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Why CETI

The pioneer in oncology exercise.

Andrea Leonard began researching exercise for breast cancer recovery in 1995, before exercise oncology existed as a discipline. She spent three years working with the Chiefs of Breast Surgery at Georgetown University, George Washington University and Johns Hopkins University Medical Centers to write Essential Exercises for Breast Cancer Survivors, published by Harvard Common Press in 2000. CETI has been the global leader in the field ever since — and remains the only certifying body in oncology exercise that revises its curriculum every two years and requires a 50-question re-examination to stay qualified.

Pioneering the field since 1995 · Founded 2004 · 20,000+ specialists · 60 countries · 15 editions of the curriculum · Guided by a 23-member Medical Advisory Board

By the numbers

What twenty-four years adds up to

20,000+ specialists trained in 60 countries, over 24 years and 15 editions of the curriculum.

Every one of them examined at 80% to pass, and re-examined every two years on the current edition.

CETI has trained more health and fitness professionals to work with cancer patients and survivors than any other organization in the world.

That claim rests on a simple structure: a curriculum revised every two years, reviewed by twenty-three clinicians across nine countries, examined at 80% to pass, and renewed every two years so nobody is practicing on decade-old guidance.

The result is a specialist workforce that didn’t exist in 2004 — in countries where oncology exercise had no professional pathway at all.

cancer types in the curriculum, plus childhood cancer

600+

pages in the current edition, revised every two years

continuing education bodies approving the qualification

80%

examination pass mark

Why it exists

The gap CETI was built to close.

In 1996, when Andrea Leonard’s mother was diagnosed with breast cancer for the second time, nobody could tell her what movement was safe. Not her surgeons, not her oncologists, not anyone at her gym. The information didn’t exist in a form a fitness professional could act on.

Three decades later that gap is smaller, but it hasn’t closed. Exercise is now standard guidance across the cancer care continuum — and many people are still told to exercise by a doctor with nobody qualified to refer them to.

CETI exists to produce those people.

“Cancer strips you of everything: hair, body, self-esteem, confidence, finances, family. As an OncoVie® Cancer Exercise Specialist you have the unique opportunity to help people take control at a time when they feel they have none.”

Andrea Leonard, Founder

History

How it happened

1995

Andrea begins research into breast cancer recovery, working with the Chiefs of Breast Surgery at Georgetown, George Washington and Johns Hopkins University Medical Centers — the origin of the field

2000

Essential Exercises for Breast Cancer Survivors published by Harvard Common Press

2000

The Breast Cancer Survivors Foundation founded — an Oregon 501(c)(3)

2004

The Cancer Exercise Training Institute founded; the OncoVie® curriculum developed

2019

Partnership with the American Council on Exercise begins

2026

15th Edition released — 600+ pages, 20,000+ specialists trained across 60 countries

What’s different

Four things that set the qualification apart

Since 1995

The pioneer in oncology exercise

Andrea began her research in 1995, working with the Chiefs of Breast Surgery at Georgetown, George Washington and Johns Hopkins University Medical Centers — decades before exercise oncology was recognized in the clinical literature. The field’s foundations were built here.

20,000+ in 60 countries

The global leader

CETI has trained more health and fitness professionals to work with cancer patients and survivors than any other organization in the world — with a Medical Advisory Board spanning nine countries to match.

Every two years, without exception

The only body that re-examines

CETI is the only certifying body in oncology exercise that revises its content every two years and requires every specialist to sit a 50-question renewal examination to stay qualified. Not a fee, not a form — a 50-question examination on the current edition, at 80% to pass. That is what ongoing competence actually means.

Beyond the credential

A practice, not just a certificate

The Everything Package includes a personalized business launch plan: local market analysis, a tiered referral contact list naming nurse navigators and survivorship coordinators, pricing structures and outreach scripts.

Three ways in

Three ways to take it. One examination.

Schedule a live workshop at your own facility, join a live virtual cohort, or study online at your own pace.

Live, at your facility. Andrea travels to teach this material in person — certification courses, hospital in-services, university programs and conference workshops, hands-on with real clients in the room. Four continents so far.

Live and virtual. A month-long Zoom Guided cohort with weekly live sessions, for people who want the teaching and the questions answered without the travel.

Self-study online. The full curriculum, 180 days to complete it, taken at whatever pace the rest of your life allows.

The format is a matter of convenience. What does not change is the content — lymph node dissection, surgical reconstruction, contraindications, taught the way it has to be understood rather than simplified for a slide deck. Every specialist in those 60 countries trained on the same curriculum, passed the same 80% examination, and is re-examined every two years, whichever route they took.

Worked through in front of the room

Assessment findings on the left, the programming decisions that follow on the right

Circumferential measurement is the baseline everything else is read against

Taken at fixed anatomical points on both limbs before programming begins, then repeated — a change of roughly two centimetres against the unaffected side is the threshold most protocols treat as significant and refer on

One example of why the training matters

Lymphedema is where a well-meaning trainer can do real damage

Exercise is not the risk. Unprepared exercise is the risk.

When lymph nodes are removed or irradiated, the limb’s drainage capacity is permanently reduced. Load it faster than the remaining system can adapt to and you can provoke swelling that may not fully resolve.

That is what people mean when they say exercise causes lymphedema. It doesn’t. Progression that outruns the tissue does.

Prescribed properly, the picture changes. Slow, progressive, supervised resistance training is well tolerated by people who already have lymphedema, and in trial conditions has been associated with fewer exacerbations and reduced symptoms — by raising the limb’s capacity so that ordinary activity demands less of it.

The difference between those two outcomes is the person writing the program.

Too fast

The mechanism behind most exercise-related flare-ups — not exercise itself

Weight

Obesity is among the strongest modifiable risk factors

Inactivity

Doing nothing is not the safe option

Monitored

Repeat circumferential measurement catches a change early. Specialists also watch for other signs — a limb that feels heavy, tight or full, skin that pits or thickens, clothing or jewelry that stops fitting, aching or reduced range at the shoulder or hip

Lymphedema management sits alongside a client’s medical team, never in place of it. Specialists are taught where their scope ends and when to refer. Evidence for supervised progressive resistance training in this population includes the Physical Activity and Lymphedema (PAL) trial, Schmitz et al. 2009 — 295 breast cancer survivors, no increase in lymphedema incidence or exacerbation.

Ongoing competence

Recertification usually means paying a fee.

Across much of the fitness industry, recertification means accumulating continuing education credits and paying a renewal fee. Re-examination is rarely part of it, so current knowledge is assumed rather than demonstrated.

CETI does it differently, and always has. Every two years the curriculum is revised against current oncology research — a partial rewrite covering everything that has changed — reviewed by the Medical Advisory Board, and every specialist sits a 50-question renewal examination on it, passing at 80% or higher.

It means a CETI specialist certified this month and one certified sixteen years ago have both demonstrated current knowledge, on the current curriculum. In a field where treatment protocols change constantly, that difference matters to the people they work with.

2 years

between curriculum revisions

Every

renewal requires a 50-question re-examination

80%

pass mark, on renewal as on first qualification

editions since 2004

In their words

Institutions and clinicians

Selected from letters of reference. Full letters on file.

Institutions and program directors

“I am a hematologist-oncologist, and also a patient, and I have personal experience with this remarkable instructor and mentor — being in one of her classes given to patients with prostate cancer and women with breast cancer. She is superbly trained and is an accomplished teacher and example, as she also has a history of surviving cancer. I commend her, without reservation.”

Stephen G. Chandler, MD

Hematologist-oncologist — and a patient in her class

“When my staff asked for continuing education on how to safely and effectively train clients battling cancer, I turned to Andrea Leonard and the Cancer Exercise Training Institute. As a hospital-based fitness facility, quality is expected in all aspects — and Andrea delivered.”

Carol Lynne Teteak

Fitness Coordinator, Edward Health & Fitness Center at Seven Bridges

“Thank you so much for the recent two-day training… You kept the workshop interesting and fun and the audience involved. The workbook was well written and easy to follow. We will shortly be unveiling a full-fledged regional cancer wellness program.”

Laurie Knutson

Director, Sanford Cancer Center Hematology & Oncology

“I am a huge fan of this training course. As the YMCA strives to better serve our members, and certainly this population, this opportunity has been one that we are proud to offer to ensure that our staff are very well trained and knowledgeable.”

Sha Foland

Senior Director of Health & Wellness, El Camino YMCA (YMCA of Silicon Valley)

“I recommend the Cancer Exercise Training Institute for the OncoVie® Cancer Exercise Specialist Advanced Qualification. The training is top notch for any healthcare and fitness professional pursuing further education in exercise for cancer patients.”

Marcia Jones

Integrative Medicine, Avera Prairie Center

Graduates

In their own words

OncoVie® Cancer Exercise Specialists on what the qualification changed for them — why they took it, and what they do with it now.

“My story with The Justice began in 1999, while she was battling her first bout of cancer. Her husband Marty, knowing the effects of cancer treatment on the body, suggested that she start working out to improve her strength. She took his wishes to heart and began searching for a personal trainer. She found me.”

Bryant Johnson

Personal trainer to Justice Ruth Bader Ginsburg

“This incredible course looks at the cancer journey from every angle possible. As a Pilates fitness professional I am now qualified to prescribe personalised movement for a cancer survivor while also understanding the long term benefits.”

An ode to my late Mum.

Danielle Novytarger

Pilates professional

“I found the course very informative and felt the resources were excellent. The videos were very instructive and the manual the best I’ve come across in over 20 years of fitness training. The course has most definitely given me all I could have hoped for.”

Adrian Bell

20+ years in fitness training

“As a cancer survivor myself, and a Ph.D. student in Gdansk University of Physical Education and Sport, I know how important physical activity is for people diagnosed with cancer. I now feel equipped to support cancer patients in Poland and to continue my research on the impact of physical activity on the quality of life and pain tolerance of patients.”

Marzena Wieczorek-Przybyło

Doctoral researcher, Gdańsk University of Physical Education and Sport · Poland · cancer survivor

“I started this course in order to better serve a long-time client of mine who was diagnosed with primary bone cancer. The material has been invaluable. Thanks so much for your hard work developing this course.”

Gregory Harden

Trainer

“Filled with practical nuggets of wisdom from evidence-based guidance on how to modify and progress exercises safely for each participant. I appreciated the deep dive into client case studies… The CETI CES community has set me up for success.”

Worry less, move more. Together, we are stronger than cancer.

Debbie Persaud

13-year breast cancer thriver · biomedical scientist · NASM Corrective Exercise Specialist · LIVESTRONG at the YMCA instructor

“Thank you for an amazing course! I’m excited to be a yoga therapist specializing in yoga for the cancer community!”

Chloe Triantafillis

Yoga therapist

“Having fought my own battle against cancer, I am determined to empower others on their journey to recovery. I’m so happy I passed the exam! Looking forward to start as a CETI Cancer Exercise Specialist!”

Valerie Jehrameel April Perreras

Cancer survivor

“Andrea, I find no words to thank you! Many people in Colombia will benefit from this scholarship. On behalf of my patients and myself, I want to say thanks for such a generous heart and for paying attention to all of our needs.”

Lucia Plata

Colombia · CETI scholarship recipient

“I am so grateful for this scholarship. I am excited to become a CETI Cancer Exercise Specialist, to help the cancer community in México. I am now equipped to help people feel better and live better, healthier lives. Thank you for this opportunity.”

Montserrat Zenteno

México · CETI scholarship recipient

“I became a Cancer Exercise Specialist in response to the cancer survivors looking for my help. Fortunately, I was aware of the implications of what I did not know. Through CETI I learned about the best practices at all phases of treatment, what should be avoided, questions to ask, how to be a better listener, and how to work with their medical team.”

This course gave me confidence and made me a better human.

Ann Lutz

Master trainer

“I absolutely enjoyed your certification program and am looking forward to putting it to great use… I am honored to be CETI certified and part of this very important work.”

Lisa Marquart

Health coach, breast cancer survivor and urban farmer · north of Seattle

“I am a two-time breast cancer survivor. I was an amateur bodybuilder when I found out that I had cancer the first time back in 2016. I continued to workout throughout my entire cancer journey and I know that it helped me to overcome many of issues/symptoms during various treatments and surgeries.”

I’ve always wanted to be a personal trainer, and combining that love with something I am passionate about would be a dream come true.

Jasmine Waggner

Two-time breast cancer survivor · amateur bodybuilder

“I first passed this course back in 2004 when I was Director of Trainer Education at Chelsea Piers Sports Center in NYC. Nearly 20 years later my career has brought me back to Andrea and CETI again for this great course.”

I was very impressed with how the program has grown and continues to educate personal trainers, physical therapists, doctors and cancer survivors — very much in line with what the ACSM refers to as “Exercise is Medicine.”

Dan Hogan

Former Director of Trainer Education, Chelsea Piers · New York

“What Andrea offers is not only education and training. She opens doors to her own personal world and provides us with wings to become better people, and to work for the well-being of people by giving them some comfort and strength during such a hard disease.”

Gustavo Sämy

OncoVie® Cancer Exercise Specialist

Track record

Where CETI has taught

Certification courses, staff training, workshops and keynotes across hospitals, cancer centers, universities, health systems, rehabilitation networks and professional conferences in North America, Europe and Asia.

A limited list. Full references available on request.

Hospitals & health systems

Georgetown University Hospital

Johns Hopkins / Suburban Hospital

Memorial Hermann

Sanford Health System

Avera McKennan Prairie Cancer Center

Chesapeake Regional Medical Center

Sibley Hospital

Baptist Hospital East

Baptist Health System

Edwards Hospital

South Georgia Medical Center

Cary Medical Center

Lynchburg General Hospital

St. Mary’s

Patricia Neal Rehabilitation Center

HCA Healthcare

Advocate Health Care

Atrium Health Navicent

IU Health

CHRISTUS St. Vincent Health System

Prevea Health

North Memorial Health

Evangelical Community Hospital

Black River Memorial Hospital

Mercy Regional Medical Center

Sandoval Regional Medical Center

Gordon Hospital

Providence Hospital Medford

Highland Park Hospital Wellness Center

Loyola Hospital Wellness Center

St. Vincent’s Hospital, Portland

Baptist Hospital, Nashville

Baptist East Hospital, Louisville

SGMC Health

Cancer centers

Memorial Sloan Kettering Cancer Center

Fox Chase Cancer Center — Temple Health

Avera McKennan Prairie Cancer Center

Miles Perret Cancer Services

Sanford Cancer Center — Hematology & Oncology

Rehabilitation & therapy networks

NovaCare Rehabilitation

Select Physical Therapy

Scott Robbins Physical Therapy

Ozark Total Healthcare

Universities & academic programs

OHSU School of Nursing

Winona State University — Survivors Unite

New York Institute of Technology

McHenry Community College

Rocky Mountain University of Health Professions

Valdosta State University

Loyola University Chicago — Center for Fitness

Washtenaw Community College — Health & Fitness Center

Conferences & professional bodies

IDEA World

Healthy Aging Summit

Asia Fitness Conference

CPTN Personal Training Conference

IHRSA

TSI Summit

Medical Fitness Tour

Kaiser Permanente — Thriving with Cancer

Military, government & community

Fort Bliss Army Installation

Southern Nevada VA

Mennonite Cancer Foundation

Southeast Georgia Cancer Coalition

The Claremont Club & Spa

YMCA

JCC

Town Sports International

Fairfax County Park Authority

Chelsea Piers Fitness

Healthtrax

Healthworks Fitness Centres

Uptown Athletic Club

Wildwood Athletic Center

Carroll Wellness Center

Hanover Family Fitness

Spring Hill Recreation

Cornerstone

Fairmont Scottsdale Princess

2Unstoppable

Reach

Sixty countries, and a board to match.

A protocol that works in a Washington teaching hospital isn’t automatically right in Lagos, Bangkok or Taipei. That’s why the Medical Advisory Board spans nine countries, and why the curriculum carries continuing education approval in the United States, United Kingdom, Canada and Puerto Rico.

It’s also why virtual training is part of the qualification — so specialists can reach immunocompromised clients, rural clients, and clients in places where nobody local is qualified.

Medical Advisory Board members

countries represented on the board

board members hold the CETI qualification themselves

The referral is already being made.

Every day an oncologist recommends exercise and has nobody qualified to send the patient to.