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Watch and wait: when the plan is to keep an eye on it

What it means when your team suggests watching a tumor with scans instead of treating it now. Why it is a real plan, and what gets checked. What would change it, and the worry that can come with it.

The short version

Watch and wait means your team follows a tumor with regular scans and check-ups instead of treating it now. It is a plan, not a delay. It is chosen when treating the tumor now would likely cost you more than watching it. If the tumor grows more than expected, or you get new symptoms, the plan is looked at again, and you do not have to wait for the next scan to tell your team. The waiting can be hard, and that is worth saying out loud. It is part of the plan too, and you do not have to carry it on your own.

What is watch and wait?

It means no treatment aimed at the tumor for now, and a close eye on it instead.

Your team may call it active monitoring, active surveillance, or observation. They all mean the same thing: scans and check-ups at set times, so a change is seen early.

It is used for tumors that grow slowly and are not causing trouble. The ones it is most often used for are:

Why would my team suggest it?

Because every treatment has a cost, and for some tumors the cost of treating now is higher than the cost of watching.

An operation has risks. Radiation can affect thinking and memory years later. Treating a slow, quiet tumor today means taking on those risks today, when they could be put off, sometimes for years.

So watching is a decision, not the absence of one. Your team is choosing it because, for you and for now, they judge it to do the least harm.

It is not offered to everyone. Whether it suits you depends on what the tumor is likely to be, where it sits, how big it is, whether it is causing symptoms, your general health, and what you want. If a tumor is pressing on something important or causing problems, treating it is usually the plan instead.

What happens, step by step

The short answer is scans and check-ups at set times, and you telling your team about changes in between.

  1. A first scan becomes the starting point. Every later scan is compared with it, so a small change can be seen.
  2. You have scans at set times. Almost always these are MRI scans. Your MRI scan covers what the scan itself is like, and follow-up scans covers how each one is compared with the last.
  3. You see your team. They ask how you have been and examine you. The exam in the room goes through what they check.
  4. Some people have other tests as well. Hearing tests are part of watching an acoustic neuroma. Eye tests, which check how far out to the sides you can see, and hormone blood tests are part of watching some pituitary tumors.
  5. Between scans, you report changes. Something new, or something getting worse, is a reason to get in touch. You do not have to wait for your next scan. If something sudden, severe and new to you happens, treat it as an emergency. Get help now says what to do, and what to do in a seizure says when a seizure needs an ambulance and when it does not.
  6. If something changes, the plan is looked at again. That can mean treatment. It can mean a scan sooner than planned, which follow-up scans explains. Or it can mean going on as before.

The scans run on a timetable. Symptoms do not, which is why step five belongs to you.

How often, and for how long?

It depends on the tumor, so there is no single timetable to print here. A UK charity for people with brain tumors puts the range at anything from every few months to every couple of years. Scans are usually closer together at the start, and they spread out if nothing changes.

So ask for your own timetable, in writing, and ask what would make it change.

As for how long: for some people watching goes on for years. For some people with a small meningioma, acoustic neuroma or pituitary tumor, it never turns into treatment at all. For others it is a stretch of time before a treatment that was always likely to come, so that its costs are put off for as long as is safe.

For some people with a meningioma, it can be reasonable to talk about scanning less often, or stopping: if it has settled, or for older people whose other health problems matter more. That is something to talk through with your team, not a choice to make on your own.

What is it like to be watched?

Watching itself does nothing to your body. The tests are the only part that is done to you.

It is the other part that people describe. It can be hard to be told you have a tumor and that nobody is going to treat it yet. You might feel you are doing nothing to fight it. You might feel treatment is being kept from you. The time between appointments can feel long, and sometimes it is.

Feeling like this does not mean watching is the wrong plan for you, and it does not mean you are handling it badly. It means you are living with something unfinished. Say so at your next appointment. How you are coping is part of what your team should be asking about.

Worry and low mood, and what you can do

Worry and low mood have been studied in people being watched, and what the studies found is worth knowing. Most of that research is in people with a meningioma or an acoustic neuroma.

In those studies, worry was common in people with a meningioma whether it was being watched or had been taken out. Having it removed did not make that go away. One study from Germany found that low mood, high enough to count as a problem, was more common in the people being watched than in people whose operation had gone well. Another study found no such difference, and low mood was uncommon in both groups. For an acoustic neuroma, people being watched said they felt about as well as people who had been treated, or better. Less is known about people being watched for a glioma: A tumor that starts in the glial cells. Those are the support cells of the brain and spinal cord. Gliomas are given a grade from 1 to 4. The grade says how the tumor is expected to act. See the glossary.

So the honest summary is this. For a meningioma, the worry is real and common whichever plan you are on, so it is not a sign that you chose wrong. Whatever your tumor, it is also not something you have to sit with on your own.

What you can do about it:

If it is more than worry, and your mood keeps sinking, you do not have to wait for an appointment to say so. The numbers on Get help now can be called today.

What if it grows while we are watching?

Then the plan is looked at again, and catching that is what the scans are for. Some growth is expected with some tumors, and it does not always mean treatment. What growth means depends a great deal on the kind of tumor, so this part is split up by tumor.

Meningioma. Most meningiomas that are watched do grow a little. In many of them, the growth then slows down or stops. Even so, in a study from Norway of people whose meningioma was found by chance, more people ended up having treatment than not over the years, nearly all of it early on, and the rest had not needed it by the end. Nobody in that study got symptoms from the tumor before treatment began, and waiting did not make the treatment harder.

Low-grade glioma. This is different, and it is worth knowing plainly. A diffuse low-grade glioma usually keeps growing slowly, and over years it can change into a faster-growing type. That is why watching a glioma means watching it closely, and why it is not offered to everyone. For a glioma found by chance, one recent guideline says an operation should still come first, as long as it can be done without harming how you live. If you are being watched without an operation, it is a fair question to ask why your team chose that. For many people, watching comes after an operation, as a way of putting off radiation and chemotherapy. In one trial, starting radiation right after surgery held the tumor back for longer and meant fewer seizures. But it has not been shown to change how long people live, which is why some teams wait and keep radiation's cost for later. For some people with a grade 2 glioma that has an IDH gene change: A small change in a tumor's IDH gene. It is the first thing your team looks at when naming an adult glioma, and it can affect which treatments are offered. Your pathology report says whether your tumor has it. See the glossary change, there is now also a medicine taken by mouth, vorasidenib. It was tested against a placebo in people who would otherwise have been watched after surgery, and a biopsy counted as surgery, so ask whether it could apply to you. Low-grade glioma has a section on it, and clinical trials explains what a placebo is and what it means for the group you would be in.

Acoustic neuroma. Many small ones do not grow. But hearing on that side often gets worse while the tumor is being watched, which is why hearing tests are part of the plan and part of the decision.

Pituitary tumor. These usually grow slowly. If one grows toward the nerves for sight, eye tests check whether your sight is changing, which is why some people have them.

Whatever the tumor, ask your team how much change would make them act.

How can they know what it is without a sample?

They cannot be completely sure, and it is fair to know that. A scan can suggest what a tumor is. Only a sample of tissue can say for certain.

So a tumor that is being watched without an operation has a best guess for a name, not a confirmed one. Your team makes that guess from how it looks on the scan and where it sits.

This is one more reason the scans matter. The way a tumor behaves over time adds to what the first scan showed. If something thought to be slow grows fast, that is a reason for your team to think again about what it is, and whether it needs treating.

It is fine to ask how sure they are, and what would make them want a sample.

What you can do while you are being watched

Most of this is out of your hands. These parts are not:

Who reads it, and how do I get the result?

A radiologist: A doctor trained to read scans and write down what they show. The report goes to the doctor who asked for the scan, who then tells you. One who specializes in the brain and spine is called a neuroradiologist. See the glossary reads each scan and compares it with the earlier ones. The report goes to the doctor looking after you, and that is the person to go through it with you. Follow-up scans has more on reading a report that compares scans.

Ask before you leave how you will hear, and when. Otherwise it is easy to spend days waiting for a call that was never planned.

What to ask your team

Where to go next

This is not medical advice. It explains research in plain words. Your care team knows your case. Talk with them before you make any decision about your treatment.

Last reviewed: September 10, 2026

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