The discipline of exercise oncology is now well established, and health care professionals can deliver prehabilitation across the UK. The scope of exercise medicine in cancer is actively improving outcomes, from direct impact on the disease to prehabilitation and rehabilitation at all stages of many cancer types. However, the service is not yet embedded in the UK. Is there a place for SEM medicine in this role, and how should we find its place? Dr Robinson reviews the opportunities and challenges in the context of NHS care.