Exercise training in cancer related cardiomyopathy

The therapeutic options for malignancies have been expanding over the past decades. Since the rise of targeted therapies, improved survival rates and decreased morbidity of cancer patients are evident but these refined protocols have steadily increased the number of patients at risk for long-term side-effects of anti-neoplastic treatments. The leading causes of death in cancer survivors are now defined by cardiovascular disease. Thus, there is a growing need for understanding how cancer related cardiovascular diseases such as cardiomyopathies or vasculopathies develop and how this can be prevented. Besides classical symptoms of heart failure with or without decompensation, an overwhelming majority of cancer patients develop fatigue and a significant reduction in exercise capacity when compared to their pre-cancer state. These effects seem to be independent from the specific chemotherapeutic substance included in the treatment regimen. Recent trials have suggested beneficial effects of exercise regiments in early and late phases of cancer treatment regimens and during rehabilitation. This review focuses on the currently available literature and evidence for the role of exercise training in preventing declining cardiac function or improving an already impaired function during or after chemotherapy, radiation or other cancer-specific therapies.