Alkaline phos rising yet symptoms lessing?

[Bluebird11]

My husband began Zolodex close to 2 weeks ago. He's a 13 year Stage IV survivor. His alk phos is increasing and yet after he did the initial Casodex, got the injection of Zolodex, his symptoms are lessening greatly. He has reduced pain meds, sometimes even to the point where an Advil and Tylenol will suffice for 3 hours. He was on Oxy and now on Hydro during the night.

He was needing a patch on his back, his shin bones, he had edema in his legs, all this is not longer needed.

We are so confused because his Alk phos rose. His PSA is on the down trend...Has anyone any thoughts on this. We are having a consultation with two of his doctors tomorrow. I know it's a little early for the Zolodex to show a lot of improvement, but the alk phos jumped about 80 pts.

Could this be an initial flare. We are looking for some explanation since he's feeling SO much better with lessened symptoms.

One more key factor is, the bone specific Alk phos will take about a week to return. This Alk phos is not bone specific that is rising.

Thanks very much for any thoughts on this...

[Bluebird11]

THANK YOU.. yes, this is what we are waiting for. We have two phone consultations with our local oncologist along with our specific prostate cancer oncologist tomorrow. (planned weeks ago- test just came in today) This is the reason for my question today since, we have gone out of the box, risked much, though he's not taken the heavy new drugs since he's extremely sensitive and we are choosing no matter what to live QOL which he has all these years.

Your response is encouraging because this all doesn't make sense.

[Tall_Allen]

Initial flares are common.

[LearnAll]

Initial bounce in ALkPhos scares many people. This is in fact a good sign. In my case, my ALP shot up from 191 to 490 in two weeks after I started taking casodex....but then.it fell down like a rock to 59 and now it is fluctuating between 60 and 75.

If his liver fuction (AST,ALT, bilirubin ) are in normal range then, my above explanation has more strength.

Why this bounce happen? It is because your meds are working well and bones go into a swift healing action causing high bone turnover. (osteoblastic-osteoclastic activity)

[Bluebird11]

I so thank you for these responses. You ALL are my go to. This group has educated me so much and more than that, what can't be measured- comfort, care and knowing what this is like. Whatever the news, and, of course, we want the better news, you've all been there for me, for others, may all the goodness come back to you 1000 fold..

I'll read through these..

and LearnAll his AST, ALT and bilrubin are all within normal range. We postponed our two phone consults until we get the bone specific, though, problem here, and this is for others reading.

I asked for bone specific, though apparently what they gave me was the blood panel alk phos, twice, with this last one bone specific also. They had to send that out.

So when this bone specific comes in, we only have a comparison from our prostate cancer onc. Our local onc we like and he does deal with prostate a lot, but we will have to wait till next month to see another bone specific. At least we will have a current one to measure.

As long as my husband feels better, we can wait. I urge any of the new people to really check to get the right blood work done. Once this Covid lifts and even maybe before we will go back to our other medical center lab. They seem not to have as many glitches in their computer connections. They only found requests from November when we went for this last test!! And we've done 2 in the last month. It's really important to think ahead... check and double check...

I'll keep you posted. Thanks Tall-Allen, LearnAll and Nalakrats... Here's to 'strong health'.. and much more...

[timotur]

ALP can rise for other reasons than PCa activity-- e.g., diet with foods rich in zinc, phosphorus and vitamin B12.

Zinc-Rich Foods

Optimal blood levels of ALP are essential to the maintenance of healthy, strong bones. To evaluate the role of zinc on ALP production and activity, a team of South Korean and Scottish researchers conducted an animal study to measure the effect of zinc deficiency on ALP activity in laboratory rats.

In the findings published in the summer 2007 issue of Nutrition Research and Practice, they concluded that zinc is critical to ensure the levels of ALP production and activity needed to keep bones healthy. Zinc-rich foods include oysters, Dungeness crab, beef, pork, dark-meat chicken and turkey, fruit, yogurt, milk, cashews and baked beans, according to the Linus Pauling Institute.

Fats and Oils

Indian researchers conducted an animal study to determine what effect, if any, the consumption of various vegetable and fish oils had on serum levels of ALP. In an article in the March 2007 issue of Digestive Diseases and Sciences, they reported that the release of ALP into the bloodstream of laboratory rats seems to vary in relation to the makeup of fatty acids in the various oils they tested.

Cod liver oil produces the highest level of ALP secretion in test animals. However, other oils, including corn oil and coconut oil, also help to elevate blood levels of ALP.

Foods High in Phosphorus

Present in every cell of the body and essential to healthy bones, phosphorus makes up 1 percent of the human body's weight, according to MedlinePlus. It also is a key component in the makeup of ALP.

Eating foods rich in phosphorus is essential to maintaining optimal levels of ALP. Such foods include plain nonfat yogurt, skim milk, mozzarella, eggs, beef, chicken, halibut, salmon, turkey, whole-wheat bread, nuts, lentils and carbonated cola drinks, according to the Linus Pauling Institute.

B12-Rich Foods

A 1996 study by South Korean endocrinology researchers underlined the importance of vitamin B12 to the maintenance of healthy ALP levels and activity. Their study, published in the December 1996 issue of Metabolism, concluded that optimal dietary intake of B12 increased ALP production and activity in human bone marrow stromal osteoprogenitor cells and osteoblastic cells.

The Linus Pauling Institute says that foods rich in B12 include clams, mussels, crab, salmon, rockfish, beef, chicken, turkey, eggs, skim milk and brie cheese.

_____________________

[tom67inMA]

It could definitely be a flare or even bone damage healing. I've heard that in people without cancer, if they break or injure a bone, ALP will be elevated during the healing process.

[Newyork6264]

I had an initial rise in Alk Phos also and my Doc said it could be caused by bones healing. A couple of weeks after jump it dropped rapidly.