ALP rise after SBRT?

[Steel67]

Hi, has anyone had a rise in ALP after SBRT? My procedure was end of July with ALP of 84 now 103 6 weeks later. PSA rose as they said it might from .057 to .075 not concerned yet about that. Thank you.

[Jpl506]

Yes, mine went from 84 before treatment to hovering around 114 for 3 years post treatment. It has just fallen below 100 within the past 6 months. Drs said it was within the normal range even though it went up so stop worrying. I did. Only paid attention to it when it dropped back down. It

[SimMartin in reply to Jpl506]

actually mine started when I began the hormones just before the radiotherapy rose from my normal mid 70s to 96 now 8 months post RT

[Hidden]

Mine went from 60 to 80, hasn't recovered down yet, been 2 months. Radiation hitting the bones.

[timotur]

Yes, my ALP went from the 70's to about 115 after HDR-BT/IMRT/ADT, and went back to the 70's about a year after treatment ended.

[Steel67]

Thanks brothers- appreciate your input!

[TEBozo]

Mine is 137 and I can't explain why. No bone mets as on 06/15/23 based on a new type of PSMA PET/CT

[Seasid in reply to TEBozo]

Could you request the bone specific ALP?

[maley2711 in reply to Seasid]

are there really two separate tests ?

[Seasid in reply to maley2711]

I strongly believe so.

[maley2711 in reply to Seasid]

sciencedirect.com/science/a...

Here is a reference to the bone-specific ALP test.......apparently a more expensive test that, for whatever reason, some insurers do not cover?

[maley2711 in reply to Seasid]

from that study ...

" Approximately 15 percent of patients with prostate cancer and bone metastases have serum alkaline phosphatase levels within the normal range but 44 percent of these patients have increased bone alkaline phosphatase enzyme values.[3] "

[Seasid in reply to maley2711]

Thanks. My last ALP was 56 (in a normal range). If you dig up more about it I am interested to know more.

[maley2711 in reply to Seasid]

56 should give you great encouragement....of course nota guarantee, as that study pointed out. So it does seem the bone-specific ALP gives a more accurate picture, standard ALP measurement is much better than nothing.

[Seasid in reply to maley2711]

I really hope so that my Mets are still stable and my 0.55 PSA is coming from my prostate which was radiated and I was still capped on firmagon injection despite the fact that my prostate had CRPC but maybe the radiation missed some spots in my prostate or local area of the crpc around my prostate. I would like to have a baseline parametric MRI of my prostate to see what is happening at least for a start.

I didn't have on the psma scan visible Mets and made a decision to debulc my prostate cancer. I am actually an experiment as the standard of care would include abiraterone for 18 month.