Hormone Therapy
For cancers that need specific hormones to grow, hormone therapy can sometimes stop or slow their growth. Hormone therapy is most often given to treat breast and prostate cancer, but may be used for other cancers as well. Learning about how it works and what to expect can help you prepare for treatment and make informed decisions about your care.
- What is hormone therapy?
- How is hormone therapy used to treat cancer?
- Which cancers can be treated with hormone therapy?
- Is hormone therapy the same as hormone replacement?
- How is hormone therapy different from other cancer treatments?
- Types of hormone therapy
- When is hormone therapy recommended?
- What is it like to get hormone therapy?
- Hormone therapy drug safety
- What are the side effects of hormone therapy?
What is hormone therapy?
Hormone therapy is a type of cancer treatment that works by preventing cancer from getting the hormones it needs to grow. Depending on the type of hormone therapy used, it can:
- Stop the body from making the hormone
- Block the hormone from stimulating the cancer cells
Most hormone therapies are drugs taken as oral medicine or injections. Some types of surgery to remove organs that produce hormones can also be a type of hormone therapy.
Hormone therapy is also called hormonal therapy, anti-hormonal therapy, or endocrine therapy. When used as treatment for prostate cancer, it can also be called androgen deprivation therapy (ADT) or testosterone suppression therapy.
What are hormones?
Hormones are chemicals made by the body that send messages to control how certain types of cells or organs work. For example, sex hormones such as estrogen, testosterone, and progesterone help control sexual development and reproduction. Other hormones include thyroid hormones, cortisol, adrenaline, and insulin.
Different types of hormones help manage:
- Growth and development
- Sexual function
- Reproduction
- Mood and emotions
- Metabolism (how the body turns food into energy)
Major hormone-producing organs or glands include the thyroid, parathyroid glands, adrenal glands, pancreas, ovaries, and testicles. Each one makes specific hormones that affect different parts of the body.
How is hormone therapy used to treat cancer?
Hormone therapy treats cancer by preventing hormone-sensitive cancer cells from getting the hormones they need to grow and divide. This results in slower cancer growth and spread, and in some cases, can shrink the tumor.
The goal of hormone therapy depends on the type of cancer and how far it has spread. Hormone therapy can be used in different ways at different times. It might be used:
- Before surgery and/or radiation therapy, to shrink a tumor (neoadjuvant therapy).
- After cancer treatments, to reduce the risk that cancer will come back (adjuvant therapy).
- For cancer that comes back after treatment (recurrent cancer or recurrence).
- For cancer that has spread to other parts of the body (metastatic cancer).
Hormone therapy may also be used to help prevent or manage cancer side effects. Relieving side effects to help improve a person’s quality of life is an important part of cancer care and treatment. This is called palliative care.
Which cancers can be treated with hormone therapy?
Hormone therapy is mostly used to treat certain kinds of breast cancer and prostate cancer that depend on sex hormones to grow. Other cancers that might be treated with hormone therapy include thyroid, adrenal, endometrial (uterine), and some types of ovarian cancer.
Is hormone therapy the same as hormone replacement?
Hormone therapy for cancer treatment is not the same as menopausal hormone therapy (MHT) or hormone replacement therapy (HRT). These treatments are used to manage the symptoms of menopause.
It is also different from hormonal therapy given after the surgical removal of the thyroid gland (thyroidectomy) to treat thyroid cancer. This is called thyroid hormone therapy. In this case, it is given to replace the natural thyroid hormone that the body needs, but is no longer able to make after the thyroid gland is removed.
Hormone therapy for cancer treatment is also different from hormone therapy used by transgender people (gender-affirming hormone therapy or GAHT). If you are a transgender person with cancer and hormone therapy is a treatment option, please talk to your cancer care team for more information about how the treatment affects your situation.
How is hormone therapy different from other cancer treatments?
Hormone therapy is considered systemic treatment (like chemotherapy and other drug treatments) because the hormones it targets circulate throughout the body. The drugs used in hormone therapy travel throughout the body to find, target, and act on the hormones.
This makes hormone therapy different from local treatments like surgery and radiation therapy, which only affect only a certain part of body.
Even when hormone therapy involves surgery to remove hormone-making organs, it is still considered systemic because it blocks the production of the hormone throughout the entire body.
Types of hormone therapy
There are several different types of hormone therapy. Most are drugs designed to block or lower the amount of certain hormones in the body. Some forms involve surgery to remove hormone-producing organs. Options for hormone therapy depend on the type of cancer you have.
Some breast cancers need the hormones estrogen and/or progesterone to grow. These are called hormone receptor-positive (HR-positive) breast cancers because the cancer cells have receptors on their surface that these hormones bind to.
Blocking the hormones or lowering the amount of estrogen your body makes can help treat metastatic cancer or prevent a recurrence.
Examples of hormone therapy for breast cancer include:
- Aromatase inhibitors (AIs), such as anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara)
- Selective estrogen receptor degraders (SERDs), such as fulvestrant (Falslodex) and elacestrant (Orserdu)
- Selective estrogen receptor modulators (SERMs), such as tamoxifen and toremifene (Fareston)
- Luteinizing hormone-releasing hormone (LHRH) agonists, such as goserelin (Zoladex) and leuprolide (Lupron)
- Surgery to remove the ovaries (oophorectomy)
The growth of prostate cancer is usually driven by hormones called androgens. The most common androgen is testosterone.
Lowering levels of androgen can help slow the growth of prostate cancer. This is called androgen deprivation therapy (ADT).
Examples of hormone therapy for prostate cancer include:
- Anti-androgens, such as bicalutamide (Casodex), flutamide (Eulexin), and nilutamide
- Androgen receptor pathway inhibitors: such as apalutamide (Erleada), enzalutamide (Xtandi), and darolutamide (Nubega)
- CYP17 inhibitors, such as abiraterone (Zytiga) and ketoconazole (Nizoral)
- Luteinizing hormone-releasing hormone (LHRH) agonists such as goserelin (Zoladex), leuprolide (Lupron), and triptorelin (Trelstar)
- Luteinizing hormone-releasing hormone (LHRH) antagonists, such as degarelix (Firmagon) and reglugolix (Orgovyx)
- Surgery to remove the testicles (orchiectomy or surgical castration)
Hormone therapy can slow the growth of certain types of endometrial (uterine) cancer cells that are sensitive to estrogen and progesterone.
Examples of hormone therapy for endometrial cancer include:
- Progestins, such as medroxyprogesterone acetate (Provera) or megestrol acetate (Megace)
- Selective estrogen receptor degraders (SERDs), such as fulvestrant (Faslodex)
- Selective estrogen receptor modulators (SERMs), such as tamoxifen
- Aromatase inhibitors (AIs), such as letrozole (Femara), anastrozole (Arimidex), and exemestane (Aromasin)
An adrenal gland tumor may produce excess hormones such as cortisol, aldosterone, norepinephrine, and epinephrine. Less often, they can make excess sex hormones like testosterone and estrogen. Your doctor may prescribe various medications to control the levels of these hormones before, during, or after other treatments.
Examples of hormone therapy for adrenal cancer include:
- Adrenolytics, such as mitotane
- Anti-androgens (androgen receptor antagonists), such as bicalutamide (Casodex)
- Diuretics, such as amiloride and spironolactone
- Aldosterone receptor antagonists, such as eplerenone
- 5-alpha-reductase inhibitors, such as finasteride
- Glucocorticoid receptor antagonists, such as mifepristone
- CYP17 inhibitors, such as ketoconazole (Nizoral)
- Steroid 11-beta-monooxygenase inhibitors, such as metyrapone
- Anesthetic agents, such as etomidate
- Selective estrogen receptor modulators (SERMs), such as tamoxifen and raloxifene
Some types of ovarian cancer, such as stromal tumors, can be treated with hormone therapy. These treatments work in different ways. Some lower the amount of estrogen the body makes. Others block cancer cells from using estrogen already in the body. Lowering or blocking estrogen can help slow the growth of cancers that need it to grow.
Examples of hormone therapy for ovarian cancer include:
- Luteinizing hormone-releasing hormone (LHRH) agonists, such as goserelin (Zoladex) and leuprolide (Lupron)
- Selective estrogen receptor modulators (SERMs), such as tamoxifen
- Aromatase inhibitors (AIs), such as letrozole (Femara), anastrozole (Arimidex), and exemestane (Aromasin)
When is hormone therapy recommended?
Hormone therapy is only used for certain cancers that can be affected by changing the levels of specific hormones. Your cancer care team will consider many factors before recommending hormone therapy, including:
- The type and subtype of cancer
- The stage of the cancer (where it is, how big it is, and whether it’s spread to other parts of the body)
- Results of other tests on the tumor, such as biomarkers
- Your age
- Your overall health and current medications
- Other serious health problems (such as heart, liver, or kidney diseases)
- Goal of treatment
- Other cancer treatments you have had in the past or are currently receiving
- The risk of cancer returning or how long it has been before the cancer returned
- Whether or not you have gone through menopause
What is it like to get hormone therapy?
Getting hormone therapy can be very different depending on the type you need. Some are oral medicines you take at home, while others are injections you might get at your doctor’s office or cancer center. Some surgeries are also a form of hormone therapy.
Many types of hormone therapy are drugs that are taken by mouth. In these cases, you swallow the pill, capsule, or liquid just like other medicines. These are usually taken at home.
How often they’re taken depends on the drug and the type of cancer being treated. Because of this, it’s important to be sure you know exactly how to take it and follow instructions exactly.
Some types of hormone therapy are given as injections. They can be:
- Intramuscular (or IM) injections given in the muscle of the arm, leg, or hip.
- Subcutaneous (SC or sub-Q) injections, given just under the skin of the abdomen (belly).
How often they’re given depends on the drug and type of cancer being treated. At first, the injections might be given in your treatment center or doctor's office. Sometimes you will be taught how to give your own injections or a caregiver can be taught to give them to you. Then you can take the injections at home.
Some types of surgery can also be forms of hormone therapy:
- Orchiectomy (surgery to remove the testicles, the body’s main source of testosterone) can be an option for some men with prostate cancer who need hormone therapy as part of their treatment.
- Oophorectomy (surgery to remove the ovaries, the body’s main source of estrogen and progesterone) can be an option for some women with breast cancer.
Side effects from these surgeries tend to be like those from drugs that lower hormone levels in the body. An advantage of this type of hormone therapy is that it is done all at once, and it doesn’t require long-term treatment with medicines. A possible downside is that it is permanent, so once it’s done, it can’t be reversed.
Hormone therapy drug safety
Some hormone therapy drugs are considered hazardous and have safety precautions that should be followed. Often, these are similar to the precautions used for chemotherapy safety.
Talk to your cancer care team about any special precautions that might be needed to protect yourself and others while you are taking hormone therapy.
What are the side effects of hormone therapy?
The side effects of hormone therapy depend on the type and dose of hormone therapy, as well as your overall health and whether you are getting other types of cancer treatment.
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- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
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Last Revised: July 28, 2025
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