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Course Content
Module 1 — Principles of Hormone Therapy in Oncology
Mechanism and Dosing Overview Aromatase Inhibitors (AIs): block the enzyme aromatase (CYP19A1), which converts androgens to estrogens in adipose and peripheral tissues. Examples: Anastrozole 1 mg orally daily, Letrozole 2.5 mg orally daily, Exemestane 25 mg orally daily. These are the preferred agents in postmenopausal women with estrogen receptor–positive breast cancer. Selective Estrogen Receptor Modulators (SERMs): such as Tamoxifen 20 mg orally daily — bind the estrogen receptor and act as antagonists in breast tissue but partial agonists in bone and endometrium. Selective Estrogen Receptor Degraders (SERDs): such as Fulvestrant 500 mg intramuscularly on days 0, 14, 28, then every 28 days thereafter — promote estrogen receptor degradation. CYP17 Inhibitors: Abiraterone acetate 1000 mg orally daily on an empty stomach plus Prednisone 5 mg orally twice daily — block the CYP17A1 enzyme, suppressing androgen synthesis in adrenal glands and tumors. Gonadotropin-Releasing Hormone (GnRH) Agonists and Antagonists: Leuprolide 7.5 mg subcutaneously every 4 weeks or depot every 3–6 months; Degarelix 240 mg subcutaneously loading dose, then 80 mg every 4 weeks; Relugolix 120 mg orally daily — suppress testosterone or estrogen production by downregulating or directly blocking pituitary gonadotropin release.
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Lesson 1.1 — Hormone Dependence and Endocrine Manipulation
Lesson 1.2 — Mechanisms, Dosing, and Resistance
Lesson 1.3 — Patient Selection, Toxicity, QoL, Bone & Reproductive Health
Lesson 1.4 — Glossary and Abbreviations
Principles and Mechanisms
Module 2 — Hormone Therapy by Tumor Type (Breast & Prostate)
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Lesson 2.1 — Hormone Therapy in Breast Cancer
Lesson 2.2 — Hormone Therapy in Prostate Cancer
Lesson 2.3 — Integrating Hormone Therapy with Radiotherapy
Lesson 2.4 — Comparative Outcomes & Quality of Life
Breast & Prostate Clinical Scenarios
Module 3 — Treatment Timing and Duration
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Lesson 3.1 — When to Start Hormone Therapy
Lesson 3.2 — When and How to Stop Hormone Therapy
Lesson 3.3 — Managing Treatment Gaps and Restarts
Treatment Timing & Duration
Module 4 — Adverse Reactions and Mitigation
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Lesson 4.1 — Metabolic and Cardiovascular Toxicities
Lesson 4.2 — Bone, Musculoskeletal, and Mineral Disorders
Lesson 4.3 — Sexual, Cognitive, and Emotional Health
Lesson 4.4 — Hepatic, Endocrine, and Rare Adverse Events
Toxicities & Management of Hormone Therapy
Module 5 — Integration with Radiotherapy and Systemic Therapy
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Lesson 5.1 — Rationale for Combining Hormone Therapy with Radiotherapy
Lesson 5.2 — Sequencing with Chemotherapy and Targeted Agents
Lesson 5.3 — Integration with Immunotherapy
Lesson 5.4 — Multimodal Therapy Coordination & Follow-Up
Integration & Sequencing of Hormone Therapy with Radiotherapy and Systemic Therapy
Module 6 — Outcomes, Risks & Future Directions
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Lesson 6.1 — Survival and Disease Control Outcomes
Lesson 6.2 — Quality of Life and Patient-Reported Outcomes
Lesson 6.3 — Economic and Systemic Considerations
Lesson 6.4 — Emerging and Future Directions
Outcomes & Future Directions of Hormone Therapy
Module 7 — Appendices & Clinical Tools
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Lesson A.1 — Drug Dosing Quick Reference Table
Lesson A.2 — Adverse Effect Management Checklist
Lesson A.3 — Quality of Life (QoL) Assessment Toolkit
Hormone Therapy for Cancer Patients: Mechanisms, Indications, and Clinical Practice

Purpose: handy in-clinic lookup for drug names, trade names, doses, and intervals.

Drug / Class Mechanism Typical Dose Route / Interval Main Monitoring
Tamoxifen (Nolvadex®) Selective Estrogen Receptor Modulator (SERM) 20 mg daily Oral Thromboembolism, endometrial symptoms
Anastrozole (Arimidex®) Aromatase Inhibitor (AI) 1 mg daily Oral DEXA, lipids
Letrozole (Femara®) AI 2.5 mg daily Oral Bone pain, arthralgia
Exemestane (Aromasin®) Irreversible AI 25 mg daily Oral LFTs, DEXA
Fulvestrant (Faslodex®) Selective Estrogen Receptor Degrader (SERD) 500 mg IM D0, 14, 28 → q28d IM (gluteal) LFTs, injection site
Goserelin (Zoladex®) GnRH Agonist 3.6 mg SC q4wk / 10.8 mg q12wk SC Flare risk, testosterone
Leuprolide (Lucrin®) GnRH Agonist 7.5 mg IM/SC monthly or depot q3–6 mo IM/SC Testosterone, PSA
Triptorelin (Decapeptyl®) GnRH Agonist 3.75 mg IM q4wk / 11.25 mg q3mo IM Flare cover
Degarelix (Firmagon®) GnRH Antagonist 240 mg SC load → 80 mg q4wk SC Local site reaction
Relugolix (Orgovyx®) GnRH Antagonist (oral) 120 mg daily Oral Adherence, ECG if cardiac
Abiraterone (Zytiga®) CYP17A1 inhibitor 1000 mg daily + Prednisone 5 mg BID Oral (empty stomach) BP, K⁺, LFTs
Enzalutamide (Xtandi®) AR blocker 160 mg daily Oral Fatigue, BP
Apalutamide (Erleada®) AR blocker 240 mg daily Oral Rash, fatigue
Darolutamide (Nubeqa®) AR blocker 600 mg BID with food Oral Fatigue (less CNS)
Zoledronic acid (Zometa®) Bisphosphonate 4 mg q6–12 mo IV Creatinine, Ca²⁺
Denosumab (Prolia®) RANKL inhibitor 60 mg q6 mo SC Ca²⁺, dental check

All doses per NCCN 2025; local protocols may vary.

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