Comparison between alk phos bone specific range compared to non specific which would include liver etc.

[Bluebird11]

I have a question about the range comparison between alk phos non specific to alk phos bone specific

I know we have issues with bone mets, and also I'm trying to figure out the comparison to liver ALP1 since liver affecting meds are involved. Anything to educate me would help.

The range of bone specific our prostate onc does is bone specific 7.6-14.9 mcg/L

If I remember the regular alk phos range goes to about the 120s before considered high.

Hepatic ALP1 range is 20-136.. my husband's jumped to 410 in 7 months from 146.

I know his bone specific is moving up.. I'm trying to calculate the ratio between bone specific 105.5 when the high is 14.9

and 500 alk phos when that high is 128 or so. While looking at hepatic our of range 410 when that range is 20-136.

Before we see his doc I want to think about this. He's been on pain meds because of oral surgery, antibiotics, tylenol, advil, not much oxy 1/2 2ml.. twice a day.

We've had not much choice and I know already the tylenol advil situation, though he is now a 15 year survivor diagnosed stage 4, gleason 8, with mets in a number of places in his body, not in organs, and hasn't been on ADT lately, though we are ready to begin again. We know the risks we've taken. My question is more about the ratio comparisons.

He also has extensive osteoarthritis. I'm not dismissing his condition, though we've maneuvered through so much these years and have been extremely cautious evaluating risk reward. We continue to keep his quality of life as our important key.

He's never done chemo and has done spot radiation 2 times. The intermittent ADT has actually helped in his case.

mainly between the bone specific and non specific alk phos. Thanks very much.. I appreciate this group.

[Hidden]

I don't think a ratio between the two is useful since Alkaline Phosphatase is produced in more places than Bone Specific ALP.

Bone Specific ALP is not that valuable for our situation. Alkaline Phosphatase is specific enough for our purposes since a majority is produced in the bones.

A high ALP tells us that in all likelihood we have progression in our bone mets or less likely, liver mets. That's enough information for us to look further and do the tests that matter: imaging. So ALP tells us progression is likely, but imaging is needed to confirm it and determine the specifics.

[Bluebird11 in reply to Hidden]

Thanks gregg57, yes, psa and alk phos have always been indicators, though the difference in our lives was an oral surgery, 3 rounds of antibiotics, and from August to about the beginning of November weaning from a very large dose of oxy .. he had sciatica for 16 months.. we've done something out of the box that after 16 month the sciatica disappeared.

We then had to wean. He couldn't sit in the car for more than 10 min. and now we can travel the couple of hours it takes to doc appts etc...

I have been reading about antibiotics and pain meds along with NSAIDS creating a higher alk phos. And, yes, we are absolutely going to get a scan to see what is happening. He has severe osteoarthritis in the right hip .. something I also saw that can elevate numbers.

The ALP 1 number was in the Hepatic area of the blood work than the ALP Bone Specific.

We are working on it. I like to learn as much as I can. It's not that I'm not trusting our docs because I like them and do. Though in today's world they have 20 min. We don't know the exact reasons why we are 15 years out.. but I can say, we have checked and rechecked risk reward and made many of our own decisions.

I sincerely appreciate your post. Thank you.. This is an amazing site.. Wishes for strong health ....

[tango65 in reply to Bluebird11]

If they are measuring isoenzymes of Alk phosphatase why do you need to calculate a ratio? If the bone isoenzyme is going up in a patient with prostate cancer a scan should be done to determine if there are bone metastases or if previous bone metastases are progressing and it is time to move to other therapies.

[timotur]

Elevated ALP is also associated with osteopenia...

It was established that when testosterone levels are at less than 250 ng/dL, the alkaline phosphatase numbers are progressively higher, signaling that the patient likely has osteoporosis. From this finding, researchers then sought to determine whether or not alkaline phosphatase can be used to monitor a patient's response to testosterone-enhancing therapies.

The answer, in short, is yes, and this finding suggests that men with low testosterone should have an alkaline phosphatase evaluation added as a standard test to assess if treatment is working. If alkaline phosphatase is elevated, further evaluation in the form of a DEXA scan should be performed, Dr. Paduch said.

news.weill.cornell.edu/news...

[Baddawg]

What is his platelet count?

[Bluebird11 in reply to Baddawg]

I believe it is 209

[Baddawg in reply to Bluebird11]

Great! Good bone marrow.

[Bluebird11 in reply to Baddawg]

in days like this... hugs for your beautiful response to me.. may you be blessed with great strong health... YES !!!!!!

[Baddawg in reply to Bluebird11]

God bless!

[Bluebird11]

thanks everyone.. there are a number of grey areas here. we saw our oncologist today.. we are going to test again in 4 weeks.. so much has gone on in the last 4 months... I appreciate your comments...

we will be imaging after that..

such a great site...

[larry_dammit]

A high alkaline phosphate level was the tattle tell that finally told my doctors I had something wrong. (900). I had been running from doctor to doctor and all said something else. My old friend and doctor recommended I do my annual blood work early. Boom there it was