[Speaking: Linda] My name is Linda, I was diagnosed with a non-Hodgkin lymphoma,
and the haematologist offered me a treatment option called watch and wait.
The haematologist explained watch and wait to me as a treatment option
where they monitor you, look at your symptoms and as they develop over time,
they will decide when is the best time to start treatment.
[Speaking: Dr. Robert Marcus] My name is Robert Marcus, I’m a consultant haematologist,
and I have a special interest in lymphoma.
Watch and wait is an appropriate option for patients with low grade, slow growing, unaggressive lymphoma
without symptoms, who can be observed without therapy
and yet can still be offered effective treatment when they require it.
[Speaking: Linda] I thought it was a bit strange because I imagined you would need to treat cancer immediately.
[Speaking: Dr. Marcus] It’s often very difficult for patients to be told they’ve got cancer
and yet you’re not going to treat it.
But we need to emphasise that there is no advantage in treating a patient
with no symptoms, and conversely there’s no disadvantage in waiting two, three or even
five years before treatment is given because the treatment will be
as effective if given then as at the time of diagnosis.
[Dr. Marcus] The advantages of watch and wait are
the patients aren’t having therapy, so they’re not having treatment with side effects and toxicity,
they’re not having frequent hospital visits; patients should know though, that
they’ll be carefully monitored and they will receive treatment when they require it.
Patients on a watch and wait policy will live as long as those patients who have immediate
therapy for this kind of low-grade lymphoma.
Monitoring of patients on a watch and wait programme
will involve regular, clinical assessment, blood tests and may involve some scans.
[Speaking: Linda] My experience with watch and wait was fairly simple; a blood test every two to three months
and a consultation with a haematologist. She would look at the results with me and monitor to
see if there was any other symptoms occurring, and that whole process lasted, for me,
two years and two months. The main difficulty I found with watch and
wait was just not knowing when the waiting would be over and treatment would begin,
so to take my mind off that I just went along to the normal things that I enjoyed, for me,
is going to art classes or painting and drawing at home; just anything that would make me
feel relaxed.
[Speaking: Dr. Marcus] We would start patients on treatment, who had been previously on a watch and wait
policy if they had symptoms of lymphoma, so they
start to get sweats, fevers or weight loss, or the lymph glands start to compress something
important, so the patients start to get difficulty with swallowing, cough or shortness of breath,
abdominal swelling or, if on a scan we found the kidneys were being obstructed by the lymphoma.
[Speaking: Linda] The watch and wait period ended when I noticed my symptoms getting worse.
I had heavier nosebleeds and dizziness, and that all came quite rapidly
so the chemotherapy was what I had as a treatment.
[Speaking: Dr. Marcus] It’s very important for patients to be able to talk to their doctor and the clinical nurse
specialist about watch and wait. If patients are finding it difficult to cope
with the idea of watch and wait, they can always discuss this with the clinical nurse specialist
their doctor at the clinic visits, join a support group or talk to other patients
in a similar position, and I hope that will be helpful for them.
[Speaking: Linda] The watch and wait process seems like a good idea because when you’re feeling well and
not needing the treatment at the start of your diagnosis, you can lead a normal life
up until the point where you’re feeling unwell, and then the treatment will begin.
For other people who are about to start watch and wait I would say don’t worry at the
beginning, because you’re feeling well, you probably don’t have any, or very few symptoms
but at the same time, don’t forget to let your doctors know if you notice anything
developing, any symptoms worsening, and together with them, they will decide with you when
is the best time to start treatment.