Watchful waiting

The term Watching and waiting, Eng. watchful waiting or active surveillance is called in medicine a specific treatment strategy. The disease is initially not treated (Therapy ), the course of the disease but is checked at regular intervals ( diagnosis). If certain diagnostic parameters reached, a therapy can be initiated.

Description and examples

Watching and waiting is displayed especially in diseases

• In which a high probability of simultaneous self-healing is or
• In diseases in which a high degree of uncertainty of the diagnosis is made or
• In diseases for which the therapy is associated with a high risk or the risk and are expected side effects of the intervention is greater than the advantages of the procedure.

Watching and Waiting, for example, be used when prostate cancer. This concept is agreed between patient and doctor that initially no treatment is done, but by regular diagnosis (palpation, imaging, tumor markers (PSA ), etc. ) is the tumor growth. Watching and waiting is mainly used in relatively small, well-differentiated prostate tumors when the remaining life expectancy of the patient is less than ten years. The potential side effects (impotence, incontinence ) a surgical intervention can significantly affect the quality of life of the patient. The therapy may be delayed if necessary until it becomes necessary. Referred to by some authors as active surveillance - - background with this approach is that small, well-differentiated prostate tumors will not progress to the point that a therapy is needed at all. The probability that the patient will die from another disease is comparatively high. Therapy performed - With a relevant tumor progression is then - with the consent of the patient.

During watchful waiting, however, carried a largely palliative disease management in patients of advanced age and high comorbidity. Curative treatment is not carried out. A hormone withdrawal is only performed if the patient is symptomatic.

Other examples of diseases in which watch and wait may be an option, hemangiomas, mood disorders, and renal cell carcinomas (for a tumor diameters up to 4 cm).

Demarcation

In contrast, the primary tumor is removed immediately, but relinquish any therapeutic measures ( radiotherapy and chemotherapy), first in the wait-and -see strategy. Through close-knit investigations also, the further course is observed to apply such further therapeutic options. An example of such a tumor is a non- metastatic seminoma. The terms are, however, often mixed in daily practice.