ALP back within range

[Benkaymel]

Since my first blood test at the point of diagnosis, my alkaline phosphatase (ALP) has been above range (range = 20 - 150 u/l, readings were between 206 and 220). I assume this is due to having several bone mets.

However, after just 3 months on ADT alone (Prostap), my ALP has dropped to well within range (113). Is this normal/expected or is it wishful thinking that I've done better than average?

[Tall_Allen]

Yes, bone and liver put out ALP. There is a specific test for bone ALP that shows bone met activity.

[Benkaymel in reply to Tall_Allen]

Thanks Allen

[Gl448]

My ALP was a pretty consistent mid-40s from 2019-2021, but then started a rapid climb in the three tests I've had since August, going to 88,128, and 145 this week (normal range 35-144). I've got about a half dozen visible bone mets, so assume they're the cause for the rise.

But mine is climbing despite being on Eligard since August; perhaps just too soon to see a positive impact from the ADT.

If I read it right, smurtaw's link doesn't mention leuprolide drugs as affecting ALP, but other 2nd generation ADT drugs do, so I think Lupron, etc., should have some impact by reducing the met sizes over time.

[Benkaymel in reply to Gl448]

Yes, the paper says that second line HT drugs like Zytiga and Xtandi should reduce tumor load and therefore reduce ALP but ADT like Lupron and Prostap were not discussed. But I would think they should have a similar effect just not to the same degree.

[Gl448 in reply to Benkaymel]

Isn’t that what I said? Glad you agree.

[Benkaymel in reply to Gl448]

Well, you seemed to be saying that Lupron was a second generation hormone therapy drug but maybe I misinterpreted what you wrote. So I was just clarifying what I understood from the paper. I think we do agree.

[Gl448 in reply to Benkaymel]

”but ADT like Lupron and Prostap were not discussed. But I would think they should have a similar effect just not to the same degree.”

That may have been awkwardly phrased. We are saying the same thing.

Cheers!

[Shooter1]

My Alk/phos has climbed before each time I got new mets... everything seems active right now. Alk/phos at 318. And PSA climbing monthly..

[Shooter1]

Well, I don't need ADT acct. having Orchiectomy. Xtandi quit working. In between things right now with Daralutamide ordered slightly off label.. With luck it may help. Dr. says I might get 4 or 5 mo. out of it... we'll see,

[Benkaymel in reply to Shooter1]

I hope the daralutamide works for you, Shooter1.

[Benkaymel]

Thanks Russ, that paper does give me some optimism that things are moving in the right direction.

[Bret5]

Replying to an older post but my PC stage 4 in bones was diagnosed only in last couple months. RP 5 months ago Gleason 10. Surgeon biopsied 12 lymph nodes and bladder neck and all negative but cancer cells escaped apparently. My ALP was 700 range before starting meds in last 60 days, now down to 400 range as of 2 weeks ago at chemo infusion #2. On triple therapy.

I looked back at my annual physical blood work for last 3 years. ALP had been steady at around 60 for several years then 7 months ago went to 120. Even though it doubled, it was still in range so I guess it didn’t jump out at my Doctor. But I think it was probably an early sign that PC had started into bones. Note all liver functions continue normal. It is surprising what we learn AFTER PC develops.