For years, research has demonstrated that physical activity improves outcomes for people living with and beyond cancer. Yet despite overwhelming scientific evidence, many cancer patients remain inactive, not because they don’t care, but because they are uncertain, fearful, overwhelmed, or simply don’t know where to begin.
A new JAMA Insights article, Communicating With Patients About Physical Activity, shifts the conversation from what clinicians should recommend to how they should communicate those recommendations. The publication provides practical, evidence-based guidance that is directly applicable to every Exercise Oncology Program.
Exercise Counseling Is a Clinical Skill
The authors emphasize that discussing physical activity should begin by asking permission rather than giving instructions.
Instead of saying:
“You need to exercise more.”
Clinicians should ask:
“Would it be okay if we talked about physical activity today?”
This simple change transforms exercise from another medical directive into a collaborative discussion that respects the patient’s goals, values, and readiness for change. The article also reminds clinicians that inactivity often reflects real barriers, including fatigue, pain, transportation, finances, lack of confidence, or limited social support, not a lack of motivation.
Every Movement Counts
One of the most important messages is that patients do not need to become athletes.
The authors distinguish physical activity from exercise. Walking the dog, climbing stairs, gardening, and household chores all contribute to better health. Patients who believe exercise only means structured gym workouts often become discouraged before they even begin.
Equally important is the reminder that any increase in activity is beneficial. Even small increases in daily movement improve health outcomes. For many cancer patients, particularly those receiving chemotherapy, recovering from surgery, or living with metastatic disease, the best exercise prescription is to start low, progress slowly, and find an activity level that is challenging but tolerable.
Behavior Change Is More Important Than Motivation
The article reviews evidence supporting practical behavioral strategies that help patients become more active, including:
- Self-monitoring with activity logs or wearable devices
- Setting realistic, behavior-focused goals
- Providing regular feedback
- Celebrating small successes rather than perfection
Wearable technology can increase daily activity, but the greatest long-term improvements occur when patients also receive coaching and ongoing encouragement.
Community Matters
One of the strongest messages for Exercise Oncology is that exercise should NOT become another solitary task.
Patients are more likely to remain physically active when they participate with others through:
- supervised exercise programs
- walking groups
- community fitness classes
- peer support
- social prescribing by healthcare professionals
Social connection is itself an intervention. The combination of accountability, encouragement, and shared experience helps patients maintain healthy behaviors long after formal treatment ends.
Why This Matters for Exercise Oncology Programs
This publication extends well beyond physician communication. It provides a blueprint for designing high-quality Exercise Oncology services.
Successful programs should include:
- Standardized exercise counseling training for every member of the cancer care team.
- Motivational interviewing and patient-centered communication techniques.
- Individualized exercise prescriptions that begin with achievable goals.
- Wearable technology and progress tracking.
- Ongoing coaching and follow-up rather than one-time exercise recommendations.
- Group exercise opportunities and peer support to improve long-term adherence.
- Referral pathways that connect patients with certified Exercise Oncology professionals and community-based programs.
Perhaps most importantly, the article reinforces one of the central principles of CancerFitness.org:
Exercise is not simply a treatment recommendation, it is a means of restoring confidence, independence, and control during one of life’s most challenging experiences. The authors note that physical activity can help patients rebuild routines, regain a sense of coherence, and cope more effectively with chronic illness by taking small, realistic steps that align with what matters most to them.
The future of Exercise Oncology depends not only on better exercise science but also on better communication. Every oncology visit is an opportunity to empower patients with realistic, compassionate guidance that makes movement feel possible rather than overwhelming.
Programs that combine evidence-based exercise prescription with supportive communication, behavior-change strategies, and community engagement will achieve higher participation, better adherence, and ultimately better patient outcomes.
Call to Action
At CancerFitness.org, we believe every cancer patient deserves more than the advice to “exercise more.” They deserve a personalized, supportive Exercise Oncology program that teaches how to become active, provides ongoing encouragement, and integrates physical activity into every stage of cancer care, from diagnosis through long-term survivorship. Together, we can make exercise counseling a standard component of comprehensive oncology care.
Reference: Communicating With Patients About Physical Activity. Julie Midtgaard, PhD; Søren T. Skou, PhD; Alessio Bricca, PhD. JAMA Published online August 6, 2026.
