What is the significance of high ALP in advanced prostrate cancer patients?

[Rahul_Patel]

My father has been diagnosed with advanced metastatic prostate cancer.

Gleason score-9

PSA-310

ALP-2100

What is the significance of this high ALP in terms of his prognosis?

[Magnus1964]

I could mean the cancer has spread to the bone.

[Rahul_Patel in reply to Magnus1964]

Yeah actually it has spread to the bones.

I was curious about the problems caused by very high ALP.

After two rounds of chemo it has decreased to 1100.

[noahware]

The high ALP is just confirming the bone mets, which I presume have already been found with scans? The initial PSA and ALP at diagnosis are not going to tell you with any certainty, in advance, about how he responds to successive treatments. What is the current treatment plan?

[Rahul_Patel in reply to noahware]

Orichtectomy has been done.

Right now my father is going through chemo.

9 rounds of chemo has been scheduled.

He has already completed two chemo sessions.

ALP has come down to 1100 from a high of 3063.

Was curious about effect of high ALP on bone health.

[Tall_Allen]

Two sources - bone metastases and liver. You can get bone-specific ALP to determine which.

[Rahul_Patel in reply to Tall_Allen]

Orichtectomy has been done.

Right now my father is going through chemo.

9 rounds of chemo has been scheduled.

He has already completed two chemo sessions.

ALP has come down to 1100 from a high of 3063.

Was curious about effect of high ALP.

[Tall_Allen in reply to Rahul_Patel]

It is a biomarker. It has no effect.

[Rahul_Patel]

Yes two rounds of chemo has been completed and ALP has come down to 1100 from a high of 3063.

[Jost-58]

I started with over 2000 in November 2018. I am at between 50 and 60 now. The chemo made the dramatic decrease for me. Now Zytiga hold my PSA on low level, Not undetectable but on 0.4 level the last year.

[Herman_PSA_OK in reply to Jost-58]

Did your MO start you on Xgeva as your ALP increased that high? Did you feel any bone pain and has your bone pain decreased as your numbers dropped? Thanks for the feedback.

[Jost-58 in reply to Herman_PSA_OK]

No Xgeva . I take pills Ibrandonate. One pill every day.

[Jost-58 in reply to Jost-58]

No pain now. Had paint on several places 2 years ago.

[Herman_PSA_OK in reply to Jost-58]

I learned something new today. I looked up the Ibrandonate for your bones you are taking. I was not familiar with the drug name. It's the generic drug name for Boniva which I'm sure everyone has heard. I remember the Sally Fields ads. Looks like she was on it.

Interesting that it comes in both pill form (3 tablets/month) and also injections. Wow! The monthly 3 tablets pill form is only $21.88/month dose compared to the Xgeva cost to Medicare must be significant. You would think they do the same thing to slow calcium loss from the bones for those at risk for bone loss and potential bone fractures due to ADT side-effects. Thanks Jost-58!

[Cheerr]

It usually means the disease is spread to the bones. (Widespread skeleton metastasis). There could be a possible bone marrow invasion with such high levels. But none the less, do not worry looking at the high numbers. Focus on the treatment and results. A reduction to 1100 is good, the treatment is working so far. With further cycles it will mostly come down a lot more.

[Rahul_Patel in reply to Cheerr]

Thank you Cheerr 😀.

Hoping to see reduced ALP number after upcoming chemo sessions.

[j-o-h-n]

How Alkaline Phosphatase Relates to Cancer

Prostate cancer, when it spreads beyond the prostate, usually moves to the bones. The bones of the pelvis and spine are some of the most common areas prostate cancer spreads to. When prostate cancer or another cancer moves to the bones, bone, and tissue in the cancerous areas break down and release increased levels of alkaline phosphatase into the bloodstream.

Measuring how much alkaline phosphatase is in your blood can, therefore, help your doctor determine whether or not prostate cancer has spread to the bones.1

An elevated level of alkaline phosphatase does not necessarily mean that your cancer has spread to your bones. There are numerous other causes of a high alkaline phosphatase, but in a man already diagnosed with prostate cancer, a rising alkaline phosphatase is a worrisome sign.

A high alkaline phosphatase cannot tell your doctor that your prostate cancer has definitely spread to the bones. Bone scans, CT scans, and other diagnostic tests are needed for this.

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 04/01/2021 9:54 PM DST