SPPORT (ROTG 05340

[twostrats]

Good morning, my first post here. I'm a 62 year old who had an RP in March. So far my psa tests have come back undetected, but realistically I'm a T3a that had a psa of 6.1 when I got my RP. Also GS of unfavorable 7 (4+3). Do we have anyone on here who has been through the SPPORT (ROTG 0534) process that combines whole pelvic salvage radiation with short term ADT. Curious about how you made out ...side effects, efficacy etc

[Tall_Allen]

FYI:

prostatecancer.news/2018/10...

[rogerandme in reply to Tall_Allen]

Hello so this study was concluded in 2018? Is this a repost.

[twostrats in reply to rogerandme]

Hi I'm new here and I was hoping to get a few people experience with the whole pelvic salvage radiation with the short term ADT.

[Tall_Allen in reply to rogerandme]

Not sure what you're asking.

[rogerandme in reply to Tall_Allen]

The link you provided is from 2018 correct

[Tall_Allen in reply to rogerandme]

Yes, I wrote that in 2018.

[tango65]

Early salvage radiation has similar results than adjuvant radiation. If you PSA is undetectable you should not worry. You could follow the PSA and if there were 3 consecutive increases of ultra sensitive PSA or a PSA 0.2 or higher, then you could consider to talk with a radiation oncologist about radiation of the prostate fossa and the whole pelvis.

[twostrats]

Hi thanks for all responses. I realize that so far with the undetectable psa tests I am not going to start the whole pelvic salvage radiation +adt yet , but I also know that with positive margins, and being a high risk T3a that sooner or later I will most likely have to consider a treatment and since this treatment seems like the standard I am trying to find out how people tolerated it, and how effective it has been for them. I could look at trials and study's but I was hoping to talk to actual people who have done it.

[ehiker in reply to twostrats]

I had RP in 2012. Positive margin but psa undetectable. Good until recurrence in 2018. Had 6 months Lupron and 33 radiation treatments to pelvis and prostate bed. Psa undetectable since. Thankful/grateful. Getting used to the required full bladder prior to treatment took a bit to “time” right. Other than that the daily drive back and forth was probably biggest hassle. So far I don’t seem to have any delayed toxicity issues. 68 years young! One day at a time. Enjoy every moment. dan

[twostrats in reply to ehiker]

Thanks Ehiker, I may have a commute as well. 2 hours. Prayers for continued best results

[Blackpatch]

Hi

I was pT3b after RRP in Dec '17, with negative margins. Undetectable on micro-PSA for five months, then recurred at 0.024 and continued to increase. Doubling time was around 4 months - I know the formal definition of DT doesn't encompass micro-PSA measurements, but I found a paper by a guy who did a PhD on this that showed the trend in the low-PSA region post-recurrence tends to continue, so I was very concerned. I sent a path specimen to the US for Decipher testing and that came back with a very bad reading (0.91) so I pressed the button on e-SRT in Jan 2019 (ca. 14 months after surgery - PSA was 0.117 by the time the radiation actually commenced) with 12 months ADT plus Zytiga for the first 8 months - I had intended the ADT + Zytiga to run for 12 - 18 months but I couldn't handle the side effects.

My T started recovering about 6-8 months after the final ADT shot was scheduled to wear off, and was back to normal (~ 21) after another few months,

PSA went undetectable as soon as the ADT started and remains that way today i.e. for the last 34 months.

Decipher gave me a very high PORTOS score, which supposedly means I was susceptible to SRT, so maybe that's why it hasn't recurred to date. Either way, my view is that Decipher is well worth doing in the pT3 setting - if the news is bad, I would opt for SRT soon after any recurrence.

In my heart, I still expect it to recur at some point - there are lots of papers that show eSRT +/- ADT as "curative" for some men but it always bothers me that these studies only run for five to ten years post-SRT. I guess some men may be lucky and manage to cover everything with the SRT + ADT combo, but I think the odds are against it.

[twostrats in reply to Blackpatch]

Thanks Blackpatch best of luck for best success

[Cooolone]

Yes, my salvage therapy followed the SPPORT protocol.

Just a quick run through...

Diagnosis, G4+3, SVI, ECE, PNI, IDC-p, 3Tb... RP April 18, all above confirmed and +Margins.

Persistent PSA @ 1st follow up, 0.05ng, doubling time was <2 months. Tests, scans, genetics, all tests that could be done. Agreed on salvage therapy which followed SSPORT.

ADT began Nov 18', IMRT = 40x 1.8gy (72gy total) began Jan 19'. 25 sessions to Prostate Bed, 15 to Nodes and suspect hot spots. Completed Mar 19'... Next two PSA checks were ok. Mar 20' persistent PSA once again. Follow up in Aug 20' and PSADT <2 months again... A multitude of things going on for me at this time though, is all here in my posts, much testing and diagnosis, etc. But flank pain led to attempted Appendectomy which discovered PCa in my Peritoneal and Appendix (StgIV). So game over with curative attempts, now onto systemic therapy and the fight to control the PCa.

So... For me, ehhhh, no, it didn't have a chance. I knew with all my adverse features I was low/high risk for recurrence, but gave it a shot anyways to try and fall into a small percentage group that in my staging experienced good results as well. But everyone is different... You cannot use my example to model yours! My cancer isn't yours...

But the SPPORT trial methodology has shown good results for RP patients in a salvage setting. The results were so good they released the data early knowing it wouldn't improve much from what they were seeing (if I recall correctly). One of the radiation oncologist I had met, probably nailed it with just my original scans and dre, lol. Wanted to do ADT (2 yrs), HDBT & RT... But I didn't like his demeanor or approach, was way too aggressive. A mindset I didn't have at the time. There's no way of knowing if the results would have been different if I had followed that path, no regrets. Just making note of the encounter. Point is...

There are many paths to the top of the mountain, but the view is all the same regardless of how you arrived!

Good Luck and Best Regards

[MGBman]

Good Morning. I was 65 when PC detected in 2014. My PSA was 35, T3b and Gleason (4+3). Went thru RP in Jan 2015, started ADT (Zoladex) and in June/July 32 external beam radiation treatments. I was on ADT for two yrs (8 x injections). PSA dropped to 0.01. I was well aware that my PSA would eventually climb as the PC had escaped my prostate and was in my seminal vesicles, which were also removed. The RP and hitting the cancer with pelvic radiation and longer term ADT has given me seven decent yrs. The cost of all that was….no more sex - kaput, gone, hospitalized for 10 days with internal radiation burns, peeing blood, requiring a bladder fulguration and wearing a pad 24/7. Now seven yrs on and my PSA has climbed slowly back - it was 6.01 in Oct. Time to ‘pay the piper’ again as I have to return to ADT (degarelix) for eight months (monthly injections). I have a PSMA PETscan coming up in Dec to see what it might discover. I’m under no illusions as to how my story will end, hopefully a little later rather than sooner.

[twostrats in reply to MGBman]

Wow, lots of sides, hope things improve for you soon, thanks

[twostrats in reply to twostrats]

You seem like you're a good candidate for psma

[twostrats in reply to MGBman]

Praying for useful results for you from the psma that will lead to continued good days

[j-o-h-n]

Greetings twostrats,

Please tell us your bio. Age? Location? When diagnosed? Treatment(s)? Treatment center(s)? Scores Psa/Gleason? Medications? Doctor's name(s)?

All info is voluntary, but it helps us help you and helps us too. When you respond, copy and paste it in your home page for your use and for other members’ reference.

THANK YOU AND KEEP POSTING!!!

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 11/12/2021 11:48 PM EST

[twostrats in reply to j-o-h-n]

John I thought I did that. The profile interface is a little on the kluge side, I'll look at it again thanks

[j-o-h-n]

Thank you.... the more you place in your home page will help you and others. Stay with us, you'll be thankful you did. KILL the Monster..... (keep smiling)...

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 11/13/2021 11:58 AM EST

[Engman713]

I'm about a third way through this program of 6 months ADT/Lupron and salvage radiation at MD Anderson in West Houston. Finished 12 of my 35 radiation visits and so far no issues or side effects. I only lose about 90 minutes out of my day with the driving to and from including the 15 minute radiation appointment.

[twostrats in reply to Engman713]

Awesome great to hear, thanks