What Is Watchful Waiting?

For certain medical conditions, delaying treatment while regularly monitoring the progress of disease — a strategy doctors refer to as “watchful waiting,” active surveillance or expectant management — may benefit some people more than a rush to medications or surgery.

The purpose of “watchful waiting” is to see if a condition progresses. That way, patients, caregivers and physicians can learn more about what kind of threat a problem poses and they can all make a better decision about the type of treatment (if any) is needed and how soon to start it. Some people might never need treatment; for example, those with a very slow-growing cancer. With other conditions people can sometimes delay treatment for months or years.

How Is “Watchful Waiting” Done?

First of all, watchful waiting does not mean doing nothing. If you and your doctor agree that watchful waiting is a good choice for you, you may still need regular checkups. These checkups could include tests like blood tests, biopsies or imaging scans. You may also be asked to track your symptoms and record any problems you experience.

For What Kinds of Conditions is Watchful Waiting a Possible Approach?

Watchful waiting is sometimes used with cancers that may grow slowly or with pre-cancerous conditions. It can also be used for minor illnesses like children’s ear infections, since many go away on their own. Back pain or pulled muscles are other common problems where watchful waiting may be suggested.

How Do You Know if Watchful Waiting Is Right for You?

When there are multiple options for treatment for a health problem or when the risks of treatment are high and the benefits are uncertain, it may be best to give yourself and your doctor time to observe your problem and get more information.

You should always talk to your doctor to figure out the best treatment at any time in your illness.

What Are Some Questions You Should Ask Your Doctor if He or She Suggests Watchful Waiting?

  • What is the expected course of this condition or disease?
  • If I wait, will my condition be harder to treat later?
  • What types of monitoring will I receive while under active surveillance? How often?
  • At what point would you recommend I move from active surveillance to treatment?
  • Are there therapies or activities I can do to slow or halt the course of my condition or disease?

What Are the Pros and Cons of Treatment?

Here are a few resources that can help specifically compare and contrast procedures and treatments for a specific condition or disease, to prepare you to have a discussion with your clinicians.

Where can I find treatment information?

  • MedicineNet.com is a general health information site that also contains short descriptions of common medical procedures. The site is owned and operated by WebMD.
  • Mayo Clinic's public health site contains "decision tools" that help you decide what kind of treatment is best for your condition. Videos and slide shows explain several diseases and medical procedures.
  • US Food and Drug Administration offers information on both drugs and medical devices.
  • Consumer Reports Best Buy Drugs is a new service by Consumers Union with free information comparing various prescription options for specific conditions. Some information is available in Spanish.
  • Harvard Health Publications-Diagnostic Tests is a searchable guide to diagnostic tests such as MRI, spinal taps and catheterization. It provides information about what to expect before, after and during the tests, and what tests might indicate.
  • The National Cancer Institute has short summaries about different adult cancers and pediatric cancers with info on treatment, screening and prevention, genetic and alternative and complementary medicine research from over 70 peer-reviewed journals. The summaries are updated monthly and many are available in Spanish. They are freely available at the NCI website or by calling the NCI helpline at (800) 4-CANCER or (800) 422-6237.
  • The Effective Health Care Program created by the Agency for Healthcare Research and Quality has several guides for patients and consumers based on research on a variety of topics, such as cancer, diabetes, and mental health.

Resources reviewed June 2013

MORE MAKE GOOD TREATMENT DECISIONS RESOURCES
Finding Treatment Information
Want to find out more about the treatments your doctors suggest? Here are some resources for doing your research and comparing your options.
Understanding Medical Terms
Doctors can sometimes use unfamiliar and complicated terms to describe your illness and treatment. Here are some resources to help you understand.
What Is Watchful Waiting?
Tips to help you weigh the pros and cons of treatment and decide if watchful waiting is right for you.
Should I Get a Second Opinion?
Advice for deciding whether you should get a second opinion, telling your doctor and resources for finding and paying for a second opinion.
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RESOURCES

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