- Behavior change is hard, particularly when you're struggling with side effects from cancer treatment.
- Understanding the values shaping your goal can increase your success.
- Using SMART goals and self-compassion can increase the odds you'll achieve your goal.
For many of us, the new year provides an opportunity to examine our day-to-day habits and make a commitment to change. Unfortunately, the vast majority of new year’s resolutions are abandoned by February.1
For cancer survivors, there may be a greater sense of urgency tied to successful resolutions. A diagnosis of cancer can be a catalyst for many to focus on healthy behavior change2 as a means of reducing the risk of recurrence, managing side effects from treatment, or improving the effectiveness of treatment.3 The American Cancer Society highlights the importance of modifying health behaviors, such as smoking and a sedentary lifestyle, to help reduce the risk of recurrence.4 In fact, a study conducted in 2016 suggests that modifying these types of behaviors could reduce the risk of cancer-related death by nearly half.5
Despite this persuasive evidence, it appears that cancer survivors struggle to make these changes. A recent study of nearly 13,000 cancer survivors6 found small differences in reported healthy behaviors between cancer survivors and people without a history of cancer. For example, this study found that 16.8 percent of people surveyed without a history of cancer reported that they currently smoked, compared with 14.1 percent of cancer survivors. Sadly, those with a cancer history were also more likely to report a higher BMI and moderate to heavy alcohol use than those without.
Why is it so challenging to make healthy behavior change, even when there is a strong motivation to do so? As I described in my last post, cancer survivors face significant barriers in the form of cancer-related fatigue and often struggle with insomnia, pain, and “chemo-brain”—all of which can make sticking to change very difficult.7,8,9
In addition to these physical challenges, few people know how to successfully reach their behavioral goals. This may lead to an unintentional undermining of progress. It’s easy to understand how after several unsuccessful attempts at a goal, one may conclude they are not capable of making the change they wish to make.
In order to successfully reach goals, we need to get specific with the why and the how.
Why you have a goal may seem obvious—however, it’s important to dig in to the answer. Goals are often motivated by our values—those big-picture attitudes and beliefs that shape our behavior.10 Without clarity on how values are driving our goals, we could run into difficulty with motivation and self-compassion when we stumble.
Let’s take losing weight—a common New Year’s Resolution—as an example. Imagine I decide to set a weight loss goal that is motivated by what I’ve seen in the media as an “ideal” body shape. Or perhaps that goal is influenced by unkind comments made by someone in my life. These goals are then driven by something outside of myself that is 1) subject to change at any time and 2) possibly unachievable or unrealistic. Instead, if my weight loss goal is based on a value that reflects prioritizing my health and well-being, I am in control of the parameters. I can choose a timeline, process, and end goal that fits within that value.
Once you identify the "why," it's time to examine the “how.” Often, resolutions fail because there is either a lack of attention to what needs to happen in order for the goal to be achieved, or because the goal is unrealistic to begin with. It is also common for us to be unkind to ourselves when we face difficulties meeting our goals. These factors combined can lead to a cycle of unsuccessful attempts, chased by harsh self-criticism and subsequent loss of motivation.
SMART goals originated in the 1980s11 as a way to assist managers in corporations to define goals. Since then, SMART goals have been found to be a useful tool for assisting in behavior change.
SMART goals are:
- Specific: Identify what actions you will take and the specifics around the when, where, and what you need to accomplish them. A vague goal may be: “I’m going to quit smoking.” A specific goal would be: “I’m going to smoke two less cigarettes each day for the next week. I’ll tell my partner for accountability and ask them to be my cheerleader when I’m having trouble. I’ll put the cigarettes in my car to make them harder to reach. I’ll use a straw to keep in my hands and mouth if I feel the urge to smoke.”
- Measurable: The goal should be something you can track so it’s clear when you’re meeting your objective. In this example, the individual has chosen a number—two cigarettes—as their goal. This is a quantifiable and trackable goal.
- Adaptive: Will this goal improve the quality of your life? If the answer is no, this may be an unsustainable goal.
- Realistic: Your goal should be realistically achievable. Be honest with yourself and take into account factors that may influence your ability to accomplish your goal, such as your stress level, competing demands for your time, your health, or any other tools or skills you need to be successful. This is particularly important for cancer survivors. Set your goal based on what you currently feel capable of, not what you could expect to achieve pre-cancer. (See my previous blog post for a refresher on the importance of activity pacing.)
- Timebound: To make your goal tangible and manageable, put a timeframe around it. In this example, the person set a goal for a week. They may have a longer-term goal, such as “I want to be smoke-free in four months,” but by setting their two-week goal, they took a step in the right direction without overwhelming themselves.
It is so common for us to be unkind to ourselves when we fail to reach a goal. “I’m such a failure!”; “Why even bother, I obviously can’t do this,” “I should be able to do this, it’s not that hard!” This all-or-nothing way of thinking contributes to a cycle of blame and demotivation—increasing the likelihood that you won’t make your goal. Instead, when you struggle, try speaking to yourself as you would a child or one of your friends: “I know you didn’t accomplish what you wanted today. Change is hard. Learn from it and try again—you can do this!” It may also be useful to challenge your self-talk: “I’m not a failure. There are plenty of things I’m good at. This is hard because it is new and it will get easier with time.”
You have the ability to make change! Try these strategies to set yourself up for success and make this new year an opportunity to move in a direction that will improve the quality of your life.
Luciani, J. (2015). Why 80 Percent of New Year's Resolutions Fail. Retrieved from https://health.usnews.com/health-news/blogs/eat-run/articles/2015-12-29….
Demark-Wahnefried, W. (2010). Changing health behaviors after treatment. In Jimmie C. Holland, William S. Breitbart, Paul B. Jacobsen, Marguerite S. Lederberg, Matthew J. Loscalzo, & Ruth McCorkle (Eds). Psycho-Oncology, 2nd edition (pp 551-556).
Cleveland Clinic (2020). 3 Reasons to Quit Smoking After a Cancer Diagnosis. Retrieved from: https://health.clevelandclinic.org/smoking-cancer-diagnosis-quit-now/.
American Cancer Society (2020). Cancer facts and figures 2020. Atlanta: American Cancer Society.
Song M., & Giovannucci, E. (2016). Preventable incidence and mortality of carcinoma associated with lifestyle factors among white adults in the United States. JAMA Oncol, 2, 154–61
Arem, H., Mama, S.L., Duan, X., Rowland, J.H., Bellizzi, K.M, & Ehlers, D.K. (2020). Prevalence of healthy behaviors among cancer survivors in the United States: How far have we come? Cancer Epidemiol Biomarkers, 29(6), 1179-1187.
Yue, H.J., & Dimsdale, J.E. (2010). Sleep and cancer. In Jimmie C. Holland, William S. Breitbart, Paul B. Jacobsen, Marguerite S. Lederberg, Matthew J. Loscalzo, & Ruth McCorkle (Eds). Psycho-Oncology, 2nd edition (pp. 258-269).
Breitbart, W.S., Park, J., & Katz, A.M. (2010). Pain. In Jimmie C. Holland, William S. Breitbart, Paul B. Jacobsen, Marguerite S. Lederberg, Matthew J. Loscalzo, & Ruth McCorkle (Eds). Psycho-Oncology, 2nd edition (pp. 214-228).
Ahles, T.A., Saykin, A.J., Noll, W.W., Furstenberg, C.T., Guerin, S., Cole, B., & Mott, L.A. (2003). Therelationship of APOE genotype to neuropsychological performance in long-term cancer survivors treated with standard dose chemotherapy. Psycho-Oncology, 12, 612-619.
Sagiv, L., & Roccas, S. (2021). How do values affect behavior? Let me count the ways. Personality and Social Psychology Review, 25(4), 295-316.
Doran, G. T. (1981). There's a S.M.A.R.T. way to write management's goals and objectives. Management Review, 70(11), 35-36.