Unstable alkaline phosphatase

[Drcrunch]

Anyone experiencing big swings in alkaline phosphatase, steady rise,then drop for 3 months 50%, the back up. Medonc says ignore alk phos. She only focuses on imaging. Psa doubling time the same.

[ctarleton]

My alk phos experience has been roughly linear as broad treatments started or became less effective, with minor monthly variabilities while steady on a treatment.

When I was originally diagnosed with a Very high psa of 5,006 and Many bone mets, my alk phos right after starting Lupron + Zometa was in the 400s. It came down into the 50s as my psa came down into the 1-2 range, but would bounce around by +/- 10 points for no apparent reason. When resistance started, my psa got as high again as 95, and the alk phos also went up to around 83. After I started Xtandi, my psa has dropped again to 2.6, so far, and the alk phos went back down again into the upper 40s.

Charles

[Hidden]

My response with Alk Phos was similar to Charles. Mine started above 600 at diagnosis and has been steadily declining with ADT and Taxotere chemo treatment, as has my PSA. My last blood test yesterday at 3 1/2 months into treatment shows Alk Phos at 79, well within the normal range.

There have been a lot of articles written about the relationship of Alk Phos and bone mets. You can do a google search and find lots of them. During bone metastasis there is breaking down and building up of bones. Here's a quote from one of the articles: "Markers of bone formation include serum osteocalcin, procollagen I extension peptides, total serum alkaline phosphatase (S-ALP) and bone-specific alkaline phosphatase (B-ALP)."

So for your doctor to say ignore Alk Phos, I would have to disagree with that. It's an important indicator.

[eggraj8]

What the numbers are is important. At MSK the top of the normal range is 129. My Alk Phos was up to 407 when I started chemo and fell just below the top of the normal range and is now bouncing around the 129 level, sometimes above sometimes below. There are many different indicators which the onc should use to determine what is happening in your body besides imaging, PSA, and alk phos. It becomes a problem to decipher it all as different ones often conflict, but of course that is what we hope the onc is there for to decipher all the different indicators.

[Karkawry1970]

How would that work for Neuroendocrine PCa, which generally secretes low PSA?

Thanks

Kark

[Karkawry1970]

Thanks Nalakrats