If you treat cancer survivors but avoid recommending lifestyle changes out of fear of overwhelming or stressing them out, you’re not alone. According to a recent study published in Cancer, the journal of the American Cancer Society, promoting healthy habits is not on the to-do list of most oncologists and specialists. They make this choice despite the American Society of Clinical Oncology’s guidelines that encourage health-promotion counseling for cancer survivors.‍

What Did the Study Find?

The research, conducted through Northwestern University’s Feinberg School of Medicine, focused on 91 practitioners (30 primary care providers, 30 oncologists, and 31 specialists) who treat survivors of prostate and breast cancers and melanoma. Of these providers, only 9.7 percent of specialists and 26.7 percent of oncologists recommend healthy habits, such as losing weight and quitting smoking, to patients in remission. On the other hand, roughly 90 percent of PCPs take these steps.

Explaining their decision-making, participating oncologists said they felt emphasizing a healthy lifestyle might distress their patients and didn’t have the training or time to make such recommendations. They also cited concerns that some patients would be less likely to take their medication to prevent cancer recurrences if they were focused on losing weight.

The authors noted that there’s no research addressing “whether health-promotion efforts compromise medical regimen adherence.” But the absence of lifestyle counseling for cancer survivors can hurt their health long-term. As a result, cancer survivors face an increased risk of cardiovascular disease, among other conditions.‍

How Can Clinicians Help Cancer Survivors Form Healthy Habits?

“Making healthy lifestyle changes is a great way for a cancer survivor to feel more in control of his or her health,” study co-author Bonnie Spring, Ph.D., director of the Institute for Public Health and Medicine at Northwestern University, says.

As a provider, Dr. Spring explains that you should advise patients to build up gradually. In her words: “Someone who’s had weight-related cancer and is overweight might want to try using an app to monitor what they eat, to learn which foods or eating episodes are supplying a lot of their calories.” You can also help your patients decide on a new habit that they feel “can stick with so they can build up a track record of successes and self-confidence,” Dr. Spring says. “For many, it will be becoming more physically active,” she adds. “They may choose a wearable tracker to count their steps, or if they’re interested in weight loss, there are many free or inexpensive diet tracking apps.” And, of course, encourage any patients who smoke to quit.