When you first learn of your cancer diagnosis, your immediate response might be to gear up for the fight of your life. So it might be confusing when the doctor says that when it comes to treatment, for the time being you’ll do nothing at all.
Active monitoring, or “watch and wait,”
is an approach that involves closely monitoring a cancer, holding off on treatment until symptoms appear or change. This tactic is typically used for slow-growing cancers, where symptoms typically do not appear for years, if at all. It’s a safe
approach for certain tumor types (like early-stage prostate, breast, thyroid, or rectal cancers) and some forms of blood cancers, allowing people to avoid complications from potentially toxic cancer treatments.
But this hands-off approach can come with a different set of complications—namely, a lot of worry. It’s understandable to want to treat a cancer in your body, so playing a waiting game can bring about feelings of anxiety or fear. You may also have a lot of big questions, like, “What, exactly, are we watching for?” or “What happens if we wait too long?”
First off, you can (and should!) ask your cancer care team those questions. In fact, we’ve created a whole list of questions you may want to ask your doctor before starting a watch and wait
approach. The more you know about why your cancer care team has chosen this approach, the more comfortable you may feel with the decision. If you want to get a second opinion from another doctor, that’s also a great way to feel reassured you’re taking the right approach.
Even then, you might feel nervous or even fearful from time to time. Anxiety is common
for people taking the active surveillance approach to their cancer, but there are ways to manage these feelings. Here’s how to keep your watch-and-wait from turning into watch-and-worry.
Name your worries. Sometimes, saying it out loud makes it less scary. Whether you share your fears with a therapist, an oncology social worker, or your best friend, openly discussing what makes you nervous can be the first step in removing those fears. Together, you can work toward actionable ways to reduce your anxiety.
Build a network of people who get it.
If you’re feeling like your concerns aren’t being heard by your spouse, family members, or friends, (or if you’re just not ready to share with them) try an online or in-person support group.
Knowing there are people out there who are familiar with your fears and are thriving with your particular type of cancer and/or treatment approach can be hugely comforting.
Check out clinical trials.
Some clinical investigations provide extremely close monitoring, genetic testing, and (in some cases) early treatment for those who would normally be told to watch and wait. If this interests you, ask your doctor or visit clinicaltrials.gov.
In addition to getting a higher level of observation, your participation in clinical trials will help other people who have cancer.
Be an active part of your surveillance. The “watch” in watch-and-wait involves regular testing from your doctor. Whether it’s a monthly blood draw or yearly CT scan, it’s important that you attend all appointments, even if you’re scared of what these tests might uncover. Learn about the signs or symptoms you should watch for between appointments, and tell your cancer care team right away if you notice them.
Take care of yourself.
If you’re feeling like things are out of your control, take small steps each day to reclaim ownership of your physical and mental health. Healthy eating
, daily exercise
, and a regular sleep routine
are important – not only for keeping your slow-growing cancer from accelerating, but for preventing and managing feelings of anxiety
Decide how much (or how little) information you want. Watch-and-wait recommendations are based on years of science showing there is no benefit in starting invasive treatment for certain cancers before it is needed. Some people find peace of mind in reading the latest studies on their particular type of cancer, since it helps reaffirm their decision to watch and wait. Others feel overwhelmed by such information, and prefer to trust their doctor will let them know of the latest developments. There is no one “best” way to approach this—only the way that is best for you and your mental health.
Learn new ways of thinking.
Cognitive-behavioral therapy, which involves changing the way you think about events, has been found to help with managing negative thoughts about cancer. Learn how to re-frame your thoughts, either with the help of a trained therapist or oncology social worker, or through free resources like CancerCare’s CBT Guide.
Take time to appreciate the good things.
Negative, fearful thoughts can become all-encompassing if you let them. Keeping a positive frame of mind can help you to put things in perspective. Take time each day to do things you truly enjoy, whether it’s a good book, time with loved ones, or an hour-long run. You might also consider keeping a daily gratitude journal, which has been found
to foster feelings of well-being.
Talk with your cancer care team. Active surveillance isn’t for everyone. If your anxiety about watch-and-wait is significantly impacting your quality of life (or if your cancer-related symptoms are particularly intense), talk with your doctor, nurse, or oncology social worker. After weighing all of your options, you and your healthcare professionals can decide if beginning treatment would be useful at this stage. Remember, you’re a key part of your cancer care team, so don’t be afraid to speak up if something doesn’t feel right for you.
Remember, your cancer care team recommends the watch-and-wait strategy based on years of scientific evidence demonstrating its effectiveness. With the right mindset and coping skills, you can feel confident and calm using this strategy, too.