watchandwait

Watch-and-wait, commonly referred to as watchful waiting or active surveillance in some contexts, is a medical management approach in which immediate treatment is deferred after a diagnosis. The strategy rests on regular monitoring to detect signs that the condition is progressing or that symptoms have developed, at which point treatment would be reconsidered. It is used when the risks or side effects of treatment may outweigh the potential benefits, or when the condition is likely to remain stable for an extended period.

In practice, watch-and-wait is most often applied in oncology and certain chronic conditions. For example, in older or frail patients with low-risk prostate cancer, or in individuals with indolent chronic lymphocytic leukemia (CLL) who have no symptoms or organ involvement, clinicians may opt for careful observation rather than immediate therapy. Monitoring typically includes scheduled visits, physical examinations, laboratory tests (such as PSA for prostate cancer or blood counts for CLL), and imaging as indicated. Treatment is initiated if there is evidence of progression, new symptoms, or declines in function.

Advantages of this approach include avoidance of treatment-related side effects and preservation of quality of life, especially when the disease is slow-growing. Disadvantages include the potential for anxiety due to living with untreated disease and the need for ongoing, sometimes intensive, follow-up. Selection criteria depend on disease biology, patient health, and life expectancy. See also active surveillance, expectant management, and patient monitoring.