment.1

However, watchful waiting requires you to accept living with untreated cancer as a trade-off to avoid the immediate risk from treatment. I was shocked and disturbed at the notion of having cancer when I was diagnosed and told that treatment would be delayed. I had trouble wrapping my head around this concept. It was not until I reviewed the published literature that I began to understand.

This approach can be challenging. But patient support groups, online communities like, and individual and family counseling can all provide reassurance. As a Leukemia and Lymphoma Society First Connection Program volunteer, I have listened to and supported patients who had concern.

Harm will not come from waiting to start treatment

We know from research that harm will not come from waiting. Some physicians have compared NHL to a chronic disease such as diabetes or hypertension.2

With watchful waiting, you do not have to deal with treatment side effects such as hair loss, infections, and nausea.2

Even though you are not receiving actual treatment, you will visit the physician every few months for physical assessments and laboratory work. Your oncologist also will ask you to report any symptoms you are having.2

This hands-off approach has been proven to work just as well as treatment in select people without the risk of side effects. My watchful waiting lasted 1 year, after which my lymph nodes became larger as my disease progressed. I then began chemotherapy and immunotherapy.1,2

Research continues in the treatment of NHL. It is my hope that while waiting for treatment, other breakthrough treatments are in the pipeline.

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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