Watchful waiting for non-Hodgkin lymphoma

If non-Hodgkin lymphoma (NHL) is growing slowly and isn't causing any symptoms or problems, you may be offered watchful waiting.

Watchful waiting means that your healthcare team watches the cancer closely for changes. It doesn't mean that nothing is being done or that your cancer diagnosis is being ignored. You will be having regular checkups so your healthcare team can closely monitor you. They will use tests and exams to check if NHL is growing or spreading. Other treatment is given when you develop symptoms or the cancer changes.

During your regular checkups, your healthcare team will ask you how you are feeling. They will ask about any symptoms you have, including fever, unexplained weight loss or night sweats (also known as B symptoms). If you notice any changes, tell your healthcare team right away. Don't wait until your regular checkup.

The healthcare team will also do:

  • physical exams, including feeling the lymph nodes or spleen to see if they are larger than normal
  • blood tests, including complete blood count

Watchful waiting helps avoid side effects that can happen with treatments such as targeted therapy or chemotherapy. There is no evidence so far that people won't live as long when they get watchful waiting compared to other treatments. And there is no evidence that watchful waiting has other negative effects if or when you start treatment.

Expert review and references

  • PDQ® Adult Treatment Editorial Board. Adult Non-Hodgkin Lymphoma Treatment (PDQ®) – Patient Version. Bethesda, MD: National Cancer Institute; 2021: https://www.cancer.gov/.
  • PDQ® Adult Treatment Editorial Board. Adult Non-Hodgkin Lymphoma Leukemia Treatment (PDQ®) – Health Professional Version. Bethesda, MD: National Cancer Institute; 2022: https://www.cancer.gov/.
  • American Society of Clinical Oncology (ASCO) . Cancer.net: Non-Hodgkin Lymphoma . 2021 .
  • Cancer Research UK. Treatment Options. 2020: https://www.cancerresearchuk.org/.
  • American Cancer Society. Treating Non-Hodgkin Lymphoma . 2018: https://www.cancer.org/.
  • Lymphoma Canada. Understanding NHL: A Patient's Guide to Non-Hodgkin Lymphoma. 2020: www.lymphoma.ca.
  • Alberta Health Services. Clinical Practice Guideline: Lymphoma. Edmonton: 2019: https://www.albertahealthservices.ca/.

Medical disclaimer

The information that the Canadian Cancer Society provides does not replace your relationship with your doctor. The information is for your general use, so be sure to talk to a qualified healthcare professional before making medical decisions or if you have questions about your health.

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