Perspective:

This study provides compelling evidence for the CV benefits of physical activity in cancer survivors, with important implications for clinical care and research. The finding that exercise benefits persist even when started after cancer diagnosis is particularly encouraging, suggesting it is never too late to begin an exercise program. From a practical standpoint, these results support integrating exercise programs into standard survivorship care. Yet implementation will require addressing several challenges, including developing infrastructure for exercise programs, training health care providers in exercise counseling, and overcoming barriers to physical activity that cancer survivors often face during and after treatment. The study's limitation to a Korean population and lack of detailed clinical information about cancer stages and treatments suggests the need for validation in diverse populations with more comprehensive clinical data.

Moving forward, randomized controlled trials should focus on determining optimal exercise timing and types for different cancer populations, while accounting for specific cancer treatments and their potential cardiotoxicity. Understanding the underlying protective mechanisms and developing practical implementation strategies across diverse health care settings will be crucial. The goal should be to translate these findings into personalized, sustainable interventions that can help cancer survivors reduce their CV risk, while recognizing that exercise is likely part of a broader lifestyle approach that includes other health behaviors not captured in this study.