It's amazing how some topics just won't go away.
Watching and Waiting is one of them. It's especially interesting to me because I watched and waited for two years. I suppose I shouldn't really care anymore, since that ship has long since sailed, but I'm still interested in what research has to say about whether or not I made the right choice. (It certainly seems like I did, almost 7 years later....)
Researchers at the National Cancer Center Hospital in Tokyo are interested in whether or not Watching and Waiting is still a valid strategy in the Rituxan Era. This has been the way the subject has been thought about for a while: the idea behind watching and waiting was that it was better to do nothing because the alternatives could do harm (when the alternatives were traditional chemotherapy). But with Rituxan, and its minimal side effects, is there really a reason to wait? Another reason for W & W: with a limited number of available treatments, isn't it better to hold them in reserve until absolutely necessary? But now, we have so many new treatments available and in the pipeline, why not just treat immediately?
There have been lots of responses to those questions in the last 5 years or so, with answers on both sides. But neither side has been able to come up with research that shows that their side is the winner of this debate.
So the latest attempt, to be presented at ASH, says this:
The study looked at 348 patients treated between 2000 and 2012 (101 watched and waited, and 247 were treated immediately). Of the Watch-and-Waiters, 45 patients received treatment for lymphoma within a median of 16 months. Looking at Time to Treatment Failure (how long it took until a second treatment was needed), the 45 who had watched and waited before treatment had a TTF of 92 months, while the patients who had immediate treatment had a TTF of 85 months. Statistically, there's no difference between them. Other measures had the same result: Overall Survival was essentially the same between the groups, and so was risk of transformation.
So, basically, there is no negative impact to Watching and Waiting, at least in looking at these particular factors, for this particular population. That seems to be about the same result that we've kept getting for the last five years.
Of course, the numbers don't really tell the whole story when it comes to deciding whether or not to watch and wait. Numbers can tell your head that it's an OK choice, but there's an emotional aspect to that decision, too. If you think you can handle the not-knowing, and you don't feel the need to just do something, then watching and waiting is an especially valid choice. But that's a hard thing to measure with numbers, especially in the heat of a new cancer diagnosis. That's got to come from deep inside.
So it's good to know that I made an OK choice seven years ago. Not that I would have regretted it if the numbers have come out differently. No point in regretting our choices. We have enough to worry about without adding guilt to it.....