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Cancer has been treated by hormonal manipulation for over 100 years. Although therapeutic progress during this period has resulted mainly from clinical observation, more rational treatment approaches are now emerging from insights into the molecular basis of hormone-responsiveness. Among these are the recognition that hormonal signalling effects are transduced via specific receptor proteins, and the possibility that tumour lysis by hormonal therapies is effected by triggering of a programmed cell death pathway. Clinical progress has already been achieved through basic advances: receptor assays, for example, now permit prediction of treatment benefit in various settings. However, much remains to be learned about the mechanism and application of hormonal anticancer treatments.