Watchful waiting for neuroblastoma

Last medical review:

Watchful waiting is also called observation or surveillance. It means that the healthcare team watches closely for signs or symptoms of disease rather than giving treatment right away. Treatment is given when the signs and symptoms of neuroblastoma develop or change.

Watchful waiting may be a treatment option for babies younger than 12 months who have stage 4S neuroblastoma with favourable prognostic factors and no symptoms. These tumours often disappear without treatment (called spontaneous regression) or develop into a non-cancerous ganglioneuroma.

This approach helps avoid problems or side effects that can happen with other treatments. Try to keep this in mind if you are worried that nothing is being done to treat your child. Talk to your child’s healthcare team for more information about watchful waiting.

There isn’t any evidence so far that watchful waiting reduces long-term survival or has other negative effects if or when the child starts treatment.

Expert review and references

  • Meredith Irwin, MD
  • Daniel Morgenstern, MD
  • American Society of Clinical Oncology. Neuroblastoma. 2018: https://www.cancer.net/cancer-types/neuroblastoma-childhood/view-all.
  • Lacayo NJ. Pediatric Neuroblastoma. eMedicine/Medscape; 2017: https://emedicine.medscape.com/.
  • Cancer Research UK. Neuroblastoma. Cancer Research UK; 2014.
  • PDQ® Pediatric Treatment Editorial Board. Neuroblastoma Treatment (PDQ®)–Health ProfessionalVersion. Bethesda, MD: National Cancer Institute ; 2020: https://www.cancer.gov/.
  • Brodeur GM, Hogarty MD, Bagatell R, Mosse YP, Maris JM. Neuroblastoma. Pizzo PA, Poplack DG, eds.. Principles and Practice of Pediatric Oncology . 7th ed. Philadelphia, PA: Wolters Kluwer; 2016: 30:772–797.
  • American Cancer Society. After Neuroblastoma Treatment. 2018: https://www.cancer.org/.
  • PDQ® Pediatric Treatment Editorial Board. Neuroblastoma Treatment (PDQ®)–Patient Version. Bethesda, MD: National Cancer Institute; 2021: https://www.cancer.gov/types/neuroblastoma/patient/neuroblastoma-treatment-pdq.
  • Bartholomew, J . Neuroblastoma. Baggott C, Fochtman D, Foley GV & Patterson Kelly, K (eds.). Nursing Care of Children and Adolescents with Cancer and Blood Disorders. 4th ed. APHON; 2011: 30: pp. 1038-1053.