Watchful waiting, also known as watch and wait or active surveillance, is an approach to treatment for a medical issue that relies on monitoring the patient rather than engaging in active treatment. Doctors can recommend watchful waiting for a variety of reasons. Although it sometimes comes as a surprise to the patient, sometimes the best treatment is no treatment at all.
When watchful waiting is recommended to a patient, the patient is directed to take note of any changes in status or symptoms and to call the doctor if something changes significantly. In addition, patients are usually asked to attend regular follow up appointments for examinations and testing. These appointments allow the doctor to monitor the patient's condition and to identify any troubling changes early, sometimes before the patient is aware of them.
One reason to recommend watchful waiting is because a condition may resolve on its own. Things like ear infections, colds, coughs, and the stomach flu often clear up independently, without medical intervention. A doctor might send a patient home and recommend rest, fluids, and watchful waiting to see if the condition resolves. If the patient grows worse or experiences symptoms like an altered level of consciousness, then the doctor can recommend treatments. This ensures that people do not take medication when they don't have to, and allows people to avoid potentially invasive treatments if they are not necessary.
Conditions that progress slowly can also be candidates for watchful waiting. Prostate cancer is a common example. Some patients with prostate cancer die of other causes before their cancers become problems. Providing treatment for the cancer would be expensive, invasive, and grueling for the patient, and if it isn't necessary, a doctor may not recommend it. Watchful waiting allows the doctor to take action if the cancer does take an aggressive turn. For some conditions, treating when the issue first presents is actually less effective than waiting for the disease to reach a vulnerable point, in which case watchful waiting is designed to catch the disease when it can most effectively be treated.
Another reason for this approach to treatment is an unclear diagnosis. Rather than providing treatment without being sure of a diagnosis, a doctor may recommend waiting and watching for more symptoms. This will allow the doctor more time to develop a diagnosis and offer the right treatment on the first try. This is especially important when a patient could have one of several diagnoses and treating for one could potentially exacerbate another or complicate the diagnostic process.
