A CancerFitness.org Perspective
For years, the argument for Exercise Oncology has focused primarily on clinical outcomes: better physical function, less fatigue, improved quality of life, preservation of muscle mass, and increasingly, evidence suggesting benefits for cancer outcomes.
But healthcare systems, insurers, and policymakers inevitably ask another question:
Does providing supervised exercise make financial sense?
An important 2025 review published in the Translational Journal of the American College of Sports Medicine provides compelling evidence that it does. The authors evaluated the cost-effectiveness of supervised exercise therapy (SET) for adults with chronic diseases in the United States, including cancer.
For Exercise Oncology, this publication is particularly important because cancer survivorship increasingly resembles chronic disease management. Many survivors live for years or decades with the physical consequences of cancer and its treatment. Exercise therefore should not be viewed simply as a temporary wellness intervention. It can become part of long-term cancer care.
Exercise Produces an Economic Return
The review examined eight U.S. studies involving cancer, diabetes, hypertension, obesity, depression/anxiety, and fall risk. Four were randomized clinical trials, three were modeling studies, and one was a retrospective cohort study.
The economic findings are striking.
According to the studies, supervised exercise interventions produced positive returns on investment ranging from 1.15:1 to 1.7:1, while reported healthcare savings ranged from $121 to $2,834 per participant. Savings resulted from such outcomes as fewer hospitalizations, fewer emergency department visits, reduced treatment requirements, and lower overall healthcare utilization.
This is precisely the type of evidence healthcare executives and payers need when deciding whether exercise programs deserve institutional investment and reimbursement.
The Cancer Evidence Is Especially Relevant
Cancer was not simply mentioned as one of many chronic diseases. Two of the eight studies specifically involved cancer populations.
One evaluated patients undergoing cancer treatment, approximately 60% of whom had breast cancer. Another involved women with stage I–II breast cancer. The programs included individualized cardiovascular, resistance, and flexibility exercise delivered under professional supervision.
The economic results are noteworthy.
One individualized Exercise Oncology program was associated with an average $2,834 reduction in total charges per patient. Another randomized study reported healthcare utilization costs of $6,356 in the exercise group compared with $8,598 in controls. The authors concluded that individualized Exercise Oncology programs can reduce healthcare costs while improving patient outcomes during cancer treatment.
That changes the conversation surrounding Exercise Oncology.
The question should no longer be only, “Does exercise help cancer patients?”
We should also be asking:
“What are healthcare systems spending because structured Exercise Oncology programs are not available?”
Cancer Survivorship Is Chronic Disease Management
The relevance of this paper extends beyond the specific cancer studies included in the review.
Cancer survivors may face persistent or late effects of treatment affecting cardiovascular health, metabolic health, strength, mobility and physical function. From the standpoint of healthcare utilization, Exercise Oncology therefore shares an important characteristic with cardiac rehabilitation, pulmonary rehabilitation, diabetes prevention, and other chronic-disease interventions: the potential to prevent downstream morbidity rather than merely respond to it.
This publication provides a useful economic framework for thinking about Exercise Oncology accordingly.
The authors point out that established supervised programs such as cardiac rehabilitation and pulmonary rehabilitation already demonstrate substantial economic and clinical value. They argue that the consistency of these findings supports broader integration of supervised exercise into chronic disease management and routine healthcare.
Cancer care should increasingly be part of that discussion.
Why Supervision Matters
Importantly, this paper is not simply making an economic argument for telling patients to “exercise more.”
It evaluates supervised exercise therapy.
The authors emphasize structure, accountability, professional guidance, and individualized exercise prescription. They specifically describe referrals from healthcare professionals to qualified exercise professionals capable of developing and modifying exercise programs according to patients’ conditions.
That distinction is fundamental to Exercise Oncology.
A cancer patient experiencing treatment-related fatigue, sarcopenia, neuropathy, balance problems, cardiotoxicity concerns, or substantial deconditioning may require something very different from generic exercise advice.
A true Exercise Oncology program creates a clinical pathway:
Assess → Prescribe → Supervise → Progress → Measure Outcomes → Communicate Results
And those measurable outcomes should increasingly include healthcare utilization and cost, not merely fitness.
ROI Should Become a Core Metric of Exercise Oncology Programs
Perhaps the most important lesson for CancerFitness.org is that future Exercise Oncology programs should be designed from the beginning to demonstrate economic value.
Programs should track outcomes such as emergency department visits, hospitalizations, unplanned treatment interruptions, healthcare encounters, functional status and program costs. When possible, these measures should be integrated into electronic health records and clinical workflows.
The authors make essentially this same argument, concluding that referral and tracking of supervised exercise through electronic health records could facilitate outcome measurement, reimbursement, and national scaling.
There are important limitations. Only eight studies met the review criteria, interventions and economic methodologies varied considerably, and one Exercise Oncology study had serious risk-of-bias concerns. The authors specifically call for more standardized economic evaluations before broad comparisons can be made.
Thus, this paper does not establish a universal ROI for every Exercise Oncology program.
What it does establish is something equally important: supervised exercise has a credible healthcare economic value proposition, including emerging evidence specifically within oncology.
The CancerFitness.org Takeaway
Exercise Oncology should not be viewed simply as another supportive service that adds expense to cancer care.
It should increasingly be evaluated as an investment capable of improving patient outcomes while potentially reducing downstream healthcare utilization and costs.
That distinction matters enormously when approaching cancer centers, hospital administrators, insurers, employers, philanthropic organizations, and policymakers about funding Exercise Oncology.
Clinical evidence tells us why cancer patients should exercise.
Economic evidence may ultimately determine whether healthcare systems build the infrastructure that allows them to do it.
Call to Action
Cancer centers developing Exercise Oncology programs should incorporate health-economic measurement into program design from day one. Track clinical outcomes, healthcare utilization, program costs, and cost avoidance alongside traditional exercise outcomes.
At CancerFitness.org, we believe the next stage of Exercise Oncology must move beyond proving that exercise works. We must demonstrate that professionally supervised exercise can become a measurable, scalable, and economically sustainable component of comprehensive cancer care.
Reference: A Review of the Cost-Effectiveness of Supervised Exercise Therapy for Adults with Chronic Conditions in the United States. Paul J. Chase, Connor M. Owen, Amy Bantham, Mark Stoutenberg, et al. Translational Journal of the ACSM, Volume 10 • Number 3 • Summer 2025. http://www.acsm-tj.org/
