Triptorelin is a man-made drug which is used in the treatment of prostate cancer. It is a type of hormonal therapy. Hormonal therapies alter the production or activity of particular hormones in the body. Hormones are substances produced naturally in the body, where they act as chemical messengers and help control the activity of cells and organs.
How it is given
Triptorelin is given by injection into the buttock. It is usually given as a monthly injection (every four weeks). It can be given by your GP or practice nurse at the surgery. If you are not able to visit the surgery, a district nurse can give you the injection at home. Sometimes people may find the injection slightly uncomfortable and may notice an area of redness at the injection site afterwards.
You can have a tiny amount of local anaesthetic to numb the area before the triptorelin is given if you find the injection very uncomfortable.
How it works
Most prostate cancers rely on supplies of the male hormone testosterone (which is produced by the testes and the adrenal glands) to grow.
Triptorelin acts by lowering the level of testosterone in the body. The testes will only make testosterone if told to do so by a hormone known as luteinising hormone, which is produced by a part of the brain known as the pituitary gland. Triptorelin reduces the production of luteinising hormone, leading to a fall in the levels of testosterone. This may result in shrinkage or slowing down of the growth of the cancer. There may be a brief increase in testosterone levels in the first few days or weeks of starting treatment.
Possible side effects
Each person's reaction to any medication is unique. Many people have very few side effects with triptorelin while others may experience more. We have outlined the commonest side effects, so you can be aware of them if they occur. However, we have not included those which are very rare and therefore extremely unlikely to affect you. If you do notice any effects which you think may be due to the drug, but which are not listed in the factsheet, please discuss these with your doctor or nurse.
You will see your doctor regularly while you have this treatment so that they can monitor the effects. This factsheet should help you to discuss any queries about your treatment and its side effects with your doctor or nurse, as they are in the best position to help and advise you.
Some people may experience some of the following side effects:
Tumour flare. There may be a temporary increase in testosterone levels in the first few days or weeks of starting triptorelin. Some people may experience an increase in symptoms such as bone pain, or have problems passing urine. Rarely, other problems, due to a temporary increase in the size of the tumour may occur. This is known as 'tumour flare'. If you experience any problems, you will need to let your doctor know. Other types of hormonal therapy (cyproterone acetate, flutamide or bicalutamide) may be given for the first few weeks of starting triptorelin to prevent this from occurring.
Hot flushes. These are quite common, but many people find that hot flushes wear off after a period of time and become less of a problem. Let your doctor know if hot flushes are causing you any problems as drugs can sometimes be prescribed to counteract them. There are a number of ways to help reduce hot flushes and sweats. It can be useful to avoid or cut down on tea, coffee, nicotine and alcohol.
Some people find that complementary therapies help, and your GP may be able to give you details about obtaining these on the NHS.
Impotence (a loss of ability to have an erection). There is usually a loss of the ability to have an erection. If this occurs sexual function will return to normal after stopping the drug. Your doctor or nurse can discuss this with you. More information is available in CancerBACUP's booklet Sexuality and cancer.
Breast tenderness or fullness. Men may sometimes notice slight breast swelling and tenderness. Your doctor can prescribe medication to reduce any discomfort.
Feelings of sickness (nausea), vomiting and mild diarrhoea. These effects are uncommon and if they occur are usually mild and easily controlled. Let your doctor know if you have any of these side effects as medication can be prescribed to help. CancerBACUP's booklet Diet and the cancer patient discusses ways of coping with these side effects.
What if I miss an injection?
Missing an injection by a few days should not make a great difference, but it is important to remember that the benefits of the injections are designed to last 4 or 12 weeks, so you should have them as regularly as possible.
Length of treatment
Your doctor will discuss the length of treatment that they feel is appropriate for your situation. It is often given for several months or even years.
References
British National Formulary (BNF)
A joint publication of the British Medical Association and the Royal Pharmaceutical Society of Great Britain.
For more information call CancerBACUP's Cancer Support Service on 020 7613 2121 or Freephone 0808 800 1234 to speak to a cancer specialist nurse. Lines are open Monday-Friday, 9am-7pm.
This information has been compiled by CancerBACUP's Support Service.
We thank the patients and specialist advisers who have helped with the production of this factsheet.
Last reviewed/updated: December 2001
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