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Ed Forum 2016

Watch and Wait

Watch and wait is not really a treatment but rather a philosophy to avoid treatment after diagnosis until it becomes necessary. The watch and wait approach to WM is based on the fact that it is an indolent cancer, and many patients experience slow disease progression with few symptoms over a period of months or even years. The advantage to this strategy is that a patient avoids for as long as possible the use of treatments which can have adverse side effects.

At diagnosis, it is important to begin the process of recording laboratory values and symptoms to establish a baseline disease status; as additional laboratory tests are performed and symptoms are monitored on a regular basis over time, a trend will become evident that indicates the rate of disease progression and whether watch and wait continues to be appropriate or whether treatment is required.

During the watch and wait period, WM patients should establish a pattern of regular visits with their hematologist-oncologists, perhaps every 3-6 months. Typical laboratory tests performed for these visits include the Complete Blood Count (CBC), the Complete Metabolic Panel (CMP), and the IgM measurement by nephelometry and/or serum protein electrophoresis (SPEP). Special circumstances or conditions might require additional tests. Patients should be proactive and communicate any unusual or worsening disease symptoms to their hematologist-oncologists during this period.

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