Hormonal Therapy for Cancer

Hormonal therapy, also called endocrine therapy, treats cancers that grow in response to a hormone. It is used most often for hormone-receptor-positive breast cancer and for prostate cancer, and in selected uterine and ovarian cancers. At HealOnco we run hormonal therapy as a core daycare stream, short, predictable visits, honest counselling, and side-effect management between cycles. Call +91-93060-00000 or book a visit below.

What is hormonal therapy

A hormone-sensitive cancer cell has a docking port called a hormone receptor on its surface. When the matching hormone arrives and locks in, it tells the cell to grow and divide. Hormonal therapy either takes the hormone away or blocks the receptor so the cell loses its growth signal. It is not chemotherapy. It does not kill cells in waves. It works in the background, every day, for months or years. That is why most of it is taken as a tablet at home or as an injection once a month.

The trade-off is that hormonal therapy is gentler than chemotherapy in the short term but it has its own set of side effects, mostly tied to having less of a hormone your body has been used to. People often stay on it for five years, ten years, or for life depending on the cancer and the stage.

The hormones and the cancers they feed

Oestrogen and progesterone in breast cancer

Around two out of three breast cancers in adult women carry oestrogen receptors (ER positive), and many also carry progesterone receptors (PR positive). These tumours need oestrogen to grow well. Before menopause oestrogen comes from the ovaries; after menopause the body still makes a small amount by converting other hormones using an enzyme called aromatase. Hormonal therapy for breast cancer either blocks the receptor or shuts down the supply.

Testosterone in prostate cancer

Almost all prostate cancers depend on androgens. About 90 to 95 per cent of testosterone comes from the testes and the rest from the adrenal glands. Hormonal therapy for prostate cancer is called androgen deprivation therapy, or ADT. The goal is to drop testosterone to castration levels so the cancer loses its main fuel.

Oestrogen in uterine and some ovarian cancers

Type 1 endometrial cancers, the most common kind of uterine cancer, often grow in response to oestrogen. Some low-grade serous and granulosa cell ovarian cancers also respond. Hormonal therapy is not first-line for these but it has a real role when surgery is not possible, in low-grade disease, or when chemotherapy has stopped working.

The main classes of drugs we use

For breast cancer

SERMs (Selective oestrogen receptor modulators). These sit in the oestrogen receptor and block oestrogen from getting in. Tamoxifen has been used since the 1970s and works in both premenopausal and postmenopausal women. Toremifene is a related drug. SERMs block oestrogen in breast tissue while acting like a weak oestrogen in bone, which is why tamoxifen actually protects bone density in postmenopausal women.

Aromatase inhibitors (AIs). Anastrozole, letrozole, and exemestane block the aromatase enzyme so the body cannot make oestrogen from its other building blocks. AIs only work in postmenopausal women. They are often a little more effective than tamoxifen after menopause but cause more joint pain and bone thinning.

SERDs (Selective oestrogen receptor degraders). Fulvestrant is given as a monthly intramuscular injection and breaks the receptor down rather than just blocking it. Newer oral SERDs like elacestrant are used after AIs stop working in tumours with ESR1 mutations.

Ovarian suppression. In premenopausal women, GnRH agonists like goserelin or leuprolide shut the ovaries down. Some patients have the ovaries removed surgically. Combining ovarian suppression with an AI is now standard for higher-risk premenopausal women.

For prostate cancer

LHRH agonists, leuprolide, goserelin, triptorelin, given as injections every 1, 3, or 6 months. The first dose causes a brief testosterone surge so an anti-androgen tablet is added for 2 to 4 weeks to prevent flare. LHRH antagonists like degarelix and oral relugolix shut down testosterone faster without a flare. First-generation anti-androgens bicalutamide, flutamide, and nilutamide block the androgen receptor and are paired with an LHRH drug.

Androgen receptor pathway inhibitors (ARPIs), enzalutamide, apalutamide, darolutamide, block the androgen receptor much more strongly than older drugs. Abiraterone blocks the CYP17A1 enzyme and stops the body and the tumour itself from making any androgens; it is given with low-dose prednisolone. These drugs have changed metastatic prostate cancer survival significantly. Surgical castration (bilateral orchidectomy) is a one-time operation that drops testosterone to castration levels within hours and is still common in India for men who cannot afford long courses of LHRH injections.

For uterine and other cancers

Progestins like medroxyprogesterone acetate and megestrol acetate are used in low-grade endometrial cancer, including in selected early-stage cases for fertility preservation. Tamoxifen and AIs are used in low-grade serous ovarian cancer and some uterine sarcomas.

How treatment is delivered at HealOnco

Tamoxifen, the AIs, the ARPIs, abiraterone, bicalutamide, and relugolix are all daily tablets taken at home at roughly the same time each day. Injections, LHRH agonists, antagonists, fulvestrant, goserelin implants, are given in our daycare unit by a trained nurse, taking about ten minutes per visit. A typical adjuvant breast cancer schedule is tamoxifen daily for 5 years, with a discussion about extending to 10 for higher-risk cases. A typical advanced prostate schedule is an LHRH agonist injection every 3 months indefinitely plus a daily ARPI, started together, with PSA every 3 months.

Hormonal therapy fits the daycare model perfectly. You do not need infusion chairs or chemo-grade compounding. You need a quiet room, a nurse trained in injection technique, a reliable pharmacy, and a doctor who can manage side effects between visits. Most HealOnco endocrine therapy visits are short, predictable, and friendly.

Why neoadjuvant or adjuvant hormonal therapy

Hormonal therapy is most often given after surgery (adjuvant) to mop up microscopic disease and reduce the chance of recurrence over the following decade. Five years of adjuvant tamoxifen reduces recurrence by roughly a third to a half in hormone-positive breast cancer. In prostate cancer, adding ADT to radiation improves cure rates significantly for intermediate and high-risk disease. Neoadjuvant hormonal therapy, given before surgery to shrink the tumour, is used in selected postmenopausal breast cancer patients and in men with locally advanced prostate cancer before radiation.

A day at HealOnco for hormonal therapy

You arrive at the daycare unit. Reception checks your file and walks you through to the consult room. The doctor reviews your last bloods, asks about side effects, looks at your weight, your blood pressure, your bone-protection tablets. If you need an injection, the nurse takes you to a quiet bay, gives the injection, and you wait ten minutes. You collect any tablets from the pharmacy on the way out. Most visits take under an hour. Bloods are done on the same day or the day before. Results come to you and to the doctor by SMS.

How well does hormonal therapy work

Honest answer: it depends on the cancer, the stage, and the drug. In early hormone-positive breast cancer, five years of tamoxifen reduces the chance of the cancer coming back over the following decade by roughly a third to a half compared with no hormone therapy, in the Early Breast Cancer Trialists’ Collaborative Group meta-analyses. AIs in postmenopausal women add a small further benefit. In metastatic ER-positive HER2-negative breast cancer, an AI plus a CDK4/6 inhibitor like palbociclib, ribociclib, or abemaciclib is now first line and can keep disease quiet for years.

In localised prostate cancer combined with radiation, adding ADT improves cure rates for intermediate and high-risk disease. NCCN and ESMO recommend short-course ADT (4 to 6 months) for unfavourable intermediate risk and long-course ADT (18 to 36 months) for high-risk disease combined with radiation. In metastatic prostate cancer, combining an LHRH agonist with an ARPI or abiraterone improves overall survival significantly versus LHRH alone, supported by LATITUDE, STAMPEDE, ENZAMET, ARCHES, ARASENS, and TITAN.

Side effects in plain language

For women on breast cancer hormonal therapy. Hot flashes, night sweats, joint and muscle pain (worse with AIs, knees, hands, hips), vaginal dryness, reduced libido, mood changes, bone density loss. Tamoxifen has a small risk of blood clots and a small risk of uterine lining thickening. Weight gain is common but is more about the menopause shift than the drug. Most women find side effects ease over the first six months but do not disappear entirely.

For men on prostate cancer hormonal therapy. Hot flashes, loss of libido, erectile dysfunction, loss of muscle mass, weight gain around the abdomen, breast tissue tenderness (more with bicalutamide), mood changes, bone thinning, anaemia, and a higher risk of cardiovascular events particularly in men with existing heart disease. Hot flashes often improve with time. Sexual side effects usually do not.

Drug-specific. Abiraterone can raise blood pressure, lower potassium, and stress the liver, monthly bloods for 3 months then every 3 months. Enzalutamide can cause fatigue and a small seizure risk. Apalutamide can cause skin rash and an under-active thyroid. Darolutamide has the cleanest neurological profile of the three.

Bone health is non-negotiable. Anyone on long-term hormonal therapy should have a baseline DEXA scan, calcium and vitamin D supplementation, weight-bearing exercise, and often a bisphosphonate (zoledronic acid every 6 months) or denosumab to protect bones.

Is hormonal therapy a good option for you

Hormonal therapy is right for you if your tumour is hormone-receptor-positive on testing. For breast cancer that means an ER and PR test on the biopsy or surgery sample. ER-positive is generally defined as 1 per cent or more of cells staining positive. For prostate cancer almost all tumours are androgen-driven at diagnosis, so testing is not needed before starting ADT. For uterine cancer it is offered mostly for low-grade type 1 tumours.

It is not right for you if your tumour does not carry the receptor. Triple-negative breast cancer does not respond at all and starting it would just delay treatment that might actually work. It also needs careful thought if you have a history of blood clots (tamoxifen), severe osteoporosis (AIs), severe heart disease (ADT), uncontrolled mood disorders, or pregnancy plans in the immediate future.

Benefits of modern endocrine therapy versus older approaches

The newer ARPIs (enzalutamide, apalutamide, darolutamide) block the androgen receptor much more strongly than first-generation drugs like bicalutamide, and combined with LHRH they have improved metastatic prostate cancer survival significantly over the last decade. Abiraterone going generic in India dropped advanced prostate cancer therapy cost by an order of magnitude. In breast cancer, AIs plus CDK4/6 inhibitors have changed first-line metastatic treatment from a chemotherapy decision to an endocrine decision for most postmenopausal women. Oral SERDs are opening a new line of endocrine therapy for ESR1-mutated tumours that escape AIs.

Cost of hormonal therapy in India

Hormonal therapy is one of the most affordable cancer treatments in India because most older molecules are off-patent and made by Indian generic manufacturers. Approximate monthly costs in 2026 for generic Indian-made drugs:

Drug	Indication	Approx ₹/month
Tamoxifen	Breast cancer	₹150 to ₹500
Anastrozole	Breast (postmenopausal)	₹400 to ₹1,200
Letrozole	Breast (postmenopausal)	₹400 to ₹1,200
Exemestane	Breast (postmenopausal)	₹800 to ₹1,800
Fulvestrant injection	Metastatic breast	₹6,000 to ₹15,000
Goserelin 3.6 mg monthly	Premenopausal breast / prostate	₹6,000 to ₹10,000
Goserelin 10.8 mg 3-monthly	Premenopausal breast / prostate	₹15,000 to ₹22,000
Leuprolide 11.25 mg 3-monthly	Prostate	₹10,000 to ₹18,000
Bicalutamide 50 mg	Prostate	₹300 to ₹900
Abiraterone 1000 mg (generic)	Advanced prostate	₹4,000 to ₹12,000
Enzalutamide 160 mg	Advanced prostate	₹15,000 to ₹40,000
Apalutamide 240 mg	Advanced prostate	₹15,000 to ₹40,000
Darolutamide 1200 mg	Advanced prostate	₹25,000 to ₹50,000
Surgical orchidectomy	Prostate (one-time)	₹15,000 to ₹40,000

Brand-name versions can cost two to ten times more. Insurance for outpatient oral cancer drugs in India is improving but uneven. Ayushman Bharat covers many of these molecules in empanelled hospitals. At HealOnco we walk you through a written estimate based on your stage, your specific drug, and your duration before treatment starts.

Our doctors

HealOnco’s medical oncology team manages hormonal therapy across breast, prostate, uterine, and selected ovarian cancers. Our consultants hold DM Medical Oncology qualifications and run dedicated endocrine therapy clinics. Meet our oncology team

Our centers

HealOnco Chandigarh is our flagship daycare oncology centre, with dedicated injection bays, on-site pharmacy stocking generic and brand endocrine drugs, in-house DEXA referral, and a nurse-led side-effect helpline. View our centres

What our patients say

“I have been on letrozole for two years now. The joint pain was the hardest part in the first six months. The HealOnco team adjusted my vitamin D and got me into a walking routine and it has been manageable since.” Mrs S., Chandigarh, breast cancer survivor

“My father started ADT plus enzalutamide last year for prostate cancer. The PSA dropped from 84 to under 1 in four months. He is tired some days but he goes for his walks.” R.K., Mohali

Video testimonials

Coming soon, patient video stories of life on long-term endocrine therapy.

Frequently asked questions

Is hormonal therapy chemotherapy?

No. It is a different class of drug. It does not work by killing fast-dividing cells. It works by removing or blocking a hormone the cancer needs to grow. Side effects look very different and are usually milder in the short term, but you stay on it for much longer.

Will I lose my hair on tamoxifen or an AI?

Most women do not lose their hair. Some notice it feels thinner. Full hair loss is uncommon and usually means something else is going on.

How long will I be on the tablets?

For early breast cancer, five years is standard, with a discussion about extending to ten for higher-risk patients. For metastatic disease, indefinitely as long as it is working. For prostate cancer, the duration depends on stage, 4 to 6 months for localised intermediate risk, 18 to 36 months for high risk, indefinitely for metastatic disease.

Can I get pregnant on tamoxifen?

You should not. Tamoxifen can harm a developing baby. Use reliable non-hormonal contraception throughout treatment and for several months after stopping. If you want children later, talk to your oncologist about pausing therapy after a couple of years.

Is the joint pain on AIs going to last forever?

Most women find it eases after the first six to twelve months. Some find it improves with switching to a different AI, with regular exercise, with vitamin D correction, or with low-dose duloxetine. A small group cannot tolerate AIs and switch back to tamoxifen.

My husband is starting ADT for prostate cancer. Will his personality change?

Some men feel more emotional, lower in mood, or slowed down. Most adjust within a few months. Honest conversation with the oncologist matters.

Will hormonal therapy cure my cancer?

For early-stage hormone-positive cancers, hormonal therapy added to surgery, and possibly chemotherapy and radiation, gives many patients a long-term cure. For advanced metastatic disease, it usually controls the cancer for years rather than curing it.

Can I drink alcohol on tamoxifen or AIs?

A small amount is generally considered acceptable, but alcohol is itself a risk factor for breast cancer recurrence. Many oncologists suggest cutting back to occasional and small.

Do I need to come to hospital every day?

No. The tablets are taken at home. Injections are given once a month or every three months at the daycare unit, taking about ten minutes per visit. It is one of the most outpatient-friendly cancer treatments there is.

What if I forget a dose?

Take it as soon as you remember on the same day. If it is already the next day, take that day’s dose and skip the missed one. Do not double up.

Why do I need a bone density scan?

Both AIs in women and ADT in men cause bone thinning over time. A baseline DEXA scan tells your doctor where you are starting from so they can decide whether you need bone-protecting medication.

Does HealOnco do hormonal therapy at the daycare unit?

Yes. HealOnco runs hormonal therapy as one of our core treatment streams. We handle injections, bloodwork, bone health monitoring, and side-effect management in a single visit each month.

Will I gain weight?

Many people do, particularly in the first year. Most of it is the hormone shift rather than the drug directly. Steady walking, strength training, and a protein-forward diet help.

Will hormonal therapy interact with my other medications?

Sometimes. Tamoxifen interacts with strong CYP2D6 inhibitors like paroxetine and fluoxetine, which can reduce its effectiveness. Abiraterone interacts with several blood pressure and diabetes drugs. Always show your oncologist a complete list of everything you take, including over-the-counter painkillers and herbal supplements.

Medically reviewed by

Reviewed by the HealOnco Medical Oncology Editorial Board on 2026-04-08. View reviewer profile

Hormonal therapy in top cities

• Hormonal therapy in Delhi
• Hormonal therapy in Gurgaon
• Hormonal therapy in Noida
• Hormonal therapy in Faridabad
• Hormonal therapy in Ghaziabad
• Hormonal therapy in Mumbai
• Hormonal therapy in Bengaluru
• Hormonal therapy in Hyderabad
• Hormonal therapy in Chennai
• Hormonal therapy in Kolkata
• Hormonal therapy in Pune

Hormonal therapy cost in top cities

• Cost in Delhi
• Cost in Gurgaon
• Cost in Noida
• Cost in Faridabad
• Cost in Ghaziabad
• Cost in Mumbai
• Cost in Bengaluru
• Cost in Hyderabad
• Cost in Chennai
• Cost in Kolkata
• Cost in Pune

Related treatments

• Chemotherapy
• Immunotherapy
• Targeted therapy

Supportive care

• Pain management
• Nutrition
• Counseling
• Physiotherapy
• Second opinion
• Palliative care

References

1. National Cancer Institute (cancer.gov), patient summaries on hormone therapy for breast cancer and on SERMs, AIs, and SERDs.
2. National Cancer Institute (cancer.gov), patient summaries on hormone therapy for prostate cancer (LHRH agonists, antagonists, anti-androgens, ARPIs).
3. National Cancer Institute (cancer.gov) and ESMO patient guide, endometrial / uterine cancer hormone therapy.
4. NCCN Clinical Practice Guidelines summaries, Breast Cancer, Prostate Cancer, Uterine Neoplasms.
5. Early Breast Cancer Trialists’ Collaborative Group meta-analyses, Lancet Oncology series on adjuvant tamoxifen and AI outcomes.
6. STAMPEDE, LATITUDE, ENZAMET, ARCHES, TITAN, ARASENS, practice-changing prostate cancer combination trials.
7. Globocan 2022 India country profile, IARC (gco.iarc.fr), incidence framing for breast and prostate cancer in India.
8. ICMR National Cancer Registry Programme, Indian incidence and stage-at-diagnosis data.
9. a tertiary cancer centre (a tertiary cancer centre.gov.in), clinical practice statements on adjuvant breast hormonal therapy and prostate ADT.
10. a tertiary cancer centre New Delhi (a tertiary cancer centre.edu), patient handouts on hormone therapy and side-effect management.
11. WHO cancer fact sheets (who.int).

Medical disclaimer

This page is for general patient education and does not replace a consultation with a qualified oncologist. Treatment decisions must be made on an individual basis after review of your pathology, staging, comorbidities, and goals. Reviewed by the HealOnco Medical Oncology Editorial Board on 2026-04-08.