For years, research has consistently shown that exercise is one of the most powerful tools available to improve outcomes for people living with and beyond cancer. From reducing fatigue and improving physical function to enhancing mental health and quality of life, the benefits are undeniable.
Yet despite this overwhelming evidence, exercise is still not routinely integrated into cancer care.
A 2025 publication highlights the real issue: the problem is no longer proof—it is implementation.
The Gap Between What We Know and What We Do
Today, leading organizations such as the American College of Sports Medicine (ACSM) and the American Society of Clinical Oncology (ASCO) recommend that cancer patients engage in structured exercise during and after treatment.
But in real-world clinical practice:
- Most patients are never referred to exercise programs
- Many oncologists report limited training or systems to support referrals
- Access to programs is uneven and often unavailable, especially in underserved areas
This disconnect represents one of the most important missed opportunities in modern cancer care.
Exercise Is Not an “Extra”—It Is Essential Care
One of the most important messages from this research is that exercise cannot be treated as optional or informal advice.
Telling patients to “stay active” is not enough.
To truly improve outcomes, exercise must be delivered through structured, supported programs, like chemotherapy, radiation, or surgery.
That means building:
- Clear referral pathways within oncology clinics
- Integration into electronic medical records
- Trained exercise oncology professionals
- Dedicated program space (in-person or virtual)
- Sustainable funding models
Without this infrastructure, even the best evidence will not translate into better patient outcomes.
The Missing Link: Implementation Science
So how do we move from evidence to action?
The answer lies in implementation science—a field focused on turning proven interventions into routine clinical practice.
Implementation science helps cancer centers:
- Identify real-world barriers (time, training, workflow, reimbursement)
- Develop practical solutions
- Integrate exercise into everyday care
- Sustain programs long-term
This is the “secret sauce” that can finally make exercise oncology a standard part of care—not just a recommendation.
Getting the Right Patient to the Right Program
Another key advance is the development of screening and triage systems that match patients to the right level of exercise support.
Some patients may safely begin independent programs. Others require supervised or rehabilitation-based care.
Simple, efficient screening tools—embedded into routine visits—can:
- Identify patient needs in minutes
- Automatically guided referrals
- Dramatically increase program participation
In one example, nearly half of eligible patients were successfully connected to exercise services using a streamlined clinical workflow.
This is what scalable, real-world success looks like.
Addressing Access and Equity
Not all patients have equal access to exercise oncology programs.
Rural communities, underserved populations, and many urban areas still lack available services.
In addition, most exercise oncology programs are not covered by insurance, limiting access for many patients.
Expanding access will require:
- Policy changes and reimbursement models
- Growth of the trained workforce
- Partnerships with community and virtual programs
- A commitment to equitable care delivery
A Tipping Point for Cancer Care
Exercise oncology is at a critical moment.
We now have:
- Strong scientific evidence
- Clear clinical guidelines
- Proven models for implementation
What we need next is system-wide commitment.
Call to Action: It’s Time to Make Exercise Standard in Cancer Care
For Patients and Survivors
- Ask your oncology team:
“Where is my exercise program referral?” - Seek out structured, evidence-based programs—not just general advice
- Understand that exercise is part of your treatment—not an optional add-on
For Oncology Providers
- Make exercise screening and referral a routine part of every patient visit
- Partner with exercise professionals and rehabilitation teams
- Advocate within your institution for program development
For Cancer Centers and Health Systems
- Build exercise oncology into your clinical infrastructure
- Integrate referral pathways into workflows and EMRs
- Invest in staffing, training, and program sustainability
For Policy Leaders and Payers
- Recognize exercise as essential, evidence-based cancer care
- Expand reimbursement for exercise oncology services
- Support equitable access across all communities
The Bottom Line
Exercise improves outcomes.
We have the evidence.
We have the models.
Now we must build the systems.
Because when exercise becomes standard of care,
patients don’t just survive cancer—they live better beyond it.
Reference: Implementation Science as the Secret Sauce for Integrating Exercise Screening and Triage Pathways in Oncology. Prajakta Adsul, PhD, MBBS, MPH1; Mackenzi Pergolotti, PhD; and Kathryn H. Schmitz, PhD, MPH. asco.org/edbook | Volume 45, Issue 3 https://doi.org/10.1200/EDBK-25-472854
