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Simple Summary: Nowadays, everyone is aware of the health benefits of physical activity (PA). In the case of cancer, the evidence is strong in favour of PA, but in many cases, the message does not reach patients. For this reason, in the present study, we wanted to find out the points of view of oncologists and their respective patients with regard to the prescription of PA and the possible causes for the message not passing through adequately. We observed that 97% of oncologists said that they prescribe PA in their office, while only 62% of their patients said that they have received these guidelines. It was also observed that those patients who claimed to have received recommendations for PA were more active in their daily lives, walking more days per week and more minutes per day. This study is the starting point for finding out where the discrepancies between oncologist–patient communication are. Objectives: The purposes of this current questionnaire-based study were to analyse whether oncologists prescribed PA to their patients in Spain, as well as the type of exercise recommended, the variables that influence whether or not to recommend it and to compare these recommendations with the values reported by their patients. Methods: Two online questionnaires were designed for this study. The first one, filled in by the oncologists (n = 93), contained aspects such as the attitude or barriers to promoting PA. The second was designed for patients with cancer (n = 149), which assessed PA levels and counselling received from oncologists, among other facets. Results: The majority of oncologists (97%) recommend PA during their consultations. Instead, only 62% of patients reported participating in exercise within the last 7 days. Walking was the most common form of exercise, reported by 50% of participants. Patients who received exercise recommendations from their oncologist walked for more days (p = 0.004; ES = 0.442) and more minutes per day (p = 0.022; ES = 0.410). The barriers most highlighted by patients were lack of time and not knowing how to perform PA. Conclusion: Oncologists and patients seem to be interested and able to participate in PA counselling and programmes. However, there was a discrepancy between what was reported by oncologists and expressed by patients in terms of recommendations for PA and the modality itself. [ABSTRACT FROM AUTHOR]