Adsul Prajakta, Pergolotti Mackenzi, Schmitz Kathryn H
Cancer Control and Population Sciences Research Program, Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM.
Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM.
Am Soc Clin Oncol Educ Book. 2025 Jun;45(3):e472854. doi: 10.1200/EDBK-25-472854. Epub 2025 Jun 12.
Oncology rehabilitation and exercise (ORE) exist along a continuum of care, providing essential services for patients with cancer to improve health outcomes. Although oncology rehabilitation, typically delivered by licensed medical professionals, is often covered by third-party payers, exercise oncology remains largely unfunded despite its strong evidence base. Research indicates that exercise interventions improve cancer-related fatigue, physical function, mental health, and quality of life, yet referral and implementation remain limited. A geospatial analysis highlights disparity in program availability, particularly in rural and underserved areas. Effective ORE programs require systematic planning, institutional support, clinical workflow integration, and sustainable funding. Case analyses suggest that program adoption depends on leadership buy-in, organizational readiness, and structured referral pathways. Implementation science (IS) provides a framework to address real-world barriers, ensuring efficient integration of exercise services into oncology care. Screening and triage models can aid in patient assessment, streamlining referrals to appropriate levels of exercise intervention. Despite growing policy efforts, widespread third-party reimbursement remains elusive. Leveraging IS strategies can facilitate the adoption and sustainability of ORE programs, bridging the gap between research and practice. Future directions should focus on improving clinician education, expanding access through policy initiatives, and integrating exercise interventions into standard oncology care to optimize patient outcomes.
肿瘤康复与运动（ORE）贯穿于连续的医疗服务过程中，为癌症患者提供重要服务以改善健康结局。尽管肿瘤康复通常由持牌医疗专业人员提供，且往往由第三方支付者承保，但运动肿瘤学尽管有强有力的证据基础，却在很大程度上仍未得到资金支持。研究表明，运动干预可改善与癌症相关的疲劳、身体功能、心理健康和生活质量，但转诊和实施情况仍然有限。一项地理空间分析凸显了项目可及性方面的差异，尤其是在农村和服务不足地区。有效的ORE项目需要系统规划、机构支持、临床工作流程整合和可持续资金。案例分析表明，项目采用取决于领导层的支持、组织的准备情况以及结构化的转诊途径。实施科学（IS）提供了一个框架来解决现实世界中的障碍，确保将运动服务有效整合到肿瘤护理中。筛查和分诊模型有助于患者评估，简化向适当运动干预水平的转诊。尽管政策努力不断增加，但广泛的第三方报销仍然难以实现。利用IS策略可以促进ORE项目的采用和可持续性，弥合研究与实践之间的差距。未来的方向应侧重于改善临床医生教育、通过政策举措扩大可及性，以及将运动干预整合到标准肿瘤护理中以优化患者结局。
