You watch sunsets or movies or birds. You wait for buses or amusement park rides or your turn in line. But what do watching and waiting have to do with lung cancer? It can seem counterintuitive to a lung cancer patient for their doctor to recommend “watchful waiting” or “active surveillance” as the right course of action for treating their lung cancer tumor. It is only natural to want to do everything you can to rid yourself of cancer if you have it, leading many people to say they are “battling” or “fighting” cancer. But in actuality, watchful waiting - which means closely watching a patient’s condition but not giving treatment unless symptoms appear or change - can be an important part of treating lung cancer patients.
Why would a doctor recommend watchful waiting for a lung cancer patient?
There are some types of lung cancer tumors that grow very slowly. If you have one of these types of tumors, it is possible that you could go your whole life without any problems from the tumor. But if you treat the tumor with procedures or medication, you might experience unnecessary side effects or complications. By monitoring the size and shape of the tumor through periodic CT scans, your doctor can see if treatment would be the best option for the tumor.
Sometimes your doctor might use watchful waiting in between treatments to help dictate the next best course of action. For example, your doctor might monitor your tumor with a CT scan after several rounds of chemotherapy to see if your tumor has shrunk or changed.
LUNG FORCE Hero Donna F. was struggling with side effects from her chemotherapy regimen. Her doctor recommended taking a break and watching how her tumors responded. When the tumors continued to grow pretty rapidly, she discussed all of her options with her doctor, one of which was a new clinical trial for an immunotherapy drug. She was able to get into the clinical trial and has been responding well to her immunotherapy drug for many years now.
Watchful waiting can be stressful. Some patients take solace in the fact that they have been actively treating their lung cancer and not treating it can almost feel like they are waiting for the other shoe to drop. “If you find yourself wondering why you are being told to watch rather than treat, or how to be successful in watchful waiting, talk with your medical team” says Caryn Blanton, MSW, LCSW, an oncology social worker at Rush University. “It may be helpful to begin engaging in emotional support or counseling through a support group or a mental health professional. For those seeking more spiritual guidance, faith leaders can be especially helpful in times like this as well.”
Some patients may be resistant to watchful waiting and feel that their cancer is being ignored or their doctor believes they are too sick to be treated. This is not the case. Clinicians use all of the information available to recommend the best treatment option for you, and while patients may want to feel as though they are actively “battling” the disease, sometimes active surveillance really is the best option.
“The best way to help reduce the stress and uncertainty of the watchful waiting approach is to be open and communicative with your treating team throughout your treatment journey. No physician wants a treatment for a patient that is worse than the underlying disease and leads to complications or worsening quality of life, if it doesn’t appear to be necessary. Make sure your physician clearly explains, in terms you understand, the rationale of the watchful waiting approach and why it is better than other options at that time,” says Albert Rizzo, M.D., Chief Medical Officer of the American Lung Association.
If you ever feel uncomfortable with a decision about your care, speak with your doctor and don’t hesitate to seek a second opinion.