For years, the evidence has been clear: exercise plays a powerful role in cancer care. It can reduce side effects, improve quality of life, and support recovery. But for many patients, exercise programs are still not embedded in the care they receive.
Here in Western Australia, Dr Mary Kennedy and her team focus on not whether exercise works, but how to ensure every cancer patient can actually access it.
This work, led through a collaboration between Edith Cowan University and GenesisCare, sits within the field of implementation science, a branch of research focused on translating evidence into real-world care.
Dr Kennedy and the team from GenesisCare have developed a model within the organisation, designed around patient needs, to connect every patient with appropriate exercise care. Already in place at the majority of centres, work is underway to embed this referral pathway across all care settings.
Since we last spoke with them in 2024, the team have expanded this model to include two more regional GenisisCare sites, which has enabled nearly 800 additional people receiving treatment in the South West and Great Southern regions to now also receive tailored exercise recommendations and referrals.
They shared their learnings and achievements and spoke about how they hope to continue this work into the future.
Building exercise into the care team
Through ongoing collaboration with community members to design and drive this project, the feedback remains clear: people want exercise programs integrated as a standard of care.
"You shouldn't have to ask," one community advocate shared. "It should just be part of the care plan."
Dr Kennedy's research is helping make exercise a part of standard care by integrating exercise physiologists into cancer care teams. Exercise physiologists are trained clinicians who tailor safe, individualised exercise programs during treatment. Yet, they are still not consistently embedded within standard cancer care teams.
"That's what's missing across the board", Dr Kennedy says. "Exercise physiologists are not necessarily part of most care teams."
At GenesisCare, integrating exercise physiologists directly into care has allowed clinicians to refer patients through a trusted and structured pathway.
Over the past year, this research has shown the importance of including opt-out rather than opt-in referrals, as well as incorporating dedicated administrative staff to manage these referrals and bookings to reduce oncologist workload and to ensure patients are automatically and seamlessly connected into exercise care.
For Taryn Kelly, the Lead Exercise Physiologist at GenesisCare, this integration is what makes the model work in practice.
When exercise is embedded into the care pathway, it becomes part of treatment rather than an optional extra." Taryn says.
Reaching regional communities
Even within one organisation, the way of working cannot be one-size-fits-all. As the research has expanded into regional Western Australia, including Albany and Bunbury, feedback from patients highlighted the need for flexible delivery that may look different in different locations and contexts.
"Even within GenesisCare, the way exercise is delivered is very different at different sites, because of the facilities and resources in each location." Dr Kennedy says.
In regional settings, where access to exercise services is limited, they've adapted care through phone-based consultations and referral into local community supports.
Flexibility is key to changing standard care. It's about getting the essentials right, such as having access to a qualified exercise professional and a structured referral pathway, while adapting delivery to local needs.
Funding and policy change
Designing practical services is only part of the solution. Funding and policy also play a major role in whether new models of care can be expanded and used more widely.
At the moment, funding for exercise physiology is still not available across all health systems. Because of this, services often rely on local funding or short-term research grants, rather than being embedded as standard care.
Without changes to funding, access to exercise support will continue to depend on postcode, provider, or temporary project funding.
That is why the next phase of this work is focused on moving from research into everyday health systems and showing the long-term value of including exercise in standard care.
What comes next
"This is not finished," Dr Kennedy says.
The goal is no longer simply to show that exercise works in cancer care. It is to build the working parts to make it routine across Western Australia and beyond.
Until that happens, the gap between evidence and practice will remain.
Exercise has incredible value for people going through a cancer treatment and beyond, and everyone should have the chance to access that care." Dr Kennedy says.
Innovative research projects, such as Dr Kennedy's, would not be possible without generous community support. Donate to support local cancer research today.
