Watchful Waiting l WAW (Wait And Watch)

Watchful Waiting or WAW (Wait and Watch) is an approach to a medical problem in which time is allowed to pass before medical intervention or therapy is used. During this time a number of repeated tests are performed.  Usually, watchful waiting is an outpatient process and may have duration of months or years.

It is recommended in situations with a high likelihood of self resolution’ in situations where there is high uncertainty concerning diagnosis and in situations in which the risk of intervention or therapy may outweigh the benefits.

In recent years men diagnosed with prostate cancer who opt for ‘Watchful Waiting’ are in such a good condition that they consider it as a reasonable alternative to immediate treatment. It has become more popular with advent of PSA (Prostate- Specific- Antigen).

Survey conducted on patients in the US between the year 1992 to 2002 shows that there is 94% chances of survival in case of ‘Watchful Waiting’. Researchers therefore suggest that the survival rate with conservative management is so high that there may be less possibility of improvement from active treatment.

Studies prove that the vast majority of men suffering from prostate cancer detected by PSA testing have a very good prognosis and are unlikely to die of their cancer or suffer serious medical consequences from diseases spread at 10 or more years, even if not treated with surgery, radiation or hormone therapy.

Research also proves that many men are detected with prostate cancer and are treated, but seldom benefit from the treatment. It is here that the process of ‘Watchful waiting’ works, saving the patients from the harmful side effects of the rest of the treatment.

According to the US urologist Brantley Thrasher, ‘Watchful Waiting’ more appropriately known as ‘Active surveillance’ has a place in the treatment of prostate cancer, but to generalize the ‘Active surveillance’ is a good option would be both erroneous and inaccurate.

‘Watchful Waiting’ is a reasonable option for patients who are more than 75 years and have low grade tumors that are clinically localized with low PSA levels, and who have other health problems. Whereas patients with high grade tumor, and if the patient is younger and is in good health; in that situation active treatments like a radical prostatectomy could be more beneficial.

There has been a reduction in mortality with the advent of ‘Watchful waiting’