alkaline phosphatase trending up....significance??

peterz54
peterz54 Member Posts: 341
edited April 2012 in Colorectal Cancer #1
haven't got a straight answer on this from Onc...

My wife, who is stage IV with significant liver mets, has been on FOLFOX w/avastin since December, having just completed her 10th treatment. two to go, then possible colon surgery.

I noticed her alkaline phosphatase has been steadily trending up for last 2 months. came down initially, falling to below 140, now at 240. from what I gather this is not a good thing at it may indicate disease progression - tumors becoming unresponsive to chemo. prior to this period her CEA bottomed at about 300 but then rose to 500 for last two visits. late March PET/CT did see indications that colon tumor has become more active while liver mets are still responding to chemo....

thoughts?

Comments

  • John23
    John23 Member Posts: 2,122 Member
    #2
    alkaline phosphatase
    alkaline phosphatase

    "Many drugs affect the level of alkaline phosphatase in the blood.
    Your health care provider may tell you to stop taking certain
    drugs before the test. Never stop taking any medicine without
    first talking to your doctor. Drugs that may affect the ALP level
    may include:

    •Allopurinol
    •Antibiotics
    •Birth control pills
    •Certain diabetes medicines
    •Chlorpromazine
    •Cortisone
    •Male hormones
    •Methyldopa
    •Narcotic pain medicines
    •Nonsteroidal anti-inflammatory drugs (NSAIDs), used for arthritis and pain)
    •Propranolol
    •Tranquilizers
    •Tricyclic antidepressants

    Higher-than-normal ALP levels may be due to:

    •Biliary obstruction
    •Bone disease
    •Eating a fatty meal if you have blood type O or B
    •Healing fracture
    •Hepatitis
    •Hyperparathyroidism
    •Leukemia
    •Liver disease
    •Lymphoma
    •Osteoblastic bone tumors
    •Osteomalacia
    •Paget's disease
    •Rickets
    •Sarcoidosis
    --------
    •Alcoholic liver disease (hepatitis/cirrhosis)
    •Alcoholism
    •Biliary stricture
    •Gallstones
    •Giant cell (temporal, cranial) arteritis
    •Multiple endocrine neoplasia (MEN) II
    •Pancreatitis
    •Renal cell carcinoma"
    From: MedlinePlus

    Having any irregular readings at any time, should invoke some
    research into the medications that one may be taking. All too
    often a medication (or combination of medications) will produce
    side effects that can greatly skew blood tests, etc.

    Perhaps your oncologist already is aware of the problem,
    and is the reason he doesn't feel too concerned? He should
    really explain that to you, however..

    Best of health,

    John
  • PhillieG
    PhillieG Member Posts: 4,866 Member
    #3
    A Bit More Info
    John posted some very good info. Here's a link that may have a bit more information.
    Just reviewing my test results going back to 2006, I've always been in the 100-150 range,
    even during growth spurts.
    I did see this in my results: Note: New reference range as of April 28 2009.
    Not sure what the change was and if it was universal or what...
    -Phil
  • peterz54
    peterz54 Member Posts: 341
    #4
    PhillieG said:

    A Bit More Info
    John posted some very good info. Here's a link that may have a bit more information.
    Just reviewing my test results going back to 2006, I've always been in the 100-150 range,
    even during growth spurts.
    I did see this in my results: Note: New reference range as of April 28 2009.
    Not sure what the change was and if it was universal or what...
    -Phil

    Neulasta connection
    Phil, your link mentioned bone activity as being connected to ALK. My wife has been getting neulasta shots to increase a type of white blood cell to guard against infection. I am speculating that this could be at least part of the reason for the increase. pete
  • PhillieG
    PhillieG Member Posts: 4,866 Member
    #5
    peterz54 said:

    Neulasta connection
    Phil, your link mentioned bone activity as being connected to ALK. My wife has been getting neulasta shots to increase a type of white blood cell to guard against infection. I am speculating that this could be at least part of the reason for the increase. pete

    Hi Pete
    I hope that's it Pete, that certainly sounds possible. So many things like meds can affect it.
    That link is connected to my lab results page that Sloan Kettering posts for me online. I don't know if that necessarily makes it a more reliable resource but if it was giving incorrect info I'd like to think they would have fixed it by now...
    -p
  • have2believe
    have2believe Member Posts: 134
    #6
    peterz54 said:

    Neulasta connection
    Phil, your link mentioned bone activity as being connected to ALK. My wife has been getting neulasta shots to increase a type of white blood cell to guard against infection. I am speculating that this could be at least part of the reason for the increase. pete

    I hope it's the neulasta
    I've learned that on the internet you can find tons of info to reassure you that it's nothing, and just the opposite, tons of info to scare you half to death. I'm really hoping it's nothing. Hang it there. Hugs.

    L
  • peterz54
    peterz54 Member Posts: 341
    #7
    have2believe said:

    I hope it's the neulasta
    I've learned that on the internet you can find tons of info to reassure you that it's nothing, and just the opposite, tons of info to scare you half to death. I'm really hoping it's nothing. Hang it there. Hugs.

    L

    internet - nothing and everything
    which is why I rely most heavily on the NIH library of medicine and trying to be thorough and not cherry pick when gathering information. much research points to ALK levels as a siginificant prognostic indicator.

    thanks for your support...
  • pepebcn
    pepebcn Member Posts: 6,331 Member
    #8
    peterz54 said:

    internet - nothing and everything
    which is why I rely most heavily on the NIH library of medicine and trying to be thorough and not cherry pick when gathering information. much research points to ALK levels as a siginificant prognostic indicator.

    thanks for your support...

    Pete have nothing on my liver since nearly 3 years ( thanks God)
    But my ALK levels are in the 400/500 since I was operated of liver, as well every time I go back to chemo, then it can rise up to 800!.Liver doc is not concerned at all.
    Hope it helps.

Discussion Boards