Watch and wait for non-Hodgkin lymphoma

Your doctor may suggest that you don’t need to start treatment straight away. Instead you 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 is a way of delaying treatment until it is needed.

Watch and wait is an option for some people with low-grade lymphoma. It is not suitable for high-grade lymphoma.

Watch and wait is most likely to be offered to people who have low-grade lymphoma but who do not have symptoms.

A watch and wait treatment plan lasts an average of about three years. For some people, it is shorter than this, and for others it can be much longer.

Sometimes people worry about not having treatment immediately. But there can be advantages to delaying treatment.

Advantages of watch and wait

  • Studies have shown that people who decide to put off having treatment until it is needed live as long as people who start their treatment immediately. They also respond just as well to treatment.
  • You will not experience side effects from treatment until it is absolutely necessary.
  • Effective treatments can be kept in reserve for you until they are needed.
  • Low-grade lymphoma can go through periods when it is more active and others when it is stable or even shrinks. In some people, the lymphoma may shrink without any treatment. This is called spontaneous regression.

Monitoring

Even when you are not having any treatment for lymphoma, you will still see your cancer specialist regularly. At each appointment, they will check you for signs that you may need to start treatment. These signs might include:

  • unexplained weight loss, severe night sweats or unexplained fever (B-symptoms)
  • a lower than normal number of red blood cells (anaemia), white blood cells or platelets in your blood
  • the lymphoma starting to grow quickly
  • the lymphoma starting to affect an important organ, such as a kidney
  • the lymph nodes getting bigger and bulky
  • a build-up of fluid in the tummy area (ascites) or in the lining of lungs (pleural effusion).

An image of Linda, affected by non-Hodgkin lymphoma.

Lymphoma - watch and wait

In this cancer information video, Dr Robert Marcus explains how patients with lymphoma are regularly monitored until treatment starts. This is called watch and wait. Linda talks about her experience.

About our cancer information videos

Lymphoma - watch and wait

In this cancer information video, Dr Robert Marcus explains how patients with lymphoma are regularly monitored until treatment starts. This is called watch and wait. Linda talks about her experience.

About our cancer information videos

Coping with watch and wait

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

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