Fig. 1.

Suggested algorithm for exercise prescription in adult cancer patients peri- and post-cancer therapy. *Considered to be at increased cardiovascular risk by ASCO guidelines (52): Treatment with high-dose anthracycline therapy, high dose radiation therapy (when the heart is included in the treatment field), or low dose anthracycline therapy in combination with low dose radiotherapy; Treatment with low-dose anthracycline or trastuzumab alone plus the presence of two or more risk factors (smoking, hypertension, diabetes mellitus, obesity, dyslipidemia, age greater than 60 years at time of treatment, or the presence of compromised cardiac function); Treatment of low-dose anthracycline followed by trastuzumab. **In settings where CPET unavailable investigators can use maximal incremental exercise tolerance testing (ETT) to determine workload and peak exercise heart rate. CPET, cardiopulmonary exercise testing.