Can anybody point to a study showing Bone alakaline phosphatase to be a marker of bone metastasis in prostate cancer? It would be helpful to have it to get my primary care doc to write me a prescription for such a test since that is needed here. I find studies indicating ALP (not bone-specific) being somewhat of a marker, and I found one study on Bone ALP as a marker in the case of gastric cancer, but it would be stronger to have a study relating Bone ALP to prostate cancer.
BMC Cancer. 2016; 16: 385.
Published online 2016 Jul 4. doi: 10.1186/s12885-016-2415-x
PMCID: PMC4932725
PMID: 27377907
Bone alkaline phosphatase as a surrogate marker of bone metastasis in gastric cancer patients
Sun Min Lim, Youn Nam Kim, Ki Hyun Park, Beodeul Kang, Hong Jae Chon, Chan Kim, Joo Hoon Kim, and Sun Young Rhacorresponding author
Written by
Purple-Bike
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There are many other articles which indicate the assessment value and prognostic value of bALP.
BALP is the accurate measure of Osteoblastic activity at any given point of time.
The real reason insurance companies do not easily allow this test is that bALP costs 3 times as much as total ALP.
Explain to your PCP that the bone ALP portion is that part of Total ALP which reflects only bone issue whereas Total ALP includes bone, liver and intestine fractions...and therefore..is not accurate.
Yes, Approximately....IF your liver is perfectly normal. In healthy person with normal liver and intestine, the bone portion is about 30 to 40 % of total ALP.So Total ALP being a cheaper test, Insurances are fine with this....and doctors will GUESS based on 40% value of total ALP.
For example, based on my past bALP readings, I know that my bone fraction is about 20% . So sometimes I do total ALP and calculate 20% and consider it bALP. Last week, my total ALP was 44 so 20% (in my case) comes 8.8... And that becomes my approximate bALP.
Taller men with bigger and heavier bones, bALP tends to be higher than men like me who are 5'6" tall and have less overall skeletal area. So make that provision too when assessing.
Bone ALP: Up to 20 mcgm/L is usually considered normal. When you have growing bone mets, your bones are churning out more and more Alkaline phosphatase....this indicates that bone is getting corroded and it is trying to repair itself.When normal degree of repair is happening, Bone ALP remains below 20 mcgm/L.
If bALP is very high ,say 84 mcgm/L , it means there are growing bone mets releasing a lot of bALP.
Finally I managed to get a bone-ALP. It came to 19 micrograms per liter, just below the 20 mark. My total ALP came to 102 IU/L. I cannot find any conversion table to figure out the percentage of bone ALP. Do you have any idea?
Bone ALP of 19 mcg/L indicates that the bone corrosion and consequent repair is going on at normal speed. Meaning bone repair is going on just like the person who does not have osteoblastic (sclerotic) lesions due to prostate cancer.Its a good news .Bone mets are dead at least for now. Needs monitoring of ALP /BALP to keep track if any thing changes in future.
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Sclerotic bone lesions are these a metastasis?
Question on Alkaline phosphatase 
