Metastasis with no elevated WBC, or other markers?

[sm60]

Just curious. Is this possible?...typical?...probable?...unlikely?...impossible?

Thanks in advance.

[sm60]

Anyone?

[sm60]

Thanks for the info. Any idea how common it is to have anything beyond very minuscule mets without any markers? Is there any reading/links on this topic you know about? Thanks in advance.

[sm60]

Yes. That I knew. What I would like to know is if it is common to have no markers for mets beyond the level of these micros. TIA....

[noahware]

I would think it's possible, but probably not typical. The "typical" PC metastasizes to the bone, and so progression would raise ALP levels (specifically the BAP component of ALP).

An elevated ALP does not mean bone metastasis, but the advance of bone metastasis would usually mean an elevated ALP.

Personally, I think a very high PSA and/or a very high Gleason means that when in doubt, assume metastases, even if not yet at a clinically significant point of the disease shooting serum markers out of "normal" ranges.

[sm60 in reply to noahware]

Thanks. Very helpful.

[sm60 in reply to noahware]

Do you what the language for the lab request would be to request those two numbers? TIA....

[COOP8 in reply to sm60]

ALP is Alkaline Phosphatase. My husband has mets to bones and ALP is one of the main things we look at to see if there’s any activity. It’s on the Comp Metabolic Panel bloodwork. His WBC was high at diagnosis, and he had elevated PSA and ALP.

[sm60 in reply to COOP8]

Just had that number done up! I'm a 55 on their "normal" scale of 38-126, so I guess that's encouraging. All the best and GOD BLESS to you and your husband.

[COOP8 in reply to sm60]

That’s good news! My husband has been over 200 at times. We’re just happy when his falls in the normal range!

[Tall_Allen]

No elevated WBC is common. No elevated PSA is uncommon, but possible with certain anaplastic forms.

[SalishSoul in reply to Tall_Allen]

My husband did not have elevated psa and did not have elevated wbc. That was change to nepc.

[sm60 in reply to SalishSoul]

Oh my. So sorry. THAT is so scary.

[Avanat]

Possible, yes but I don’t know how common. My husband was diagnosed last April with Stage IV, Gleason 9, multiple mets and lymph nodes yet no elevated WBC. In fact, I looked back at his results and they were only elevated once since April 2020 and that was in August when it was barely elevated. He did the genetic testing and has no genetic abnormalities. We really are all just statistics of one.

[sm60 in reply to Avanat]

Amazing. (AND SCARY) Thanks so much for the info! God bless and keep you and your husband!

[Avanat]

I forgot to mention his PSA was only 3.8 when he was diagnosed. As of May, his PSA is now .04. This disease is so different for each man. Good luck to you on your diagnosis & treatment.

[sm60 in reply to Avanat]

.04!!! Awesome, and congrats!! Yes, I agree. That is why "cookie cutter" "medicine" can be SO frustrating.

[sm60]

Fascinating, that with all the "advances" in Western medicine that we still haven't been able to identify a single marker that might stop or delay invasive techniques, fat billings and "therapies."