# Innovative Exercise in Routine Cancer Care: Insights from Eight Years of Integrated Oncological Exercise Therapy (OTT)

## TL;DR

This study shows that structured exercise therapy can be integrated into cancer care, improving patients' physical performance and quality of life, though attendance remains low.

## Contribution

The study provides real-world evidence of integrating supervised oncological exercise therapy into routine cancer care over eight years.

## Key findings

- Exercise improved strength, endurance, and patient-reported outcomes like quality of life and fatigue.
- Only 1% of patients met the recommended exercise frequency, highlighting adherence challenges.
- Older age and shorter travel distance were linked to higher exercise attendance.

## Abstract

The beneficial effects of exercise in cancer patients are increasingly understood, whereas the inclusion of structured oncological exercise as a standard of care remains a challenge. Herein, we evaluate the innovative, supervised Oncological Exercise Therapy (OTT) integrated into the standard of clinical care and report patient characteristics, exercise participation and attendance, and effects on patient-reported outcomes (PROs) and physical performance.

An observational study was conducted to analyze patient and exercise cohort data collected between 2012 and 2020 on the OTT. Cancer patients were encouraged to attend the personalized OTT intervention for a minimum of three months. Demographic, medical and treatment-related patient data were documented at enrollment. Exercise attendance was measured up to one year after enrollment, and exercise efficacy was evaluated between 6 and 24 weeks of exercise and included strength and endurance assessments and PROs on quality of life, fatigue, and psychosocial distress.

Most of the n = 1660 enrolled patients (median age: 54 years [18–86]) were female (70%), diagnosed with breast cancer (40%), without metastasis (80%) and were receiving anticancer treatment (65%). One-third (32%) exercised for an average of 19 ± 10 sessions in a 19-week (± 13 weeks) period. Only 1% of patients reached the recommended average of ≥ 2 weekly sessions on the OTT. Older age and shorter travel distance were associated with increased exercise attendance. Exercise improved strength and endurance performance and PROs, indicating more pronounced effects in patients with greater exercise attendance.

Innovative exercise programs can be established as standard of cancer care in hospital settings. These real-world data suggest a beneficial effect of exercise in cancer patients on PROs and physical outcomes, with more pronounced effects in patients with greater exercise attendance. Therefore, strategies to increase exercise attendance appear crucial to maximize benefits derived from real-world exercise interventions in cancer patients.

The online version contains supplementary material available at 10.1186/s40798-026-00988-0.

Innovative exercise programs are feasible in clinical cancer care.

Personalized exercise can benefit patients’ physical condition and patient-reported outcomes.

Real-world exercise habits do not meet exercise recommendations.

Exercise adherence seem vital to maximize the beneficial effects.

The online version contains supplementary material available at 10.1186/s40798-026-00988-0.