Aims
Despite strong evidence supporting exercise during cancer treatment, access to timely assessment and rehabilitation remains inconsistent. The Physical Activity during Chemotherapy to Enhance Recovery (PACER) service aimed to establish a sustainable model integrating early physical function assessment, exercise support, and targeted physiotherapy intervention within routine chemotherapy care.
Methods
PACER was developed within a tertiary cancer centre to transition exercise oncology from a reactive referral model to proactive supportive care. Patients commencing intravenous chemotherapy underwent screening integrated into routine oncology workflows, including SARC-F, Five Times Sit-to-Stand assessment, and bioimpedance spectroscopy assessment of skeletal muscle mass. Screening informed a risk-stratified pathway, with interventions ranging from education and self-management resources to physiotherapy assessment and individualised rehabilitation. Implementation included multidisciplinary collaboration, staff education, consumer-informed resources, workflow redesign, and sustainable referral pathways.
Results
Over 260 patients across diverse tumour streams have accessed PACER over two and a half years. The model was successfully integrated into routine chemotherapy care and identified patients requiring additional support who may not otherwise have received rehabilitation input. Approximately two-thirds of patients maintained or improved physical function during treatment. Consumers valued objective assessment, early personalised advice, and clear exercise recommendations. Staff reported increased confidence identifying patients requiring intervention and improved referral pathways. Key enablers included leadership support, multidisciplinary partnerships, and alignment with oncology workflows. Challenges included competing clinical priorities, space limitations, and workforce sustainability.
Conclusions
PACER demonstrates a practical and scalable approach to embedding exercise and rehabilitation into routine cancer care. By identifying patient needs early and matching support to individual risk, PACER enables proactive, personalised supportive care and provides an adaptable framework for translating exercise oncology evidence into everyday clinical practice.