Watch and wait

This is an option for some people with indolent lymphoma|. It’s not suitable for aggressive lymphoma.

Watch and wait is most likely to be offered to people who have advanced-stage indolent lymphoma (stage 3 or 4) but who aren’t having symptoms. It’s a way of delaying treatment until it’s needed.

The average time that people follow a watch and wait treatment plan is about three years. But, for some people it’s shorter than this, and for others it can be much longer.

Sometimes people worry when they’re told they won’t begin treatment immediately. However, there can be many advantages to delaying treatment.

Advantages of watch and wait

People who put off having treatment until it’s needed live for as long, and respond to treatment as well, as people who start their treatment immediately.
You won’t experience side effects from treatments such as chemotherapy until absolutely necessary.
Effective treatments can be kept in reserve for you until they’re needed.
Indolent lymphoma can go through periods when it’s more active and periods when it’s stable or even shrinks. In some people, the lymphoma may shrink without any treatment (spontaneous regression).

Monitoring

Even when you’re not having any treatment for lymphoma, you’ll still see your cancer specialist regularly. At each appointment they’ll check for signs that show you may need

to start treatment. Changes that might mean you need to begin treatment include the following:

unexplained weight loss, severe night sweats, or unexplained fever. Go to our section on staging for more information on B-symptoms.
a lower than normal number of red blood cells (anaemia), white blood cells or platelets in your blood
the lymphoma begins growing quickly
the lymphoma starts affecting an important organ, such as a kidney
the lymph nodes get bigger than 5-7cm (2-3in) (this is called bulky disease)
a build-up of fluid in the tummy area (ascites) or in the lining of lungs (pleural effusion).

Coping with watch and wait

If you’re worried about delaying treatment, here are some helpful tips from people who have experienced watch and wait:

Make sure you understand why watch and wait is recommended. If you have any concerns, talk to your doctor.
Think of your time without treatment as an opportunity to maximise your quality of life. Use it to do things you enjoy, and to get as fit and healthy as you can. You may find our sections on eating well and physical activity helpful.
Try to focus on the present rather than what might happen in the future.
Express your feelings - you can do this by talking to family and friends, joining a support group or online forum, or by keeping a journal.

Although watch and wait can be difficult to adjust to at first, many people find it gets easier as time goes on.

Content last reviewed: 1 April 2012

Next planned review: 2014

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