Cancer Research Frontiers. 2016 Feb; 2(1): 22-32. doi: 10.17980/2016.22 Review - 22 - Review Pre-habilitation-Promoting Exercise in Adolescent and Young Adult Cancer Survivors for Improving Lifelong Health - A Narrative Review 1 Margaux Barnes; 2 Eric Plaisance; 3 Lynae Hanks; 1 Krista Casazza 1 University of Alabama at Birmingham, Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine. 1601 4 th Ave S, CPP I 310, Birmingham, Alabama, 35233, US. 2 University of Alabama at Birmingham, Department of Human Studies. 901 13th Street South, Birmingham, Alabama, US 3 University of Montevallo, Department of Kinesiology, Station 6385, Bloch 109, Montevallo, Alabama, 32115, US Abstract Given the crucial role of exercise in the enhancement of cancer survivors’ long-term health and wellbeing, the aim of the current paper is to review what is known regarding the physiological mechanisms underlying treatment for cancer in adolescent and young adults (AYAs), summarize the interventions that have been implemented to date to increase AYA survivor exercise, and provide recommendations for specific strategies to promote exercise engagement with consideration of developmental issues relevant to AYA survivors. As musculoskeletal function is among the greatest determinants of morbidity and mortality across the life course, and the strength-structural properties of the musculoskeletal system are largely established in adolescence and young adulthood, perturbations during this time may have profound implications as AYA survivors age. While evidence exists supporting interventions delivered at any time point in the cancer journey, the most effective interventions may be those implemented prior to the onset of late effects or noted declines in key health behaviors. Targeting adolescents is of vital importance as physical activity in AYAs continues to decline with age and onset of chronic conditions. As an endocrine organ, contractions of skeletal muscle via resistance exercise exert indirect effects on overall metabolic pathways via the paracrine and endocrine effects of skeletal muscle and direct effects via muscle hypertrophy. By intervening at an earlier stage of survivorship, prior to the onset of many late effects, and by providing supervised strength training with immediate feedback to survivors, interventions may be associated with increased efficacy in the mitigation of long-term health risks. Keywords: Resistance training; adolescent and young adult cancer survivors; physical activity; comorbidities; lean body mass Introduction While advances in medical treatments have increased survival rates above 80% in adolescent and young adults (AYAs), cancer and its associated treatment increases risk for long-term morbidity and mortality (1). The mortality rate in AYA survivors due to cancer recurrence, secondary cancers, and cardiovascular and lung disease as a result of their original diagnosis and subsequent treatment greatly surpasses rates seen in the general population and survivors of cancer diagnosed later in life (2-4). AYA cancer survivors also report a significantly higher prevalence of adverse physiologic *Corresponding author: Krista Casazza PhD, RDN. University of Alabama at Birmingham, Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine. 1601 4 th Ave S, CPP I 310, Birmingham, Alabama, 35233, US. Email: kcasazza@peds.uab.edu Citation: Margaux Barnes, et al. Pre-habilitation- Promoting Exercise in Adolescent and Young Adult Cancer Survivors for Improving Lifelong Health - A Narrative Review. Cancer Research Frontiers. 2016 Feb; 2(1): 22-32. doi: 10.17980/2016.22 Copyright: @ 2016 Margaux Barnes, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Competing Interests: The authors declare that there are no competing interests. Received Oct 30, 2015; Revised Dec 18, 2015; Accepted Dec 29, 2015. Published Jan 21, 2016