Ness KK, Plana JC, Joshi VM, et al. - Exercise intolerance was assessed among survivors exposed or not to cardiotoxic therapy, and associations were examined among organ system function, exercise intolerance, and mortality. Participants were 1,041 individuals who had survived cancer ≥ 10 years (and had or did not have exposure to anthracyclines and/or chest-directed radiation) and 285 controls. Exercise intolerance is prevalent among childhood cancer survivors and associated with all-cause mortality. Treatment-related cardiac (detected by global longitudinal strain), autonomic, pulmonary, and muscular impairments increased risk. Survivors with impairments may require referral to trained specialists to learn to accommodate specific deficits when engaging in exercise. Researchers observed a lower mean (± SD) peak oxygen uptake among survivors (mean age ± standard deviation [SD], 35.6 ± 8.8 years) than control individuals. They observed exercise intolerance in 63.8% of exposed survivors, 55.7% of unexposed survivors, and 26.3% of control individuals. Exercise intolerance was associated with mortality (hazard ratio, 3.9; 95% CI, 1.09 to 14.14). The increased risk was observed in correlation with treatment-related cardiac (detected by global longitudinal strain), autonomic, pulmonary, and muscular impairments. Referral to trained specialists may be required for survivors with impairments to learn to accommodate specific deficits when engaging in exercise.