Almost every patient with cancer will have oncologist input, but not every patient will meet an exercise oncology health professional. This positions oncologists as uniquely influential in advocating for exercise as part of their routine clinical workflows. Exercise is a well recognised non-pharmacological intervention with broad health and wellbeing benefits and minimal side effects, supported by robust evidence linked to reduced cancer risk and improved survival following cancer diagnosis. Yet gaps persist in meaningfully prescribing exercise in routine practice, in part due to a lack of top-down buy-in to expand and sustain exercise oncology services for oncologists to refer to. Until this occurs, oncologists will need to move beyond the traditional "assess, advise, and refer" model toward one of implementation, collaborative goal-setting and re-envisioning of exercise as precision medicine. By studying and prescribing exercise as precision medicine, with defined doses, costs, safety parameters, monitoring and reporting of outcomes aligning with institutional goals, and by curating trial portfolios with embedded exercise oncology data and outcomes, oncologists may optimise their patients' care and champion exercise oncology policy change.