Watch and wait for Hodgkin lymphoma

Watch and wait means delaying treatment until it is needed. It is sometimes used for a type of Hodgkin lymphoma called NLPHL.

What is watch and wait (active monitoring)?

If you have nodular lymphocyte predominant Hodgkin lymphoma (NLPHL), your doctor may suggest you do not need to start chemotherapy straight away.

Instead, you will have regular tests and appointments to monitor the lymphoma and check for signs that you need to start treatment. This is called watch and wait. It may also be called active surveillance or active monitoring. It is a way of delaying treatment until it is needed.

NLPHL often develops slowly and you may not need treatment for a long time. Your doctor may suggest watch and wait if you have NLPHL:

  • that was in a small area but was completely removed by surgery or treated with radiotherapy
  • that is not causing symptoms
  • that has come back, but you do not have any symptoms.

Watch and wait does not make your treatment less effective when you need it.

Sometimes people worry about delaying treatment. However, cancer treatments cause side effects. Some side effects may be long term or start to affect your health years after treatment. Watch and wait means you can have treatment when you need it and avoid side effects for as long as possible.

Coping with watch and wait

If you are worried about delaying treatment, here are some helpful tips:

  • Make sure you understand why watch and wait is recommended and what other treatment options there may be. If you have any concerns, talk to your doctor.
  • Think of your time without treatment as an opportunity to make the most of a good quality of life. Use it to do things you enjoy and to get as fit and healthy as you can.
  • 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 with time.

About our information

  • References

    Below is a sample of the sources used in our Hodgkin lymphoma (HL) information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    Hodgkin lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up; European Society for Medical Oncology (2018).

    National Institute of Health and Care Excellence (NICE). Blood and bone marrow cancers. NICE Pathways. Last accessed 3 December 2020.

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Rajnish Gupta, Macmillan Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.