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Quality in Sport

Cardio-Oncology Rehabilitation: Strategies for Cardiovascular Risk Reduction and Recovery in Cancer Survivors
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  4. Medical Sciences

Cardio-Oncology Rehabilitation: Strategies for Cardiovascular Risk Reduction and Recovery in Cancer Survivors

Authors

  • Wiktoria Michnowska University Clinical Centre in Gdańsk, Medical University of Gdańsk, ul. Dębinki 7, 80-952 Gdańsk, Poland https://orcid.org/0009-0003-7161-0105
  • Paweł Pustuła Family Medicine Center, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland https://orcid.org/0009-0003-4494-1080
  • Ewa Szplit Faculty of Medicine, Medical University of Gdańsk, ul. Dębinki 7, 80-211 Gdańsk, Poland https://orcid.org/0009-0001-1464-6027
  • Patryk Hebda Andrzej Frycz Modrzewski University, ul. Gustawa Herlinga‑Grudzińskiego 1, 30‑705 Kraków, Poland https://orcid.org/0009-0006-4660-3554
  • Bartłomiej Błaszkowski F. Ceynowa Specialist Hospital, ul. Powstańców Warszawy 11, 84‑200 Wejherowo, Poland https://orcid.org/0009-0001-9898-2908
  • Roman Cemaga Medical University of Bialystok, Jana Kilińskiego 1, 15-089 Bialystok, Poland https://orcid.org/0009-0003-8372-2905
  • Maria Król Lower Silesian Center for Oncology, Pulmonology and Hematology, Ludwika Hirszfelda Square 12, 53-413 Wroclaw, Poland https://orcid.org/0000-0003-0068-7837
  • Adam Wolski Faculty of Medicine, Medical University of Gdańsk, ul. Dębinki 7, 80-211 Gdańsk, Poland https://orcid.org/0009-0005-1969-0640
  • Mateusz Kubicki Faculty of Medicine, Jan Kochanowski University in Kielce, al. IX Wieków Kielc 19a, 25-516 Kielce, Poland https://orcid.org/0009-0005-5646-8109
  • Katarzyna Więckowska Individual Medical Practice Katarzyna Więckowska, ul. Deszczowa 18, 40‑318 Katowice, Poland https://orcid.org/0009-0002-4233-1927

DOI:

https://doi.org/10.12775/QS.2026.51.68396

Keywords

cardio-oncology rehabilitation, cancer survivorship, cardiotoxicity, exercise training, cardiovascular risk, cardiac rehabilitation

Abstract

Background: Improved cancer survival has increased the number of survivors at risk of cardiovascular disease due to therapy-related cardiotoxicity. Pharmacological treatment alone often fails to address cardiovascular and functional impairments. Cardio-oncology rehabilitation (CORE) combines structured exercise with comprehensive cardiovascular risk management.

Aim: To summarize current evidence on the role of CORE in cardiovascular risk reduction and functional recovery in cancer survivors exposed to cardiotoxic therapies.

Materials and methods: A narrative review of PubMed, Scopus, and Google Scholar was performed, including randomized trials, observational studies, systematic reviews, meta-analyses, guidelines, and consensus documents focusing on adult cancer survivors.

Results: Cancer survivors frequently exhibit elevated cardiovascular risk and reduced cardiorespiratory fitness. Exercise-based CORE programs consistently improve fitness, functional capacity, fatigue, and quality of life, with emerging benefits for cardiometabolic risk factors and vascular function. Evidence for reduced major cardiovascular events remains limited, although higher physical activity is associated with improved survival. Digital and hybrid CORE models appear feasible.

Conclusions: CORE represents an effective strategy to enhance cardiovascular health and functional recovery in cancer survivors, though large trials are needed to confirm long-term outcomes.

References

1. Yeh, E. T., & Bickford, C. L. (2009). Cardiovascular complications of cancer therapy: incidence, pathogenesis, diagnosis, and management. Journal of the American College of Cardiology, 53(24), 2231–2247. https://doi.org/10.1016/j.jacc.2009.02.050

2. Armenian, S. H., Xu, L., Ky, B., Sun, C., Farol, L. T., Pal, S. K., Douglas, P. S., Bhatia, S., & Chao, C. (2016). Cardiovascular Disease Among Survivors of Adult-Onset Cancer: A Community-Based Retrospective Cohort Study. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 34(10), 1122–1130. https://doi.org/10.1200/JCO.2015.64.0409

3. Curigliano, G., Cardinale, D., Suter, T., Plataniotis, G., de Azambuja, E., Sandri, M. T., Criscitiello, C., Goldhirsch, A., Cipolla, C., Roila, F., & ESMO Guidelines Working Group (2012). Cardiovascular toxicity induced by chemotherapy, targeted agents and radiotherapy: ESMO Clinical Practice Guidelines. Annals of oncology : official journal of the European Society for Medical Oncology, 23 Suppl 7, vii155–vii166. https://doi.org/10.1093/annonc/mds293

4. Zamorano, J. L., Lancellotti, P., Rodriguez Muñoz, D., Aboyans, V., Asteggiano, R., Galderisi, M., Habib, G., Lenihan, D. J., Lip, G. Y. H., Lyon, A. R., Lopez Fernandez, T., Mohty, D., Piepoli, M. F., Tamargo, J., Torbicki, A., Suter, T. M., & ESC Scientific Document Group (2016). 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). European heart journal, 37(36), 2768–2801. https://doi.org/10.1093/eurheartj/ehw211

5. Carver, J. R., Shapiro, C. L., Ng, A., Jacobs, L., Schwartz, C., Virgo, K. S., Hagerty, K. L., Somerfield, M. R., Vaughn, D. J., & ASCO Cancer Survivorship Expert Panel (2007). American Society of Clinical Oncology clinical evidence review on the ongoing care of adult cancer survivors: cardiac and pulmonary late effects. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 25(25), 3991–4008. https://doi.org/10.1200/JCO.2007.10.9777

6. Hooning, M. J., Botma, A., Aleman, B. M., Baaijens, M. H., Bartelink, H., Klijn, J. G., Taylor, C. W., & van Leeuwen, F. E. (2007). Long-term risk of cardiovascular disease in 10-year survivors of breast cancer. Journal of the National Cancer Institute, 99(5), 365–375. https://doi.org/10.1093/jnci/djk064

7. Mulrooney, D. A., Yeazel, M. W., Kawashima, T., Mertens, A. C., Mitby, P., Stovall, M., Donaldson, S. S., Green, D. M., Sklar, C. A., Robison, L. L., & Leisenring, W. M. (2009). Cardiac outcomes in a cohort of adult survivors of childhood and adolescent cancer: retrospective analysis of the Childhood Cancer Survivor Study cohort. BMJ (Clinical research ed.), 339, b4606. https://doi.org/10.1136/bmj.b4606

8. Mulrooney, D. A., Yeazel, M. W., Kawashima, T., Mertens, A. C., Mitby, P., Stovall, M., Donaldson, S. S., Green, D. M., Sklar, C. A., Robison, L. L., & Leisenring, W. M. (2009). Cardiac outcomes in a cohort of adult survivors of childhood and adolescent cancer: retrospective analysis of the Childhood Cancer Survivor Study cohort. BMJ (Clinical research ed.), 339, b4606. https://doi.org/10.1136/bmj.b4606

9. Scott, J. M., Zabor, E. C., Schwitzer, E., Koelwyn, G. J., Adams, S. C., Nilsen, T. S., Moskowitz, C. S., Matsoukas, K., Iyengar, N. M., Dang, C. T., & Jones, L. W. (2018). Efficacy of Exercise Therapy on Cardiorespiratory Fitness in Patients With Cancer: A Systematic Review and Meta-Analysis. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 36(22), 2297–2305. https://doi.org/10.1200/JCO.2017.77.5809

10. Jones, L. W., Eves, N. D., Haykowsky, M., Joy, A. A., & Douglas, P. S. (2008). Cardiorespiratory exercise testing in clinical oncology research: systematic review and practice recommendations. The Lancet. Oncology, 9(8), 757–765. https://doi.org/10.1016/S1470-2045(08)70195-5

11. Peel, A. B., Thomas, S. M., Dittus, K., Jones, L. W., & Lakoski, S. G. (2014). Cardiorespiratory fitness in breast cancer patients: a call for normative values. Journal of the American Heart Association, 3(1), e000432. https://doi.org/10.1161/JAHA.113.000432

12. Anderson, L., Oldridge, N., Thompson, D. R., Zwisler, A. D., Rees, K., Martin, N., & Taylor, R. S. (2016). Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease: Cochrane Systematic Review and Meta-Analysis. Journal of the American College of Cardiology, 67(1), 1–12. https://doi.org/10.1016/j.jacc.2015.10.044

13. Balady, G. J., Williams, M. A., Ades, P. A., Bittner, V., Comoss, P., Foody, J. M., Franklin, B., Sanderson, B., Southard, D., American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology, American Heart Association Council on Cardiovascular Nursing, American Heart Association Council on Epidemiology and Prevention, American Heart Association Council on Nutrition, Physical Activity, and Metabolism, & American Association of Cardiovascular and Pulmonary Rehabilitation (2007). Core components of cardiac rehabilitation/secondary prevention programs: 2007 update: a scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Prevention, and Nutrition, Physical Activity, and Metabolism; and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation, 115(20), 2675–2682. https://doi.org/10.1161/CIRCULATIONAHA.106.180945

14. Lavie, C. J., & Milani, R. V. (2011). Cardiac rehabilitation and exercise training in secondary coronary heart disease prevention. Progress in cardiovascular diseases, 53(6), 397–403. https://doi.org/10.1016/j.pcad.2011.02.008

15. Gilchrist, S. C., Barac, A., Ades, P. A., Alfano, C. M., Franklin, B. A., Jones, L. W., La Gerche, A., Ligibel, J. A., Lopez, G., Madan, K., Oeffinger, K. C., Salamone, J., Scott, J. M., Squires, R. W., Thomas, R. J., Treat-Jacobson, D. J., Wright, J. S., & American Heart Association Exercise, Cardiac Rehabilitation, and Secondary Prevention Committee of the Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; and Council on Peripheral Vascular Disease (2019). Cardio-Oncology Rehabilitation to Manage Cardiovascular Outcomes in Cancer Patients and Survivors: A Scientific Statement From the American Heart Association. Circulation, 139(21), e997–e1012. https://doi.org/10.1161/CIR.0000000000000679

16. Kirkham, A. A., Shave, R. E., Bland, K. A., Bovard, J. M., Eves, N. D., Gelmon, K. A., McKenzie, D. C., Virani, S. A., Stöhr, E. J., Warburton, D. E. R., & Campbell, K. L. (2017). Protective effects of acute exercise prior to doxorubicin on cardiac function of breast cancer patients: A proof-of-concept RCT. International journal of cardiology, 245, 263–270. https://doi.org/10.1016/j.ijcard.2017.07.037

17. Adams, S. C., Rivera-Theurel, F., Scott, J. M., Nadler, M. B., Foulkes, S., Leong, D., Nilsen, T., Porter, C., Haykowsky, M., Abdel-Qadir, H., Hull, S. C., Iyengar, N. M., Dieli-Conwright, C. M., Dent, S. F., & Howden, E. J. (2025). Cardio-oncology rehabilitation and exercise: evidence, priorities, and research standards from the ICOS-CORE working group. European heart journal, 46(29), 2847–2865. https://doi.org/10.1093/eurheartj/ehaf100

18. Naaktgeboren, W. R., Stuiver, M. M., van Harten, W. H., Aaronson, N. K., Scott, J. M., Sonke, G., van der Wall, E., Velthuis, M., Leiner, T., Teske, A. J., May, A. M., & Groen, W. G. (2023). Effects of exercise during chemotherapy for breast cancer on long-term cardiovascular toxicity. Open heart, 10(2), e002464. https://doi.org/10.1136/openhrt-2023-002464

19. Schmitz, K. H., Courneya, K. S., Matthews, C., Demark-Wahnefried, W., Galvão, D. A., Pinto, B. M., Irwin, M. L., Wolin, K. Y., Segal, R. J., Lucia, A., Schneider, C. M., von Gruenigen, V. E., Schwartz, A. L., & American College of Sports Medicine (2010). American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Medicine and science in sports and exercise, 42(7), 1409–1426. https://doi.org/10.1249/MSS.0b013e3181e0c112

20. Campbell, K. L., Winters-Stone, K. M., Wiskemann, J., May, A. M., Schwartz, A. L., Courneya, K. S., Zucker, D. S., Matthews, C. E., Ligibel, J. A., Gerber, L. H., Morris, G. S., Patel, A. V., Hue, T. F., Perna, F. M., & Schmitz, K. H. (2019). Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Medicine and science in sports and exercise, 51(11), 2375–2390. https://doi.org/10.1249/MSS.0000000000002116

21. Fong, D. Y., Ho, J. W., Hui, B. P., Lee, A. M., Macfarlane, D. J., Leung, S. S., Cerin, E., Chan, W. Y., Leung, I. P., Lam, S. H., Taylor, A. J., & Cheng, K. K. (2012). Physical activity for cancer survivors: meta-analysis of randomised controlled trials. BMJ (Clinical research ed.), 344, e70. https://doi.org/10.1136/bmj.e70

22. Holmes, M. D., Chen, W. Y., Feskanich, D., Kroenke, C. H., & Colditz, G. A. (2005). Physical activity and survival after breast cancer diagnosis. JAMA, 293(20), 2479–2486. https://doi.org/10.1001/jama.293.20.2479

23. Meyerhardt, J. A., Giovannucci, E. L., Holmes, M. D., Chan, A. T., Chan, J. A., Colditz, G. A., & Fuchs, C. S. (2006). Physical activity and survival after colorectal cancer diagnosis. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 24(22), 3527–3534. https://doi.org/10.1200/JCO.2006.06.0855

24. Jones, L. W., Habel, L. A., Weltzien, E., Castillo, A., Gupta, D., Kroenke, C. H., Kwan, M. L., Quesenberry, C. P., Jr, Scott, J., Sternfeld, B., Yu, A., Kushi, L. H., & Caan, B. J. (2016). Exercise and Risk of Cardiovascular Events in Women With Nonmetastatic Breast Cancer. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 34(23), 2743–2749. https://doi.org/10.1200/JCO.2015.65.6603

25. Cornette, T., Vincent, F., Mandigout, S., Antonini, M. T., Leobon, S., Labrunie, A., Venat, L., Lavau-Denes, S., & Tubiana-Mathieu, N. (2016). Effects of home-based exercise training on VO2 in breast cancer patients under adjuvant or neoadjuvant chemotherapy (SAPA): a randomized controlled trial. European journal of physical and rehabilitation medicine, 52(2), 223–232.

26. Nilsen, T. S., Scott, J. M., Michalski, M., Capaci, C., Thomas, S., Herndon, J. E., 2nd, Sasso, J., Eves, N. D., & Jones, L. W. (2018). Novel Methods for Reporting of Exercise Dose and Adherence: An Exploratory Analysis. Medicine and science in sports and exercise, 50(6), 1134–1141. https://doi.org/10.1249/MSS.0000000000001545

27. Armenian, S. H., Lacchetti, C., Barac, A., Carver, J., Constine, L. S., Denduluri, N., Dent, S., Douglas, P. S., Durand, J. B., Ewer, M., Fabian, C., Hudson, M., Jessup, M., Jones, L. W., Ky, B., Mayer, E. L., Moslehi, J., Oeffinger, K., Ray, K., Ruddy, K., … Lenihan, D. (2017). Prevention and Monitoring of Cardiac Dysfunction in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 35(8), 893–911. https://doi.org/10.1200/JCO.2016.70.5400

28. Gregory, M. E., Cao, W., Rahurkar, S., Haroun, F., Stock, J. C., Ghazi, S. M., & Addison, D. (2024). Effectiveness of mobile health for exercise promotion on cardiorespiratory fitness after a cancer diagnosis: A systematic review and meta-analysis. Cancer medicine, 13(17), e7079. https://doi.org/10.1002/cam4.7079

29. Garcia, D. O., & Thomson, C. A. (2014). Physical activity and cancer survivorship. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 29(6), 768–779. https://doi.org/10.1177/0884533614551969

30. Ballard-Barbash, R., Friedenreich, C. M., Courneya, K. S., Siddiqi, S. M., McTiernan, A., & Alfano, C. M. (2012). Physical activity, biomarkers, and disease outcomes in cancer survivors: a systematic review. Journal of the National Cancer Institute, 104(11), 815–840. https://doi.org/10.1093/jnci/djs207

31. Kodama, S., Saito, K., Tanaka, S., Maki, M., Yachi, Y., Asumi, M., Sugawara, A., Totsuka, K., Shimano, H., Ohashi, Y., Yamada, N., & Sone, H. (2009). Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA, 301(19), 2024–2035. https://doi.org/10.1001/jama.2009.681

32. Hayes, S. C., Newton, R. U., Spence, R. R., & Galvão, D. A. (2019). The Exercise and Sports Science Australia position statement: Exercise medicine in cancer management. Journal of science and medicine in sport, 22(11), 1175–1199. https://doi.org/10.1016/j.jsams.2019.05.003

33. Brown, J. C., Huedo-Medina, T. B., Pescatello, L. S., Pescatello, S. M., Ferrer, R. A., & Johnson, B. T. (2011). Efficacy of exercise interventions in modulating cancer-related fatigue among adult cancer survivors: a meta-analysis. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 20(1), 123–133. https://doi.org/10.1158/1055-9965.EPI-10-0988

34. Pekmezi, D. W., & Demark-Wahnefried, W. (2011). Updated evidence in support of diet and exercise interventions in cancer survivors. Acta oncologica (Stockholm, Sweden), 50(2), 167–178. https://doi.org/10.3109/0284186X.2010.529822

35. van Cappellen-van Maldegem, S. J. M., Mols, F., Horevoorts, N., de Kruif, A., Buffart, L. M., Schoormans, D., Trompetter, H., Beijer, S., Ezendam, N. P. M., de Boer, M., Winkels, R., Kampman, E., Schuit, J., van de Poll-Franse, L., Seidell, J. C., Hoedjes, M., & OPTIMUM research team (2021). Towards OPtimal TIming and Method for promoting sUstained adherence to lifestyle and body weight recommendations in postMenopausal breast cancer survivors (the OPTIMUM-study): protocol for a longitudinal mixed-method study. BMC women's health, 21(1), 268. https://doi.org/10.1186/s12905-021-01406-1

Quality in Sport

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2026-02-12

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MICHNOWSKA, Wiktoria, PUSTUŁA, Paweł, SZPLIT, Ewa, HEBDA, Patryk, BŁASZKOWSKI, Bartłomiej, CEMAGA , Roman, KRÓL , Maria, WOLSKI, Adam, KUBICKI , Mateusz and WIĘCKOWSKA , Katarzyna. Cardio-Oncology Rehabilitation: Strategies for Cardiovascular Risk Reduction and Recovery in Cancer Survivors. Quality in Sport. Online. 12 February 2026. Vol. 51, p. 68396. [Accessed 12 February 2026]. DOI 10.12775/QS.2026.51.68396.
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Vol. 51 (2026)

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Copyright (c) 2026 Wiktoria Michnowska, Paweł Pustuła, Ewa Szplit, Patryk Hebda, Bartłomiej Błaszkowski, Roman Cemaga , Maria Król , Adam Wolski, Mateusz Kubicki , Katarzyna Więckowska

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