Some of the mechanisms by which exercise protects against cancer and sensitizes cancer cells to death include: •Increased blood flow, shear stress on the vascular bed, temperature increases, sympathetic activation and endocrine (release of catecholamines and exercise hormones, myokine secretion) •Increased tumor perfusion, oxygen delivery, •Metabolic stress within the tumor, cellular damage, and reactive oxygen species production. These acute changes are able to elicit signaling pathways that prevent metastasis. •Improved immune function, reduced systemic inflammation, and improved metabolic health, as well as intratumoral changes in the form of enhanced blood perfusion, immunogenic profile, and immune cell infiltration.