Alkaline phosphate level

[phelie]

How does the alkaline phosphate level relate to advanced prostate cancer? My husband , 67 years old,. Diagnosed 8/16 with metastatic prostate cancer. Skull mets, cranial nerve damage, just started zytiga one month ago. His alkaline phosphate level is 305.

[jimhagood]

Like PSA, alkaline phosphate (ALP) is considered a tumor marker for mets PC. ALP is specific to discerning generalized bone metastasis. PSA, ALP, and bone scans together enable us to determine the efficacy of ADT and other therapy intended to slow or halt the rate of metastasis. In the case of ALP we attempt to discern the rate of bone metastasis. I hope this is of help to you. The very best to you and your husband.

[phelie in reply to jimhagood]

Thank you!

[Tall_Allen]

Bone alkaline phosphatase (ALP) increases markedly when there are active bone mets - 305 is high, indicating active bone mets.

[phelie in reply to Tall_Allen]

Thank you for responding. I'm interested in what others levels are?

[ctarleton in reply to phelie]

Over 4 years ago at age 65 when I was first diagnosed very metastatic to many bones and lymph nodes and with a PSA of 5,006 my Alk Phos was 424. After starting ADT with Lupron my Alk Phos dropped to the range of 50-55 within around 6 months as my PSA went down to a nadir of 1.0. As primary ADT stopped working and my PSA eventually rose to around 95 around 16 months ago, my Alk Phos rose again to around 80. After I went on added Xtandi my PSA dropped to a nadir of 1.2, with an Alk Phos around 30. Latest PSA was 2.0 with an Alk Phos of 22. (I've also been on the bone agent Zometa (zoledronic acid) the entire time, approximately monthly for the first 2+ years, then every three months, and more recently every 4 months.) My response/numbers may not be typical, and just biological luck of the draw. "Individual mileage may vary."

Charles

[phelie in reply to ctarleton]

Thank you for that information

[pjoshea13 in reply to phelie]

My ALP was below the normal range when a met was found at L5. So I guess the L5 met wasn't very active.

And yet, after I had radiation on L5, my PSA dropped by two-thirds.

-Patrick

[Hidden]

When my partner was diagnosed his was 847

[phelie in reply to Hidden]

How is he now?

[Hidden in reply to phelie]

Hi Phelie, unfortunately he passed away in October 17. He was just 44. When diagnosed (Dec 16) it was stage 4 and already in ribs, pelvis, hips, legs and skull to name a few. He also had a bleed on the brain. Once this was stable he had upfront chemo and hormone injections ans this reduced his psa to 18, but that is as low as it got. It was very aggressive and just took over very quickly. His ALP did get up to 3833. So this indicated a lot of disease in the bones. I wish your husband well.

[phelie in reply to Hidden]

I am so sorry for your loss . How terrible for you both. My husband also has Mets to the skull and finished 14 radiation treatments to the skull in March. He is having a lot of pain now even on Zytiga. Thank you for your response

[Hidden in reply to phelie]

Thank you. I hope they get on top of his pain, I know this is also very difficult time for you as well, having to watch your loved one suffer. Has he always been on Zytiga ? Is he on any other treatment ? Take care of yourself

[phelie in reply to Hidden]

He started zytiga sbout 6 weeks ago. Also gets injections iofLupron and Xgeva every 3 months. Taking Tylenol with codeine for pain. Has cranial nerve damage to the left side so mouth droops (must drink thru a straw) and left eye will not shut so needs ointment in it .

[MelaniePaul]

I thought ALP is the marker for liver tumors? Am I wrong here?

Mel.

[phelie in reply to MelaniePaul]

From what I’ve read it can mean disease in the bones or in the liver.

[PhilipSZacarias]

Alkaline phosphatase is associated with many tissues and therefore only a general indicator of activity on the bones. To know whether bone activity has changed the various "isoforms" have to be differentiated. My oncologists don't seem to follow this parameter that much.

[PhilipSZacarias]

Looks like there is some controversy here...need to perform a more in depth review.

[ontheroad589]

I also have extensive bone mets. My current Alk Phos is 666, been over 850 in January. Currently on round 6 of Docetaxel, second time around. Currently getting Zometa every 6 weeks, lupron every 13 weeks. Also on prednisone 10mg per day.