An exercise evaluation or test is important for people with cancer. Exercise tests assess the safety of exercise for a person with cancer and enable the design of an individualized exercise prescription. The individualized exercise prescription describes the level of exercise that is safe and effective for the person with cancer. Exercise evaluations for people with cancer are typically submaximal tests. These submaximal exercise evaluations can be simple field tests, clinical tests, or more formal graded exercise tests. (For an excellent review on methods for administering the various submaximal tests, see Noonan & Dean, 2000).

Field tests, which are simple to perform and require only limited equipment or training, provide information on a subject's fitness category. Typical field tests are the 6- and 12-minute walk tests, the Cooper 1.5-Mile Walk Test, the Rockport Fitness Test, and the 12-minute run test. Clinical exercise tests provide additional information on coordination, balance, and motor planning. Examples of clinical exercise tests include the Timed Up and Go Test, the Modified Shuttle Walk, and the Bag and Carry Test. The formal exercise tests provide good predictive information on a person's maximal oxygen consumption and level of fitness.

Formal exercise tests appropriate for persons with cancer include the Modified Bruce Treadmill Test, The Astrand-Rhyming Cycle Ergometer Test, and The Single Stage Submaximal Walking Test. Formal exercise evaluations that are combined with electrocardiographic (ECG) analysis are the most valid and reliable measure of fitness, cardiovascular function, and safety for performing aerobic exercise. These formal tests should be used for people with a complex health status, or when there is a need to assess potential risk factors associated with performing exercise. Formal testing with a 12-lead ECG monitoring of cardiac responses is recommended by the ACSM (2000) when people have any of the following:

• Known cardiac, pulmonary, or metabolic disease
• Two or more risk factors for cardiac dysfunction such as elevated cholesterol levels, smoking, hypertension, or diabetes mellitus
• One or more signs or symptoms of cardiac disease such as dizziness, chest pain, or irregular heart rates or rhythms, or shortness of breath
• Chemotherapy medications which are toxic to the heart or lung such as doxorubicin hydrochloride (Adriamycin), or bleomycin sulfate (Blenoxane).
• Radiation treatments that may have caused pulmonary fibrosis, pneumonitis, or pericarditis

Re-evaluations should be performed at a 6- or a 12-week interval, depending on the subject's progress or frailty. Thereafter, exercise evaluations can be performed on an annual basis to monitor a person's health and fitness status, as well as provide them with motivation and encouragement to continue their exercise regimen. Exercise testing should also be performed when clients develop new signs or symptoms associated with abnormal responses to exercise, or a decline in function.