Triptorelin (Decapeptyl®) for breast cancer

Hormones are chemicals that our bodies make. Hormones act as messengers and help control how cells and organs work. Hormonal therapies are drugs that change the way hormones are made or how they work in the body.

Many breast cancers rely on the hormone oestrogen (or estrogen) to grow. This type of breast cancer is called oestrogen-receptor positive (ER positive) breast cancer. Triptorelin stops the body making oestrogen.

Triptorelin (Decapeptyl^®) is given as an injection into a muscle (intramuscular). It is given every 28 days (4 weeks). 

The injection can be given by your practice nurse at your GP surgery. If you are not able to visit the GP surgery, a district nurse can give you it at home. Tell your doctor or nurse if you are taking any medicines to thin your blood, as this may increase bruising.

Your nurse or doctor will talk to you about your treatment plan. 

Hot flushes are a common side effect of this treatment. During a flush, your neck and face may feel warm. If you have white skin, your skin may look red. If you have black or brown skin, your skin colour may deepen. Flushes can last up to 5 minutes. You might also have sweats or feel anxious or irritable during a flush. 

Here are some things you can do to reduce the effects of hot flushes:

• Wear natural fabrics, such as cotton.
• Wear layers so you can remove clothes as needed. 
• Use cotton sheets and layers of bedding you can remove. 
• Try cooling pads or pillows to keep you cool.
• Keep rooms cool or use a fan.
• Have cold drinks and avoid caffeine and alcohol. 

You might have fewer hot flushes as your body adjusts to this treatment. You could try therapies to help you cope with hot flushes, such as:

• talking therapies like cognitive behaviour therapy (CBT)
• controlled breathing exercises
• yoga
• acupuncture. 

If they do not improve, talk to your doctor. Certain drugs can help to improve hot flushes. 

Flushes usually stop a few months after treatment ends. But some people continue to have them.

This treatment can cause vaginal dryness and a lower sex drive. Non-hormonal creams, gels or lubricants may help with vaginal dryness and discomfort. You can buy these from a chemist, or your doctor can prescribe them. We have more information about cancer and sex.

This treatment can cause vaginal bleeding or change the usual pattern of periods. 

You may have bleeding when you start this treatment, or if you change to it from another treatment. If bleeding continues for more than a few days, tell your doctor or nurse. 

If you have periods, you may find they become irregular, lighter, or sometimes stop altogether during this treatment. This does not always mean you are unable to get pregnant. Even if your periods stop or are irregular when taking this treatment, you still need to use contraception to prevent a pregnancy. Your doctor or nurse can tell you more about this.

Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest between activities.

Being physically active can help to manage tiredness and give you more energy. It also:

• helps you sleep better
• reduces stress
• improves your bone health.

If you feel sleepy, do not drive or operate machinery.

This treatment can cause sleeping problems (insomnia). If you are finding it difficult to sleep, talk to your nurse or doctor.

This treatment may cause headaches. If you have headaches, tell your doctor, nurse or pharmacist. They can give you advice about painkillers that may help. Tell them if the headache does not get better, or gets worse.

This treatment can make you feel sick, but this is usually mild. If it does not get better, your doctor can give you anti-sickness drugs to help. Some men may get pain in their lower tummy. Let your doctor know if this happens to you.

You may gain weight when you are having this treatment. Eating healthily and being active can help you keep to a healthy weight. Your doctor, nurse or dietitian can give you more advice.

You may feel low or depressed, or have mood swings, during this treatment. Talking to family and friends about how you feel might help. If mood changes last for more than a few weeks, tell your doctor, nurse or pharmacist. They can talk to you about different ways to manage low mood or depression.

You may get pain in your muscles or joints. If this happens, tell your doctor or nurse. They can give you advice and painkillers or other drugs to help. Being physically active and keeping to a healthy weight may help with the pain. It can keep your joints flexible and reduce stress on them. If the pain does not get better, tell your doctor or nurse. They may talk to you about changing to a different hormonal drug.

Taking this treatment for several months or more can increase the risk of bone thinning. This is called osteoporosis. It can make you more likely to get a broken bone (fracture). 

You may have bone density scans to check your bone health before and during treatment. These scans can diagnose osteoporosis or osteopenia (low bone density) so that it can be monitored. If your scan shows osteoporosis, your doctor usually prescribes:

• drugs to protect your bones called bisphosphonates
• calcium and vitamin D supplements. 

Regular exercise where you support your body weight, like walking, running and dancing, can help look after your bones. This is called weight-bearing exercise. Other types of strength exercises are also helpful. If you have any bone thinning or the cancer is affecting your bones, get advice from your cancer team first. 

Eating a healthy diet and not smoking also helps take care of your bones.

This treatment may cause high blood pressure. Tell your doctor or nurse if you have ever had any problems with your blood pressure. Let them know if you feel dizzy or have any headaches.

Cancer and some cancer treatments can increase the risk of a blood clot. Contact the hospital straight away on the 24-hour number if you have any of these symptoms during or after treatment:

• throbbing pain or swelling in a leg or arm
• reddening of the skin in the area – if you have black or brown skin, this can be harder to notice, but the skin might become darker
• suddenly feeling breathless or coughing.

Always call 999 if you have:

• chest pain
• difficulty breathing.

A blood clot is serious, but it can be treated with drugs called anticoagulants. These thin the blood. Your doctor, nurse or pharmacist can give you more information about preventing and treating blood clots.

Your doctor, nurse or pharmacist will advise you not to get pregnant or make someone pregnant while having this treatment and for some time afterwards. The drugs may harm a developing baby. It is important to use contraception to prevent pregnancy. Follow their advice about:

• what types of contraception to use 
• how long after treatment you should continue to use contraception. 

Some medicines can affect how this treatment works or be harmful while you are having it. Always tell your cancer doctor, nurse or pharmacist about any drugs you are taking or planning to take, such as: 

• medicines you have been prescribed
• medicines you buy in a shop, pharmacy or online
• vitamins or supplements 
• herbal drugs and complementary or homeopathic therapies
• recreational drugs – for example, cannabis.

If you need medical treatment for any reason other than cancer, always tell the healthcare professional that you are having cancer treatment. Give them the contact details for your cancer doctor or cancer team so they can ask for advice.

If you have appointments with a dentist, always tell them you are having cancer treatment. Talk to your cancer team before you have any dental treatment.