High Alkaline Phosphatase on blood test

[Oatmeal2]

Good Morning

My husband was diagnosed with Gleason 9 in July 2023 with PSMA showing questionable node in pelvis. He had 26 rounds of IMRT whole pelvis radiation in November and December 2023 and has been receiving monthly Firmagon injections. Monthly blood tests have been good with PSA less than .05 and testosterone usually around 20. The last blood test showed the alkaline phosphatase reading at 178 higher than the 130 cut off for normal. Previous results at beginning of January and December were slightly elevated at 140. The doctor has scheduled a retest in a week. Husband is very worried now about what it could mean. I’m worried it could mean that there is spread to bone. Since PSA has not increased what other factors could cause an increase? Thank you in advance for any insight.

[Sunnysailor]

I am sorry you are dealing with this. They typically do multiple blood tests when alkaline phos is high. There’s another blood test called GGT that can help see if it’s bone or liver related.

If it’s high again would request another PMSA scan. Pray for good results.

[103532 in reply to Sunnysailor]

This is an issue that worries me too . Did your husband have a meal before the blood was drawn? Though fasting is not required, liver activity can increase ALP. I noticed my husband has a higher reading if he tests after eating. He waited four hours after a meal before his last test and the ALP was lower. I researched there is a connection to liver physiologic activity of processing digestive materials from recent food, supplements and prescriptions. I am praying everything is ok for your husband..🙏

Stephanie

[Oatmeal2 in reply to 103532]

Thank you for your prayers. Yes he had a small amount of oatmeal and coffee about 2.5 hours before the test.

[Xavier10]

ADT typically raises Alkaline Phosphatase reading. Mine went up about a third when I was on ADT. But it did not go to the high level. So perhaps take your baseline and add a third and see where that puts you. It is called ALP Flare. You may not have a pre-diagnosis reading to compare it to but if you do you take the high reading and divide by the pre-diagnosis reading to see if it is 1.33 or above. mine was right at 1.34, but I can't say that it was technically pre-diagnosis. they like under 1.33 for prognosis.

[Tall_Allen]

"Since PSA has not increased what other factors could cause an increase?" Liver toxicity

[BigJ32]

have the same issue, my MO told me, Lupron will do that but sometimes not right away. I’ve been on it for a year and a half, and it spiked. MO was not concerned, looked into it, and a study shown 60% had elevated reading at the 1-2 year mark.

[larry_dammit]

oh my, he has a right to be worried, the high alkaline Phosphate is how they caught my advanced cancer. The urologist had me on Avadart which kept the PSA reading low so he missed all the markers of advanced cancer. Find a good oncologist and lose the urologist, mine was stage 4 when they found it

[Oatmeal2 in reply to larry_dammit]

Thanks, he is still seeing the oncologist so that’s why he’s redoing the test next week and probably some others so we will see what that shows.

[dhccpa]

Lupron seemed to raise mine during the first year (2019) but then it began to decline steeply. Now about 25. I've also been on a quarterly denosumab shot (120 mg) since Jan. 2020.

[petrig]

In August 2023 my P-AFOS was 2621 U/I .Pathological bones throughout. Bones full of sclerotic foci.So I think 140 propably is not so fatal.Maybe check the liver.🤞