Adopting a new healthier behaviour is not always easy. The process of change, whether it relates to lifestyle modification for prostate cancer prevention or long-term prostate cancer management, can seem long, complex and challenging.

Understanding the patient’s readiness to change and recognizing the progress through a series of stages is key in modifying a habitual behaviour.

The Transtheoretical Model (TTM) operates on the assumption that change occurs continuously through a series of stages. More precisely, the model guides prostate cancer patients toward lasting adoption of healthier behaviours through a process of five effective steps:

• Stage 1 — Precontemplation (Not ready): The first phase focuses on the patient’s readiness to adopt the new healthier behaviour. At this stage, individuals are not even considering changing yet. Some are “in denial” of the issue at hand, some feel “immune” to health problems and others may have given up after having tried to modify their behaviour unsuccessfully multiple times. People in the Precontemplation stage are resistant to obtaining information, discussing and thinking about their unhealthy and high-risk behaviours. Therefore, they are not intending to take action in the foreseeable future (i.e. within the next 6 months).

• Stage 2 — Contemplation (Getting ready): At this point, prostate cancer patients are aware of the benefits of adopting healthier behaviours. They are also well informed of the costs, barriers and benefits to change. Some patients get stuck at this stage because they procrastinate and take some time to reflect on the idea of change. Thus, they are not ready to change yet, but are beginning to recognize that their behaviour is problematic.

• Stage 3 — Preparation (Ready): The Preparation stage acts as a transitional step between recognition and action. Prostate cancer patients that are at this stage are now ready to modify their unhealthy behaviours and intend to take concrete steps to change within the next month. Some may begin taking small steps toward behavioural change like, for example, sampling low-fat foods.

• Stage 4 — Action: Prostate cancer patients at the fourth stage have made real and perceivable diet and lifestyle changes over the last six months. At this point, observable results can appear such as reduced body weight, cholesterol level or waist circumference. Prostate cancer patients at the Action stage have acquired healthy behaviours and intend to keep moving forward with their lifestyle change.

• Stage 5 — Maintenance: In the final stage, people have made the changes and have reached their goals. They have been able to sustain action for at least six months and are working to prevent relapse. The stage is characterized by active steps taken to keep the diet and lifestyle benefits Constant daily efforts are needed to keep from sliding back into old habits. Occasional “slips” are common and most patients find themselves retrograding through the stages of change several times before the new lifestyle is truly established.

To conclude, the Transtheoretical Model (TTM) provides processes of change to guide prostate cancer patients through acquiring and maintaining a new and healthy lifestyle.

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