Speaker
Description
Background: Cancer-related fatigue (CRF) is among the most prevalent and debilitating symptoms across the cancer continuum. Exercise-based rehabilitation is an effective evidence-based intervention to reduce CRF and improve functional outcomes. However, translating this evidence into sustainable clinical programs remains a challenge.
Purpose: To describe a cancer rehabilitation model that addresses this implementation gap.
Approach: Using a rehabilitation approach, this program emphasizes functional recovery through supervised exercise. It was launched in 2007 using existing staffing and equipment in a shared hospital pulmonary gym. Initial evaluations and individualized exercise prescriptions were completed by oncology-trained physical therapists (PTs) and billed to insurance, while ongoing sessions were provided by oncology-trained exercise physiologists (EPs) on a self-pay, drop-in basis. In 2015, the program transitioned to a wellness clinic embedded within a cancer center.
Findings: Program adjustments have improved efficiency and created a more sustainable model. Moving from drop-in to scheduled supervised CRF classes optimized staffing and the use of a smaller cancer center gym. Co-location within the cancer center increased CRF program volumes, narrowing the financial gap and positioning the program for profitability next year. The nominal self-pay model ($7 per session) minimized additional cancer-related financial toxicity and preserved insurance-covered rehabilitation visits for skilled services such as cognitive, pelvic floor, or lymphedema therapy. Over the past decade, annual program metrics grew from 206 referrals, 171 PT CRF evaluations and 2,428 class visits to 436 referrals, 309 PT CRF evaluation and 4,954 attended class visits in 2025. Financial performance has made incremental gains, and modeling projects a small loss in 2025 followed by profitability in 2026.
Conclusion: A hybrid model combining insurance-based and self-pay services within a hospital outpatient setting can be sustainable. This approach offers a scalable framework for integrating exercise into oncology care.
Keywords
Cancer-related fatigue, Exercise oncology, Rehabilitation, Implementation science
| Abstract submitters declaration | yes |
|---|---|
| Conflict of Interest & Ethical Approval | yes |
