Virtual Exercise Program to Reduce Cancer Related Fatigue

The objective of this investigation is to establish the feasibility and initial effectiveness of a novel exercise program for rural cancer survivors in Colorado suffering from cancer related fatigue. Participation in an exercise program has regularly been shown to reduce fatigue in cancer survivors, though in-person, supervised participation has a greater effect on fatigue than home-based programs with no supervision. Access to these supervised programs are limited in rural areas, restricting the ability of rural cancer survivors to experience the fatigue-reducing benefits of exercise. The proposed program will use information on improvements in fatigue from participants in the BfitBwell Cancer Exercise Program to monitor improvements in fatigue in rural cancer survivors performing a home exercise program and trigger a telehealth session with a cancer exercise specialist to adapt the exercise prescription when improvements are less than expected. The BfitBwell Program is an established exercise program at the Anschutz Health and Wellness Center which has worked with over 600 cancer survivors and is highly effective at reducing cancer related fatigue. The goal of the program is to replicate the effects of a successful supervised exercise program in rural cancer survivors who do not have access to this type of program. This investigation will recruit 20 rural cancer survivors experiencing fatigue and assess their ability to participate in the program, as well as how well the program improves their fatigue. Interviews will be conducted with participants after the program to determine how future versions of the program could be improved. The investigators anticipate that this program will be feasible and effective, providing preliminary data to pursue a large-scale clinical trial of the program following this project's completion.

Inclusion Criteria: * Adult (\>= 18 years) cancer survivor. * A maximum age of 80 will be set as virtual exercise may become unsafe as individuals get older. * A cancer diagnosis of any type * CRF is a common symptom across cancer types and the current CRF reference chart was developed using data from patients with all cancer types. * Current report of moderate-to-severe fatigue (\> 3 on a 0-10 scale, per NCCN definition31) * Live in rural Colorado and surrounding areas (\> 1-hour commute to major front range city \[Denver, Fort Collins, and Colorado Springs\]) * This program attempts to target individuals in Colorado and surrounding areas with restricted access to fitness centers that may offer cancer specific services, most likely found in major front range cities. We have defined rural in terms of commute time to these cities, as it is the commute to these centers that restricts access. * Completed medical cancer treatment (chemotherapy and/or radiation) with curative intent within past 12 months or currently on treatment with no planned changes for the next 4 months (e.g. maintenance or palliative therapy). * No additional treatment planned for next 4 months. * These restrictions are made to ensure the validity of tracking changes with the established reference chart, which was developed using data from cancer survivors who had recently completed therapy or were on therapy14. It is unclear how fatigue response to exercise may change in survivors further out from treatment completion. * High-speed home internet and smartphone (or laptop with camera). Exclusion Criteria: \- Medical conditions that would impact the safety of, or participation in, an exercise program. This includes: * Orthopedic conditions such as advanced osteoarthritis, mobility-limiting amputations or chronic injuries, or mobility- limiting acute orthopedic injuries * Advanced rheumatoid arthritis * Widespread chronic pain conditions such as fibromyalgia * Significant balance impairment increasing the risk of falling * Pulmonary conditions such as chronic obstructive pulmonary disease, emphysema, interstitial lung disease, use of supplemental oxygen * Known cardiovascular disease, uncontrolled hypertension, or new cardiac event within the past 6 months.