The science
is overwhelming.
The gap is not.
Over 2,800 randomized controlled trials document what happens when cancer patients exercise.[1,2] The outcomes are extraordinary. The referral rate remains at 15 percent.[3] Here is what the evidence says — and why every patient deserves access to it.
Exercise is not a wellness add-on.
It is clinical medicine.
For decades, the instinct when facing cancer was rest. Protect. Conserve. Wait until treatment ends before thinking about movement. That instinct was deeply human — and it was wrong.
The evidence that has accumulated over the last three decades is not tentative. It is not preliminary. It spans every major cancer type, every treatment modality, every phase of care — from the week before surgery to decades of survivorship. The message is consistent and clear.
ASCO — the American Society of Clinical Oncology — formally mandated in 2022 that medical oncologists should refer all cancer patients to structured exercise programming.[5] The American Cancer Society, ACSM, the American Heart Association, and the National Comprehensive Cancer Network have issued consistent guidelines. This is not fringe science. It is the established standard of care — honored in publication and ignored in practice.
The gap between what science proves and what patients receive is not a knowledge problem. It is an infrastructure problem. There is no referral pathway. There are not enough credentialed professionals. There is no platform connecting the evidence to the patient. That is what memios is building.
These are not projected benefits. They are outcomes documented across 2,800+ peer-reviewed randomized controlled trials, endorsed by every major oncology guideline body.
The evidence base is extraordinary.
The delivery gap is unconscionable.
Over 2,800 clinical trials. Four major guideline bodies. A formal ASCO referral mandate. And still — 85 percent of cancer patients receive no exercise referral and no structured exercise support.[3,5] The failure is not scientific. It is structural.
Why does this gap exist?
The gap is not caused by lack of evidence. It is caused by lack of infrastructure. Most hospitals have no exercise oncology referral pathway embedded in their EHR. Most oncologists have no credentialed exercise specialist to refer to. Most cancer patients are never told that exercise is not just safe but clinically essential.
Geospatial analysis by Schmitz et al. (2025) mapped over 2,100 exercise oncology programs across the country. 162 US cities with populations exceeding 50,000 had no program at all.[12] Rural, low-income, and minority communities were disproportionately underserved.
The EXCEEDS triage model — implemented at the UPMC Hillman Cancer Center using just 3 to 5 minutes of staff time per patient at the second chemotherapy infusion — achieved a 45 percent patient connection rate to exercise services.[19] That outcome is not exceptional. It is what is possible when the right infrastructure is in place.
What memios does about it.
memios builds the infrastructure. The EXCEEDS triage workflow, embedded in hospital EHR systems. The network of CETI-certified Cancer Exercise Specialists, placed in hospital programs. The telehealth delivery model that reaches patients in the 162 cities with no local program.[16]
The platform covers all four phases of care — prehabilitation, active treatment, post-procedure recovery, and long-term survivorship — in a single integrated system. Every patient interaction generates structured, validated clinical outcomes data. Every data point is documented in the formats accreditation bodies and payers require.
The science is done. The guidelines are written. The mandate exists. memios makes it real for the patient sitting in the infusion chair who has never been told that moving could help.
Exercise support for every
phase of the cancer journey.
Most patients receive fragmented support — help at one point in their treatment, nothing at others. memios is the only platform that walks alongside a patient from the day of diagnosis through the rest of their life.
The window between diagnosis and surgery or first treatment is among the most powerful opportunities to change outcomes. Even two to three weeks of structured prehab reduces surgical complications, shortens hospital stays, and sends patients into treatment with greater physical and psychological reserves.[15]
Exercise during active treatment is not only safe — it is essential. A certified Cancer Exercise Specialist designs each session around the patient's treatment schedule, monitors vital signs, tracks daily fatigue and distress, and communicates directly with the oncology team. Patients exercise smarter, not harder.[5,6]
Post-procedure rehabilitation is where structured exercise makes the most immediate and visible difference. The memios care team coordinates with the surgical team to begin appropriate movement as soon as it is safe, following cancer-specific protocols for every surgery type.[17]
Treatment ends. The effects of treatment do not — and neither does the benefit of exercise. For breast, colorectal, and prostate cancer survivors, meeting exercise guidelines is associated with 31% reduced cancer-specific mortality, 22% lower recurrence, and 45% lower all-cause mortality.[11] The memios survivorship program is designed for a lifetime.
The guidelines say the same thing.
The compliance gap is real.
Every major clinical organization has issued the same instruction. Every accreditation body is moving in the same direction. The science and the policy are aligned. The only remaining gap is the infrastructure to act on them — and that is what memios builds.
ASCO guidelines state that medical oncologists should refer all cancer patients undergoing treatment with curative intent to structured exercise programming. The guideline specifically recommends referral to certified exercise oncology professionals.[5]
Formal MandateA 17-institution international roundtable synthesized the evidence across 2,800+ clinical trials and issued updated guidelines recommending individualized aerobic and resistance exercise for all cancer patients. ACSM has submitted a draft National Coverage Determination to CMS.[1]
Active GuidelinesNAPBC 2024 standards require that a documented exercise recommendation be placed in the medical record for every eligible breast cancer patient under oncology care. This is not aspirational — it is a compliance requirement that went into effect January 2024.[18]
Active Requirement — 2024The AHA issued a scientific statement establishing the CORE (Cardio-Oncology Rehabilitation) model for patients receiving cardiotoxic cancer treatments. Structured exercise during and after cardiotoxic therapy protects cardiac function and is supported by Medicare-reimbursable cardiac rehabilitation CPT codes.[8]
AHA Scientific StatementThe ACS 2022 guidelines for cancer survivors recommend regular aerobic and resistance exercise and explicitly link post-diagnosis physical activity to reduced cancer-specific mortality, reduced recurrence risk, and reduced all-cause mortality across multiple cancer types.[7,11]
Active GuidelinesThe Commission on Cancer is advancing toward requiring exercise documentation across all 1,500+ accredited cancer programs. CMS is reviewing a draft National Coverage Determination for exercise oncology services. The policy era is beginning — and institutions and payers that act now will be ahead of it.[20,21]
Advancing Standard15 years of evidence.
The field is only accelerating.
Exercise oncology has moved from a fringe idea to an established clinical discipline in 15 years. The pace of research, guideline development, and policy action has not slowed — it has accelerated. Understanding the arc helps explain why the memios moment is now.
Schmitz et al. publish the first comprehensive ACSM exercise guidelines for cancer survivors, marking the formal beginning of exercise oncology as an evidence-based clinical discipline. The guidelines establish safety and efficacy standards for exercise across major cancer types.[2]
CompleteA 17-institution international roundtable publishes updated ACSM guidelines synthesizing 2,800+ clinical trials, establishing the evidence base for all major cancer types and treatment phases. The American Heart Association simultaneously issues its cardio-oncology rehabilitation statement establishing the CORE model for cardiotoxic treatment populations.[1,8]
CompleteASCO issues guidelines formally mandating that all cancer patients be referred to exercise programming — establishing the first clear clinical obligation for oncologists.[5] The American Cancer Society simultaneously publishes updated survivor guidelines linking exercise to reduced mortality and recurrence across breast, colorectal, and prostate cancer.[7,11]
CompleteNAPBC 2024 standards requiring documented exercise recommendations for breast cancer patients take effect — creating the first binding compliance obligation in exercise oncology for accredited breast centers.[18] Simultaneously, Schmitz et al. publish a landmark geospatial analysis mapping 2,100+ exercise oncology programs, identifying 162 US cities with no program and documenting systematic access disparities by geography, race, and income.[12]
Active NowThe definitive current synthesis of exercise oncology implementation science is published in the ASCO Educational Book. The paper presents comprehensive frameworks for embedding EXCEEDS, PERCS, CORE, CREST, and PGA triage models into oncology care delivery — and provides the implementation blueprint that underpins the memios hospital program design.[21]
Active NowACSM has submitted a draft National Coverage Determination to CMS for exercise oncology services — the beginning of formal reimbursement policy. The Commission on Cancer is expected to advance documentation requirements across all 1,500+ accredited cancer programs. The institutions and payers building infrastructure today will define the standard when formal policy arrives.[20,21]
PendingThe demand is there.
The specialists are not.
Even where hospitals want to implement exercise oncology programs, the shortage of credentialed Cancer Exercise Specialists creates a bottleneck that prevents care from reaching patients. memios is addressing this directly.
The memios answer to the workforce shortage.
The memios certification pathway — delivered in partnership with the Cancer Exercise Training Institute (CETI) — creates a direct pipeline from the fitness and healthcare professional workforce to credentialed Cancer Exercise Specialist roles.
Physical trainers, physical therapists, nurses, and occupational therapists can earn the Cancer Exercise Specialist credential and be placed within memios hospital client programs. Telehealth delivery extends their reach beyond any single facility — a CES in one city can serve patients at three different hospital clients simultaneously.[16]
The memios platform handles the clinical infrastructure — exercise prescription builder, outcomes tracking, EHR integration, billing documentation — so the specialist focuses entirely on the patient.
The result is a scalable workforce model that matches the scale of the patient population that needs this care.
Infrastructure, certification,
and outcomes. In one platform.
memios is not a single product. It is the infrastructure layer that connects every stakeholder in exercise oncology — patients, professionals, hospitals, and payers — into one functioning system.
The EXCEEDS screening algorithm, embedded in your EHR, fires at the second chemotherapy infusion. A CDS Hook alerts the oncologist. The referral is placed in 3 to 5 minutes of staff time.[19]
Within 48 hours of referral, the patient completes a baseline assessment with a CETI-certified Cancer Exercise Specialist — in-clinic, via telehealth, or in a community setting. FACIT-Fatigue, PROMIS, and PHQ-9 are administered and recorded.
The CES builds an individualized exercise prescription using the memios platform — phase-specific, cancer-specific, and adjusted daily for how the patient feels. Sessions are delivered in-clinic, via HIPAA-compliant video, or guided through the memios app.
The memios patient app collects a 60-second daily check-in — fatigue, pain, mood, sleep, energy — using validated scales. Alerts escalate automatically to the clinical team when thresholds are crossed. The oncology team sees patient data in real time.[17]
Validated clinical measures are tracked at every phase transition. Outcomes are structured for NAPBC compliance reporting, MIPS quality measures, HEDIS performance, and payer data partnerships — automatically, at the point of care.[18,21]
At treatment completion, the memios survivorship program activates — annual reassessments, holistic wellness support across 8 domains, the Longevity Letter newsletter, and connection to the national survivor community. Exercise support does not end when treatment does.[11]
The science is done.
Now let us build the infrastructure.
Every cancer patient deserves access to what 2,800 clinical trials have proven can help them survive — and live well. memios is building the system that makes it real.
Research References
All statistics and clinical claims on this page are grounded in peer-reviewed research. Numbers in brackets correspond to the citations used throughout the page. Primary source: Adsul, Pergolotti, and Schmitz (2025), ASCO Educational Book, Vol. 45, Issue 3, e472854.