Purpose of review <p>The purpose of this review is to highlight considerations for prescribing exercise as a treatment for fatigue in cancer patients with medical comorbidities. Generic prescriptions may be incomplete and insufficient in patients with disabilities thus eliminating a subset from highly effective, low risk therapeutic modalities. This review aims to provide a clinically relevant summary for helping the physician promote safe exercise and therapy for cancer patients with comorbidities because of their treatment, or otherwise, to maximize benefit and promote sustainability for long term integration.</p> Recent findings <p>Recent findings in this field continue to expand on the role of exercise as paramount to improve cancer related fatigue. Even in patients with multiple medical conditions or concern for frailty, debility, and disability, exercise therapy has been shown to produce many positive physiological and psychological outcomes. This review discusses the role of exercise in cancer related fatigue and how a provider can write a safe and effective exercise prescription. Exercise can be performed safely in all stages of cancer care so long as counseling and prescribing are approached mindfully and practically.</p> Summary <p>Many cancer patients face the added challenge of medical comorbidities that contribute to fatigue. Fatigue can be debilitating to function and quality of life. Exercise is a crucial tool to help manage and treat fatigue, and cancer patients are often not prescribed or explicitly encouraged to meet appropriate exercise guidelines. Exercise, especially with appropriate modifications and considerations, is safe, effective, and helpful in cancer patients, even those undergoing treatment. The astute provider should work with patients on setting goals and drafting an exercise plan to help encourage safety, compliance, and promote support for the patient’s wellbeing and care.</p>