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cardiotoxicity, exercise, fatigue, neoplasms



  1. Wang, Hsiao-Lan PhD, RN, CMSRN, ACSM EP-C, FAAN
  2. Cousin, Lakeshia MS, APRN, AGPCNP-BC
  3. Fradley, Michael G. MD
  4. Donovan, Kristine A. PhD, MBA
  5. Smith, Barbara PhD, RN, FACSM, FAAN
  6. Szalacha, Laura EdD
  7. Lavoie Smith, Ellen M. PhD, APN, AOCN, FAAN
  8. Buck, Harleah G. PhD, RN, FPCN, FAAN


Background: Cardiac toxicity in patients with cancer results from treatment-related damage to the cardiovascular system by chemotherapy, targeted agents, or thoracic radiation. Cardio-oncology patients with co-occurring cancer and cardiovascular disease frequently experience fatigue. Exercise is recommended in clinical guidelines to manage fatigue during or after cancer treatment.


Purpose: The purpose of this article is to conduct a scoping review of the exercise randomized clinical trials in cardio-oncology patients, focusing on the components and effects of exercise interventions on patient cardiovascular and fatigue outcomes.


Methods: A scoping review methodological framework was deemed appropriate and used. Key words for search included "cancer," "oncology," "cardio-oncology," "heart failure," "physical activity," and "exercise." Search involved systematic searches of large databases (PubMed, MEDLINE, Cochrane Review, and CINAHL) and hand searches of reference lists, key journals, webpages, and experts in the field using snowballing techniques.


Results: There were 12 randomized clinical trials included in this review. Study characteristics, accordance of exercise protocols with recommendations, specific exercise training components, and cardiovascular and fatigue outcomes were mapped.


Conclusions: Recommendations for addressing the gaps included focusing on non-breast-cancer patients with cardiac toxicity risks, developing precision-based prescriptions based on various medical and physiological characteristics, and adding fatigue symptom experience as an outcome variable.