Study Design: Type 2, hybrid implementation-effectiveness study The proposed project is strongly aligned with the multidisciplinary Alberta Cancer Exercise (ACE; Culos-Reed and McNeely, Co-PIs) lifestyle initiative - a result of the accumulation of over 15 years of research in the design, implementation and evaluation of cancer exercise programs. While the Alberta model has and will continue to be adapted to the Nova Scotia context, the utilization of a Canadian-based, integrated cancer exercise model, with demonstrated success and existing training resources will provide the much-needed framework to improve health outcomes in cancer patients/survivors. In brief, ACCESS will facilitate oncologist referral of survivors to a hospital-based, Certified Exercise Physiologist (CEP) as well as "Cancer Exercise Wise" certified community-based fitness professionals. The CEP will be responsible for screening and triaging survivors to assess participant interests and needs and to determine the appropriate level of activity and any supervision required to maximize benefits and ensure participant safety. Following screening the CEP will link the survivor with the appropriate hospital or community-based physical activity supports (see "TRIAGE PATHWAY"). Exercise programming will include aerobic, resistance, balance, and flexibility training and will be consistent with the exercise delivery model developed for ACE (www.albertacancerexercise.com). Participants will include adult cancer survivors of all cancers and stages at any point along the cancer care trajectory. Eligibility: Participants will be screened for eligibility and must: 1) Have a diagnosis of cancer; 2) Be 18+ years; 3) Be able to participate in mild levels of physical activity (at a minimum); 4) Be pre-treatment, receiving active treatment, or have received cancer treatment within the past 5 years or have a late presenting/ongoing side-effects related to the cancer diagnosis; 5) be willing to attend a 12-week exercise program in Halifax; and 5) Be able to provide informed written consent in English. A Certified Exercise Physiologist (CEP), housed within the QEII cancer care center (Halifax, NS), will have (medically approved) consenting participants complete a baseline PA and cancer specific screening measure to determine appropriateness/preferences for hospital and/or community-based PA participation. The CEP will oversee baseline physical fitness testing and will evaluate screening and testing results. The CEP will then triage the participant to a hospital or a local community-based fitness center depending on their cancer-related needs and programming preferences. The hospital site, under direct supervision of the CEP, will be used for those with identified cancer or other health-related needs that preclude exercising in a community-based setting. The community-based site will be supported by the CEP and will serve those participants cleared to exercise under a "Cancer and Exercise" trained fitness professional, but without high medical needs that would require direct CEP supervision. INTERVENTION: PA programming will be consistent with the exercise delivery models used in pilot programming both in Alberta and here in Halifax (EXACT) and will include a combination of aerobic, resistance, balance, and flexibility exercises delivered in a circuit-type class setting or group/individual personal training format, twice weekly, for 12-weeks. OUTCOME MEASURES: A mixed-methods approach will be used to assess study outcomes. Patient reported outcomes (effectiveness measures) will be assessed at baseline, post-intervention, 6 and 12 month follow-up. Implementation outcomes will be assessed throughout the duration of the study.