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Breast cancer · Hormone therapy

Hormone therapy for breast cancer

One tablet a day, for five years or longer. For hormone-driven breast cancer it does more to stop the cancer returning than almost anything else. It is also the treatment women are most likely to quietly stop taking.

Talk about your side effects
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Medically reviewed by Dr. N. Kiranmayee Medical Oncologist, CION Cancer Clinics · 7+ years MBBS, Osmania Medical College · MD Internal Medicine · DM Medical Oncology · Consultations in Telugu, Hindi and English
A patient discussing long-term hormone therapy with her medical oncologist - CION Cancer Clinics, Hyderabad

These tablets only work if your report says ER or PR positive

Not your stage, and not your choice — one line in your biopsy report decides it. So before you read any further, go and find it.

What you are looking for

On the report, under a heading such as Immunohistochemistry or IHC. It will look close to this:

ER
Positive
PR
Positive

Either one being positive is enough. You may see a percentage or a score beside it — that detail matters to your oncologist, not to whether this treatment applies. Reading the whole report →

Positive — most breast cancers This page is for you, and this is the treatment that does the most Your cancer uses the body’s own oestrogen to grow. Taking that fuel away is one of the most effective things that can be done about it. That is why the tablet is offered even when the cancer has been removed completely and nothing shows on any scan.
Negative These tablets do nothing for you You will not be offered them, and that is neither good news nor bad on its own. It means your treatment relies on other things instead. If you have been offered hormone tablets and your report says negative, ask why — one of the two is wrong.

There are two kinds of tablet, and they work differently

You will be on one of them. Which one depends mainly on whether you have been through menopause, and it matters because their side effects are different.

One kind of tablet blocks oestrogen from reaching the cancer cell - CION Cancer Clinics
Blocks oestrogen from reaching the cell The oestrogen is still in your body. The tablet sits in the way, so the cancer cell cannot use it. This kind works whether or not you have been through menopause.
The other kind of tablet lowers how much oestrogen the body makes - CION Cancer Clinics
Stops the body making oestrogen Rather than blocking it, this kind lowers how much there is. It only works after menopause, or alongside treatment that switches the ovaries off.

Your tablet has a name, and this page does not use it. Ask your oncologist which of these two kinds you are on, and write it down. It decides which side effects to expect, what monitoring you need, and what you can be switched to.

Already on the tablet and struggling with it? Bring the strip and your reports. There is almost always something to change — the kind, the timing, or what is given alongside it. Stopping is the one option that costs you something.
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What the five years actually feel like

Nobody describes this part, so women assume the first bad months are how it will always be. They usually are not.

The first weeks on hormone therapy are often uneventful - CION Cancer Clinics
First weeks Starting, and waiting for something to happen Often nothing much at first. Hot flushes and disturbed sleep are the usual openers, and they can arrive suddenly a few weeks in rather than on day one.
Months three to twelve are the hardest stretch, and the point at which switching helps most - CION Cancer Clinics
Months three to twelve The hardest stretch, and when most women stop Joint stiffness, aches in the hands and knees, poor sleep, low mood. This is the window in which the tablet gets quietly abandoned. It is also the window in which switching works best.
For most women the treatment settles into an ordinary routine - CION Cancer Clinics
Years two to five It becomes ordinary For most women the effects settle into something liveable and the tablet turns into a habit. Reviews spread out. Bone strength is checked if you are on the second kind.
Around year five, a real decision about stopping or continuing - CION Cancer Clinics
Around year five Stop, or carry on to ten A real decision, taken with your oncologist. Some women are advised to continue for longer because their risk of return justifies it. Others finish at five.

The protection does not stop when the tablet does. The benefit of the years you have taken keeps working long after the last one. That is why finishing the course matters more than it feels like it should while you are in the middle of it.

Side effects, and what can actually be done

Every one of these has something that helps. Pick one to see what, and when it is worth a phone call rather than waiting for your next review.

Pick one

What helps

The commonest reason women stop. Stiffness in the hands, wrists and knees, often worst on waking, and it can feel like arthritis arriving all at once.

What helps: regular gentle movement, which feels like the wrong advice and is the best evidenced. Simple pain relief for the first months. Most importantly, ask to be switched — the other kind of tablet, or a different one within the same kind, often suits far better.

Worth a call before your next reviewIf it is stopping you sleeping or using your hands. Do not spend months waiting for an appointment to say so.

General guidance, not instructions for your case. Anything new, worsening or frightening should be discussed with your oncologist rather than managed at home.

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If you have already stopped, or cut the dose

You are not unusual and you are not being told off. But this is worth reading before you decide it is settled.

Halving it, or skipping days - CION Cancer Clinics
The quiet version Halving it, or skipping days

This is commoner than stopping altogether, and it almost never comes up at appointments. Women halve the dose so they can sleep, or skip it on working days, and then cannot find a way to mention it.

Mention it anyway. Taken irregularly, the tablet gives you the side effects and less of the protection. Your oncologist would much rather know and change something.

Switching rather than stopping - CION Cancer Clinics
What it costs Why stopping early matters

Finishing the course is one of the strongest things you can do to stop this kind of cancer coming back. The earlier you stop, the more of that you give up.

And it is almost never necessary. The other kind of tablet, a different one within the same kind, a change of timing, or treatment for the side effect itself. Switching is the answer far more often than stopping.

Stopped taking it, and have not told anyone? Come and say so. Nobody will scold you, and it is a fixable conversation. Bring the strip you were given, even if the box is long gone.
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Living with it for five years

The practical questions that come up once the treatment stops being an event and becomes a routine.

Can I…

The realistic answer

Not while you are taking it, and this is worth planning rather than hoping about. These tablets must not be taken in pregnancy, and the course is long enough to matter a great deal if you are young.

What to do: raise it before you start, not at year three. There are recognised ways to pause treatment for a pregnancy and resume afterwards, and there are fertility steps that are best taken early. Use reliable non-hormonal contraception meanwhile.

Bring it up nowAsk at your very next appointment, whatever stage you are at. Options narrow with time.

Practical guidance only. Your own plan depends on the kind of tablet, your age and your reports — confirm anything specific with your oncologist.

Ask our team 1800 202 8726

Read next

Your receptor result

The line that decides all of this.

Chemotherapy

Cycles, and how it differs.

Radiation therapy

Sessions, and what a visit takes.

Is it curable?

What remission actually means.

Choosing surgery

How the operation is decided.

Second opinion

If the plan does not sit right.

Five years is a long time to manage alone

Bring the tablet and tell us what it is doing to you

If the aches, the sleep or the flushes are making this unbearable, there is almost always something to change. Bring your reports and the strip you were given. A medical oncologist can tell you which kind you are on, what it should be doing, and what you can be switched to. Consultations in Telugu, Hindi and English.

9 clinics across Hyderabad, within a network of 35+ centres across Telangana and Andhra Pradesh. Care is delivered inside NABH-accredited partner centres.

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