Watchful waiting, which may also be referred to as active surveillance, is an approach that involves closely monitoring a patient's condition without giving treatment until symptoms appear or change.
Watchful waiting is a potential option for some indolent (slow-growing) blood cancers, including certain cases of:
Some people with certain blood cancers may manage their condition for years with a watchful waiting approach. When watchful waiting is recommended for a person with blood cancer, doctors will monitor the patient's health with regular doctor visits, including physical exams and lab tests. If symptoms appear or worsen, additional treatment options may be recommended.5
Doctors will monitor for signs and symptoms, such as:
- Swollen lymph nodes, or certain lymph nodes increasing in size
- Changes in blood cell counts
- Enlarged spleen
When watchful waiting is appropriate
Watchful waiting is not an appropriate option for all blood cancers, but it may be appropriate in cases where the blood cancer is slow-growing or where there are no noticeable symptoms from the cancer. Researchers have realized that in cases like these, earlier treatment may not change a patient's chance of survival. Delaying treatment can provide a better quality of life for the present, as patients may be able to avoid receiving certain drugs and experiencing their potential side effects until later. For patients that are good candidates for watching and waiting, the risks of certain treatments may not outweigh the benefits. Each individual should talk with their doctor about the risks and benefits of treatment and how they relate to their unique situation.5-7
Dealing with watchful waiting
When the recommended treatment is no treatment, but rather watching and waiting, it can be stressful for the individual who may have just learned they have blood cancer. It can be reassuring to know that when watchful waiting is recommended, doctors know the disease can remain stable for years and the patient is not in any immediate danger. Also, watchful waiting means the patient is being closely monitored, and any changes that might indicate that treatment is needed will be found.6
It is normal for watchful waiting patients to feel anxiety and a sense of helplessness. For those who are dealing with the anxiety of watchful waiting, consider the following approaches:
- Focus on the areas of your health that you can control, including diet, exercise, and stress management. This can improve your overall health and give you a sense of empowerment.
- Learn about your condition. Do some research and talk to your doctor to gain an understanding of the risks and benefits of treatment approaches including watching and waiting.
- Get a second opinion. Seeking another opinion from a different doctor may confirm the approach to watch and wait or may give you another option.
- Consider clinical trials. There may be clinical trials that are recruiting patients with your condition who have not yet had any treatment. Clinical trials offer an opportunity to receive the latest medications and approaches.6
- Find ways to express your emotions. Rather than bottling up your emotions like frustration, worry, fear, and anger, find healthy ways to work through them, such as journaling, talking with a friend or counselor, or joining a support group.
Patients should talk to their doctor if they have any questions, or if they have questions regarding their watchful waiting approach. While patients do not receive active treatment during watchful waiting, they should still tell their doctor about all their health conditions, as well as any medications (prescription and over-the-counter), herbal supplements, and vitamins they are taking.