Finding a Way Forward

Finding a Way Forward

How to Set New Goals for Yourself as a Cancer Survivor

by Alene Nitzky, PhD, RN, OCN

Cancer treatment can change you physically and mentally. It can be difficult to cope with the loss of goals and activities that were important to you pre-diagnosis. They often seem unattainable after cancer. When something you were able to do easily before cancer is no longer easy or even possible, you may feel a sense of loss.

The following are several examples of this type of loss:

  • An athlete who relied on upper body strength, but breast surgeries have resulted in the athlete being unable to train at the same level as before
  • A career-oriented individual whose professional goals are challenged by chemo brain
  • A woman whose fertility is lost, along with her dream of having her own children; meanwhile, her fear of recurrence hinders pursuing other ways of raising children

For highly goal-oriented people, it can be hard to find motivation without a goal. A problem with goals, however, is that they are not always appropriate for what we can reasonably accomplish. No matter your health status, if you set a goal that is too difficult, it will lead to you feeling inadequate or feeling like you will never be successful. Researchers have found that mindfulness approaches to setting new goals, and stopping the process of obsessing about old expectations, can be helpful for cancer survivors.

The feelings are important, not the goal  

A certain amount of grieving your losses must be done, but you must identify the point at which you are stuck in negative feelings. Obsessing over something you can’t have is not a productive use of your time or emotional energy.

No matter your health status, if you set a goal that is too difficult, it will lead to you feeling inadequate or feeling like you will never be successful.

At some point, you must refocus your energy on finding a way forward. Come back to the present and think about what you can do. Make a list of things that will help you switch into positive gear when you find yourself ruminating on what you have lost. With practice and awareness, you can train yourself to recognize negative feelings when they arise and use them to switch gears in a positive direction.

Building confidence  

Confidence in your ability to accomplish a task or goal is known as self-efficacy. When you believe you will succeed, you are more likely to succeed.

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To rebuild your confidence, break goals into many small steps. Each step should contain tasks that must be completed before moving on to the next step. You can build self-efficacy by working step-by-step to achieve a larger goal, without taking on too much at once. You should enjoy the task and feel comfortable doing it before proceeding. If you need help, work with others who have experienced similar feelings while learning how to proceed, and who will help you without judgment or awkwardness.

Moving forward and setting new, realistic goals  

Follow these five steps to set new, realistic goals for yourself after a cancer diagnosis:

1. First, acknowledge the loss and your feelings around that loss.
When you find yourself feeling sorry for yourself, allow yourself time to be with the feelings. Don’t forget those feelings, as they will be an important part of moving forward.

2. Identify the positive feelings you want to experience while pursuing a goal.
What feelings did you have while pursuing a past goal that made it so important to you?

3. Identify activities you can do that will bring that feeling or another equally positive feeling.
What activities do you enjoy that you can do? What is it about those activities that causes the pleasant feelings?

4. Make a list of tasks and activities you can focus on that will lead to pleasant feelings.
When you catch yourself ruminating, switch to one of the tasks on the list.

5. As you come up with ideas for goals around those new activities, write them down.
You will soon have a new set of goals to work toward.

If you’re struggling with reassessing your goals, ask a coach, counselor, therapist, or a nonjudgmental friend (who will not impose on you his or her beliefs) for help.

Dr. Alene Nitzky is an oncology nurse, author, and CEO/Founder of Cancer Harbors. She develops cancer survivorship programs and promotes cancer literacy education in her community. An outspoken advocate for patients and healthcare professionals alike, she coaches individuals, writes, and speaks about everyone’s role in providing better outcomes around cancer care and healthcare. She enjoys running ultramarathons and lives in Fort Collins, CO. You can learn more about Dr. Nitzky through her website, She can be found on Twitter at @alenegonebad.

Excerpted with permission from Navigating the C: A Nurse Charts the Course for Cancer Survivorship Care, by Alene Nitzky, PhD, RN, OCN.

This article was published in Coping® with Cancer magazine, September/October 2018.