Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 27 Aug 2026Clinical review pending
Synopsis
Select endocrine anticancer treatment by hormone dependence and disease setting, monitor response and adherence, and prevent thrombotic, skeletal, metabolic, cardiovascular and reproductive harm.
Endocrine therapy deprives a hormone-dependent tumour of ligand or blocks its receptor; it is central to many breast and prostate cancer pathways.
Treatment is selected by receptor or disease biology, menopausal or gonadal status, stage, prior exposure, comorbidity and treatment intent.
Breast strategies include oestrogen-receptor modulation, aromatase inhibition, oestrogen-receptor degradation and ovarian suppression in defined combinations.
Key red flags
Thrombotic warning
New unilateral swelling, chest pain, breathlessness or neurological deficit during selective oestrogen-receptor modulation needs urgent thrombosis assessment.
Investigation priorities
01
Tumour receptor and pathology reviewFirst step
Confirm that endocrine treatment matches the cancer biology.
Management branches
SelectMatch biology and endocrine state
Hormone-sensitive breast, prostate or another cancer is confirmed.
Define stage, intent, receptor biology, menopausal or gonadal status, prior treatment and important vascular or skeletal comorbidity.
Choose the current tumour-specific first-line endocrine option or combination and explain expected duration, onset and alternatives.
Key medicines
Tamoxifen20 mg orally once daily for hormone-receptor-positive breast cancer; duration and any extension are set by the disease stage, menopausal status, recurrence risk and current breast protocol.
Letrozole2.5 mg orally once daily in an indicated postmenopausal breast-cancer setting, or only with confirmed ongoing ovarian suppression when used before natural menopause; follow the tumour protocol for duration and sequencing.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 27 Aug 2026; clinical approval remains outstanding.