Watch and wait for Non-Hodgkin Lymphoma (NHL)
Watch and wait means delaying treatment until it is needed. For some people with non-Hodgkin lymphoma, this is an option.
What is watch and wait (active monitoring)?
If you have low-grade non-Hodgkin lymphoma (NHL), your cancer doctor may suggest you wait before starting treatment.
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 may also be called active surveillance or active monitoring. It is a way of delaying treatment until it is needed.
Your cancer doctor may suggest watch and wait if:
- you have low-grade lymphoma and you do not have symptoms or symptoms are not causing you any problems
- you have low grade lymphoma that has come back after treatment, but you do not have any symptoms or symptoms are not causing any problems.
Low grade lymphoma often develops slowly, and you may not need treatment for a long time.
Sometimes people worry about not having treatment straight away. But there can be advantages to delaying treatment.
In the video below, Dr Robert Marcus explains how patients with lymphoma are regularly monitored until treatment starts.
View the video without BSL interpreter on our YouTube Channel.
Advantages of watch and wait
- Studies have shown that people who delay treatment until it is needed usually live as long as people who start treatment straight away. They also respond just as well to treatment when this is needed.
- You will avoid the risk of treatment side effects for as long as possible.
- 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 shrinks without any treatment. This is called spontaneous regression.
- Some people do not need treatment for many years. Or sometimes, they may never need it.
Monitoring lymphoma
Even when you are not having any treatment for lymphoma, you will meet with your cancer doctor or specialist cancer nurse 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 or change (transform) into a faster growing type
- 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).
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 cancer 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 normally 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.
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