Watchful Waiting Benefits and Risks

woman looking out a window waiting
What does watchful waiting mean with cancer or an abnormal scan?. Photo©jaguarblanco

Watchful waiting is a term used to describe a period during which a patient is closely monitored by his doctor, but no specific medical treatment is given until the patient develops symptoms or his symptoms change.

Watchful waiting may also be called:

  • Active surveillance
  • Wait and watch
  • Expectant management


The term watchful waiting is used in medicine for both cancerous and non-cancerous decisions.


Watchful waiting may be considered, for example, if an individual is found to have a solitary pulmonary nodule on a CT scan of the chest that is unlikely to be cancerous.

While watchful waiting is discussed often with prostate cancer, it is considered less frequently with lung cancer, especially with early-stage lung cancers that have the potential to be cured by surgery and have a low survival rate if left untreated. Watchful waiting may at times be considered if a lung cancer is not likely to be cured by surgery, and immediate treatment is likely to cause more symptoms or discomfort than cancer itself.

Watchful waiting is also a commonly recommended approach for slow growing, or "indolent" lymphomas, such a low-grade follicular lymphoma.


If a disease is not any more likely to kill you or make you sick without treatment — and this is important to understand well — there are the advantages to choosing no treatment. These can include:

  • No side effects
  • Less chance of developing resistance to medications that might be used later on
  • Fewer clinic/hospital visits
  • Better quality of life
  • Less cost to you

Watchful Waiting Is Not...

There are a few questions friends and family will ask almost immediately upon hearing of your decision for watchful waiting, so it's helpful to talk about what watchful waiting is not.  It is NOT

  • It is not that there are no treatment options
  • It is not that you are too old
  • It is not that you are too sick
  • It's not that your cancer is too advanced to be treated
  • It is not that the treatment is too costly

Questions to Ask

If you are considering a wait and watch approach, consider asking your doctor these questions.

  • What do you expect will happen if I wait?
  • What will happen if my condition progresses?
  • Could it lower my survival if I choose to wait for treatment?
  • Will waiting make it harder to treat my condition later on?
  • What can I do while I wait?  Do a good diet and exercise have any role in my disease?


It can be very hard emotionally to choose a wait and watch approach to diagnosis or treatment. If you are coping with cancer, you realize how the public is programmed that we need to treat cancer aggressively and fast. Take time to weigh the pros and cons of your decision carefully. Ask your friends and loved ones for their input, but the decision must be your own — what you can live with yourself. This can be difficult if others have opinions which differ. Some people find that talking to a social worker or connecting with others via social media who are coping with a similar situation helpful.

You may feel like you are going backward in choosing a watchful waiting approach, but you may think of it differently. With advances in medicine, we are learning that sometimes the best treatment is truly no treatment. Hippocrates was aware of this in writing the Hippocratic oath, but some of that wisdom has been lost in our current age in which it seems more is better and aggressive is good.

Also Known As: wait and watch, WAW, expectant management, observation, active surveillance

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