Androgen-deprivation therapy (ADT) entails lowering serum testosterone levels to castrate levels and forms a cornerstone of the management of hormone-sensitive advanced prostate cancer; however, the benefit of ADT is partially offset by its detrimental metabolic and cardiovascular adverse effects. ADT decreases insulin sensitivity while promoting dyslipidemia and sarcopenic obesity, which leads to an increased risk of cardiovascular morbidity and potentially mortality. The risk seems to be highest in elderly patients who have had recent cardiovascular events before starting ADT. It is prudent to engage in an individualized risk-benefit discussion and develop a cohesive multidisciplinary management plan to medically optimize and closely observe these patients before and during treatment with ADT.Careful history taking and physical examination to diagnose, treat, and optimize active CV disease with guideline-directed therapy before starting androgen-deprivation therapyConsider metformin for diabetes, ACEIs for HTN, aspirin for vascular health, and statins for hyperlipidemia in eligible patientsSmoking cessation, lifestyle modification, exercise, and stress reduction must be emphasized in all patients Awareness to seek immediate medical attention for new or worsening CV symptoms Abbreviations: ACEI, angiotension-converting enzyme inhibitor; CV, cardiovascular; HTN, hypertension.

Background: Radiation therapy (RT)-induced cardiotoxicity is among the concerning sequelae of breast cancer (BCA) treatment, particularly in HER2-positive breast cancer patients who receive anthracyclines and trastuzumab-based therapy. The aim of this study was to assess for early RT-induced changes in echocardiographic and circulating biomarkers of left ventricular (LV) function and evaluate their association with radiation dose to the heart among patients with HER2positive BCA treated with contemporary RT.Methods: A total of 47 women with HER2-positive BCA who were treated with an anthracycline, trastuzumab, and RT to the breast and/or chest wall +/− regional lymph nodes were included in this study. Two-dimensional echocardiography with speckle tracking imaging was performed at baseline (pre-chemotherapy), prior to and after RT (pre-RT and post-RT), and 6