Alkaline Phosphate has increased from 106 iu/L to 160 in the space of 4-weeks. Currently on Enzalutamide (Xtandi) and Quarterly Pro Stap

[lcfcpolo]

Hello. My PSA appears to have reached it's nadir at 0.07 for the past 4 weeks (nope, I am not James Bond alas) but my Alkaline Phosphate has increased by 66% in the last 4 weeks. Not due to speak to my Oncologist until July. Is this something to be concerned about? Any help or thoughts gratefully received - thank you in advance.

[Tall_Allen]

It may be due to liver toxicity from something you are taking. Email your oncologist.

[lcfcpolo in reply to Tall_Allen]

Thank you. I have left a message.

[LearnAll]

Please check Bone specific alkaline phosphatase and liver enzymes (AST and ALT) The results will tell what may be going on. Do not wait till July for Onco appt.

[lcfcpolo in reply to LearnAll]

Thank you. Will do.

[timotur]

My ALP went from 75 to 120 over the course of 18 months on ADT/Lupron and PSA <0.01 for the majority of that time. Now it has normalized under 100 six months after stopping ADT with PSA:0.05 and T:600. Uro had no explanation. I chalk it up to the SE’s of ADT and low-T.

[lcfcpolo in reply to timotur]

Thank you. Hopefully the same for me.

[lcfcpolo]

Thank you. Yes will do.

[timotur]

Forgot to mention, my RO said “I won’t even ask you about bone pain since your PSA is so low”, and indicated he didn’t consider ALP as a meaningful indicator for bone mets at ultra-low PSA. However, you may consider a PAP test, which some Drs consider a proxy for bone met activity (it was the precursor to PSA testing). I believe ULN is 2.0, and over 5.0 is suggestive of bone met growth.

[lcfcpolo]

Thank you. Really helpful again. I will ask away. Currently only get some back pain from certain activities but mainly ok.