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Watch and Wait (active monitoring)

For some low grade, slow growing tumours that are unlikely to spread, a ‘Watch and Wait’ approach may be used. This is more accurately described as the active monitoring of your condition, without giving any immediate treatment, unless your symptoms develop, or worsen, or your scan changes.

The most common types of brain tumours to receive a ‘Watch and Wait’ approach are newly diagnosed low grade gliomas (grade 1 or 2 astrocytomas, grade 2 oligodendrogliomas) and grade 1 meningiomas.

Living with a low grade tumour

Please watch a recording of our live panel discussion on living with a low grade tumour. It’s chaired by Gideon Burrows, who’s living with a low grade tumour.

Why is ‘Watch and Wait’ used?

Tumours that are typically slow growing and unlikely to spread may cause no, or only a few, symptoms for many years. In this case, a ‘Watch and Wait’ (active monitoring) approach may be used, rather than give treatments that can cause considerable side-effects.

Examples where this might be the case include:

  • tumours with no symptoms that were discovered by accident e.g. following a scan given for a head injury (an incidental finding)
  • tumours in which the symptoms are such that you feel able to live with without them badly affecting your quality of life e.g. seizures that are being well-controlled by anti-epilepsy drugs
  • the tumour is growing in an area that’s difficult to operate on and possible treatments will cause more harm than doing nothing
  • you don’t want to have surgery or other treatments.

‘Watch and Wait’ is also sometimes used after initial treatment, such as biopsy or debulking surgery, where part of the tumour is removed, before giving other treatments that could cause worse side-effects.

Make the right choices for you

Our Step by Step interactive guide outlines what happens following a diagnosis, to answer your questions and help you to understand what to expect.

How does ‘Watch and Wait’ work?

If you’re on ’Watch and Wait’, you’ll see your specialist for regular check ups/MRI scans. Having MRI (Magnetic Resonance Imaging) scans means that the size and features of your tumour can be very accurately monitored and compared over time. These can vary in frequency, from every few months to every couple of years.

You might begin treatment if:

  • there’s a marked increase in tumour size
  • you develop symptoms, or worsening of symptoms, that badly affect your quality of life
    e.g. uncontrollable seizures
  • the tumour becomes a higher grade (starts growing more quickly).

Depending on your tumour and age, this could take many years, or not happen at all.

I utilised my hobbies, such as running, which helped my mental health and allowed me to de-stress.

Emotional impact of ‘Watch and Wait’

Being told that you have a brain tumour, but no active treatment will be given until it grows bigger, or becomes more aggressive, can be very frightening. The time between appointments can also seem (or be) long.

People who’ve been in this situation have told us about what they have found to help. These include:

  • learn more about your tumour and the support that’s available – it can make you feel more in control
  • learn more about available treatment options before you have to make any decisions about how you want to proceed
  • ask how far apart your appointments will be – so you know what to expect – and whether there’s a named contact
  • ask your health team for advice about when to contact a healthcare professional with regard to new or changing symptoms
  • keep a notebook in which you can write any questions that you have for your next appointment. Write them down as they come to mind
  • keep your own files of every appointment and what was discussed
  • talk to your family & friends – about the risks and benefits and how you’re feeling
  • speak to others in the same situation – we have several online support communities that you can access from anywhere in the world and at any time. You can ‘meet’ other brain tumour patients and carers and discuss your worries or fears and share ideas.
  • keep a record of how you are feeling each day using the quality-of-life tracker on BRIAN
  • some people feel more secure by wearing a medic-alert bracelet in case of accidents or seizures.

Tips from our community

“I think people tend to assume I am okay as I on watch and wait. I still get symptoms though and have good and bad days. Sometimes I have to give myself a gentle reminder that it’s ok to not be okay.”

“Initially I really wanted my brain tumour out, but now I just really want it to behave long enough to not need further treatment. It’s a personal choice and is important to talk through all the pros and cons with your consultant.”

“If you are not happy being on watch and wait, you are entitled to ask for a second opinion, just to be sure.”

“I had CBT counselling to help me to manage the anxiety that being on watch and wait gave me. I try to recognise when I am worrying, remind myself that it’s unhelpful and then refocus my mind to something else. Your GP should be able to refer you.”

By joining one of our Online Support Communities, you can get more tips about living with or beyond a brain tumour diagnosis from people who truly understand what you’re going through.

Find out more


More information

Watch and wait factsheet – PDF

Find out more about Watch and wait in the full fact sheet.

Watch & wait – Clear print factsheet – PDF

Find out more in the full fact sheet – Clear Print version, designed to RNIB guidelines


If you have further questions, need to clarify any of the information on this page, or want to find out more about research and clinical trials, please contact our team:
Support and Information Services
0808 800 0004 Free from landlines and mobiles
Phone lines open Mon-Fri, 09:00-17:00
A member of our Support & Information Team provides support over the phone to somebody affected by a brain tumour diagnosis

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If you need someone to talk to or advice on where to get help, our Support and Information team is available by phone, email or live-chat.

Share your experiences and help create change

By taking part in our Improving Brain Tumour Care surveys and sharing your experiences, you can help us improve treatment and care for everyone affected by a brain tumour.

Brain Tumours: Living Low Grade by Gideon Burrows

The patient guide to living with a slow growing tumour. Read more about his experiences and those of many others as they came to understand their diagnosis and learned how to live low grade.