Tags: cancer | myeloma | Waldenström’s | Mayo Clinic

Ins and Outs of 'Watch and Wait'

By    |   Tuesday, 24 March 2015 04:22 PM EDT

When I was diagnosed with acute myeloid leukemia, or AML, a fast-moving type of blood cancer, I began chemotherapy almost before I knew what had hit me. When treatment begins that quickly, you switch into fight mode.

At the other end of the spectrum is an approach called “watch and wait,” used for cancers that grow slowly and may cause few problems even at an advanced stage. When you have to watch and wait, the ambiguity can be unsettling.

The watch and wait approach is also often used for low-grade prostate cancer and in some instances of ductal carcinoma in situ (noninvasive) breast cancer.

But watch and wait is used most commonly for follicular lymphoma — the most common type of low-grade lymphoma, which makes up about 1 in 4 of all non-Hodgkin’s cases.

It can also be used for other low-grade lymphomas, including lymphoplasmacytic lymphoma (Waldenström’s macroglobulinaemia).

I know someone who is dealing with Waldenström’s right now. We haven’t discussed his state of mind, but he seems upbeat to me.

Yet, as noted, the watch and wait approach can create anxiety, with patients inevitably wondering when the other shoe will drop.

“We're so used to the idea that cancer needs to be treated as soon as it's discovered that it seems strange to just watch for something to happen. However, in some cases, ongoing monitoring is the best strategy,” according to a post on the Mayo Clinic website.

The same post also advises: “Watchful waiting should be considered an active strategy, as close monitoring can give you reassurance that your cancer is stable, and not aggressively growing. If a cancer is found to be progressing during the monitoring stage, then additional treatment strategies can be started.”

If you feel anxious, talk about it, whether to your doctor or nurse, some other professional, a friend, or family member.

Also, ask your doctor what warning signs might signal that treatment is required. Make a call or send an email if you are worried. Don’t just check the Internet.

People who are generally healthy have a lower risk of complications when entering treatment. Therefore, the following suggestions might help:

• Eat a healthy diet such as leafy greens, fish, lean meats, fruits, and vegetables and try to maintain a healthy weight.

• Try not to drink more than the recommended alcohol per week.

• If you smoke, try to stop.

• Exercise at least 3 days a week.

• Try to reduce or limit those parts of your life that are stressful or difficult; incorporate yoga or meditation or whatever healthy activity works for you.

• Ensure that you have time for relaxation and doing things you enjoy.

• Outline your monitoring plan with your doctor.

• Understand next steps if active treatment is necessary. Being well informed will help with your sense of control.

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The watch and wait approach is also often used for low-grade prostate cancer and in some instances of ductal carcinoma in situ (noninvasive) breast cancer.
cancer, myeloma, Waldenström’s, Mayo Clinic
Tuesday, 24 March 2015 04:22 PM
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