Advanced Prostate Cancer
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Alkaline Phosphatase going up is getting me worried

I just got my blood drawn today and my Alkaline Phosphatase is continuing to rise, now 89. One month ago it was 68 and 3 months before that it was 61. I'm just wondering if this is significant or have others had these kinds of fluctuations. Just a little concerned. My last PSA a month ago was .33, but we know that doesn't always tell the whole story.

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That’s still well within normal range. I wouldn’t worry too much

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Thanks, I'm getting a bit jumpy.

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My alkaline phosphate was 100 to 600...

sidnw

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What did your oncologist say about the increase?

My oncologist was not concerned when mine came in at 500.

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It's an important liver enzyme, and your doctor should be concerned about the rise - he/she didn't say anything?

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I sent an e-mail asking, haven't heard back yet.

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The normal range is 44 to 147. It's doing the jumping bean thing. More than likely the rise is from the half of cow you ate for Christmas dinner. Now chill and stop freaking out about every little thing. You have bigger fish to fry than this. Just remember that today is the tomorrow you worried about yesterday. Now breath and think cool, calm thoughts. I'm sure your liver is fine.

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Thanks. I'm having a bad day and the blood test results didn't help.

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Awwwwww..... you made me feel better for Gregg nameless ☺

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Just remember and believe that every day we have is a good day. Granted some days are better than other days, but certainly if we wake up, then its a good day.

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Yes I agree.

We also have to allow ourselves the freedom to occasionally express the negative emotions of sadness, dissapointment, anxiety, fear etc. Otherwise we end up burying these which is not healthy. It's easy to do that because everyone likes and encourages a positive attitude at all times. Sometimes I end up giving a "performance" for others because I don't want to let them down by sharing how I truly feel in the moment.

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Gregg as long is it is in the normal range, I used to worry when mine went up around there, and higher ,only to find the next month, or at a different lab it was back down, I would not worry with a 89. Happy New Year!

Dan

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Thanks Dan. My doctor said the same thing.

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Dr. Myers always ordered the bone specific alk phos ,as he thought that was more indicative of what was going on in the bones. How are alt,ast, and total bilrubin doing? Are you still on bicalutamide?

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I'm not on Bicalutamide. My AST is 23, ALT 34 and Bilirubin is .6, all well within range. I think I will ask for the bone specific ALKP next time. I wanted to get a baseline CgA, but my doctor said no. Had my T checked and its <20. Still waiting for my latest PSA, but a month ago it was .33

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Those numbers look pretty pristine! I wonder why you are not on casodex, I myself did what they called adt3 meaning adding an antiandrogen,such as bicalutamide,or nilandron along with dutasteride to lower DHT. I do not think it would take much to knock that psa back to UD. Your T is excellent. If you did have a psa rise would zytiga be your next plan of action?

Dan

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Dan, my doctor prefers Xtandi as second line and so do I so I will probably be going that route at CRPC. I had three doctors all say they wouldn't put me on second line ADT until I was resistant.

My ALT and AST spiked up around the time I started Casodex for the T flare at the beginning of ADT. At one point, ALT reached 5X ULN, delaying my second infusion of Taxtotere. I can't say definitively that it was the Casodex, but I may end up rechallenging Casodex before Xtandi so I'll be watching that closely. I still have some of the original prescription of Casdex, but won't use it without my doctor's agreement.

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Myers had me on triple dose casodex and it spiked my liver numbers similar to what happened with you and casodex, when liver recovered Sartor switched me to nilandron from casodex and never had a rise in liver numbers, with nilandron (another antiandrogen)or any other drug for prostate cancer. Nilandron worked well for me to control psa ,after that and never had a liver increase.

Of course what do I know!

Dan

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Hi Dan59

"Of course what do I know!"

Hey this is nameless9999 patent and I am now sure is he going to change you.

How's your Christmas with your family?

After chatting with you on Christmas Day here in Sydney ( yours is maybe 14 hours later) I have that night decided to escalate my treatment plan.

My doxycycline/vitamin c is effective in killing cancer cells but not to the extent that I would be delighted.

Remember I dosed up on 850 g canned peaches and syrup and I ended up in Hospital for 3 days waiting for my new souvenir (left ureteric stent).

Last few days I have to succumb to weakness/flu like symptoms as well as aches/tenderness in my bladder and spine in the bone areas where metastasis has been confirmed.

I have recovered from my weakness/flu like symptoms after 2 days. I was unable to play golf. Yesterday I resumed golf for a few holes. I made 3 pars from 6 holes golf. As indicated I am suffering tenderness on my spine. Also I have to ease of my medication for I has blood in my urine on the morning 28 Dec 17.

I took a great leap by having sex and the little ejaculation had blood. 2 hours later my urine was a little bloody and I was worried I might die from my treatment. I came across hemorrhagic (stroke from bleeding in the brain) due to high doses of omega 3 fish oil elevated interactions with other medication.

Fortunately I was lucky and I survived.

Last night I felt sore/tender again on the spine and I kept up my hand swinging exercise. This morning I woke up feeling better, My spine pain is slowly clearing up.

I have to see what happens next,

Have a Happy New Year.

Roland

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Roland, pain from metastatic disease is usually constant, Does your spinal pain come and go? It is easy for us to think that every ache and pain is the cancer,when more often that is not the case. Happy New Year to you, I wish you the best.

Dan

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Hi Dan59

Thanks for the reply. I just reply to Break60.

A fellow golfer. The discomfort/aches/pain are all genuine. It's the result from activities from the cancerous areas. But unlike others this time I am the one who is aggressive causing CSC death.

These are all new to me. But now I am feeling much better although there is still minor residual pain it is tolerable.

I told you about the hand exercise and it is definitely benefitting me.

If you are struggling with some pain symptoms give this a go.

Honest to goodness I am heading for recovery.

Have a good day.

I will be out moving my lawn and using the wiper snipper for the edges.

Bye for now,

Roland

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Lolol what do I know......😁😁😁

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See? And you probably chewed the nails off of everyone in your family. Happy for you.

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I wasn't that worried about it, not like I can change it anyway. I do get nervous when these liver enzymes or PSA values go up. Like to check in with others here to see if they have similar changes. Of course those numbers can back down just as easily. Have to keep it all in perspective. Glad I have this group to bounce things off.

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Hi gregg,

I am really worried because it is YOU who are worried! Not otherwise.

As nameless has rightly pointed out you are still well within the range ( 44 - 147 u/l ). Even within a normal range if you observe a significantly increasing trend, a proactive vigilance on any type of blood work can help you to arrest any impeding danger well in time. So observe the trend without worrying. No doubt, It will be a wise act. I hope you are aware, significant increases in serum bone specific alkaline phosphatase in PCa patients with PSA higher than 20 ng/ml can be due to metastatic activity involving bones. When the normal bone scans identify both the PCa mets as well as all other bone injuries as suspicious metastatic uptakes, the only way to sort out the ambiguity is to do this blood test and an MRI.

Hope you will take the situation under control soon enough.

Sisira

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That is in normal range. My numbers jump around like that. I would not worry unless the number goes over the 130 upper limit of the normal range.

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Hi Gregg57.

According to our experience and what the doctors tell us, if the ALP is up on its own there is nothing to worry about. This can happen after certain food you eat, after alcohol, but also when we take certain kinds of medication like anti-sickness drugs.

What are your other liver markers like - the AST and the ALT?

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Thanks. My AST and ALT are fine and well within the normal range. My PSA is now 0.4 which is slightly up from a month ago, but still not clear it's a trend.

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I would like to leave a comment here but I don't know nuttin about nuttin.

Good Luck and Good Health.

j-o-h-n Saturday 12/30/2017 11:38 AM EST

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I find this site very helpful as i go to a new doctor soon to see results of recent Gallium 68 pet/ct scan along with a ct scan & bone scan. At least i will be armed with some names of treatments. I had the lucrin injection & nexole tablets & felt lousy & gained weight but the psa went down & now up again to 9.4 & rising.

Thanks to you all & will post results soon

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In response to these posts regarding ALK increasing,

Mine jumped from normal to 500.

The oncologist showed no concern.

Currently on Zytiga, Xofigo and Lupron plus Xgeva very 3 months.

Concerned but have to trust the oncologist.

Anyone else send alkaline phosphate numbers jump that much over a period of 2 months and get any logical answers ?

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There is something referred to as Alkaline Phosphatase "Bounce" that often occurs at the start of Zytiga and is actually a good sign. I wrote another post about that recently. How long have you been on Zytiga and what was your ALP before you started Zytiga? My ALP went up when I started Zytiga, but is now starting to come back down.

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I have been in Zytiga a year.

Just this month did it go up from 74 to 500.

Oncologist is not concerned but I am because of the huge increase!

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