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The combination of aging and cancer places older individuals at risk for profound functional loss, negative treatment sequelae, and reduced survival rates. Although exercise training has potential to improve physical function, alleviate negative treatment effects, and promote healthy survival, few studies have examined this phenomenon in the elderly with cancer. Since 60% of cancer survivors are 65 or older, this is an area of growing concern. This article summarizes current literature on exercise training in older individuals with cancer and provides a framework for safe and effective exercise evaluation and prescription for older adults during treatment or in survivorship.