Elevated alkaline phosphatase, what next?

Kittycat15
Kittycat15 Member Posts: 8 Member
edited February 2023 in Breast Cancer #1
I finished chemo on Jan. 29, 2010 and have been receiving Herceptin every 3 weeks. All has been going fine until 3 weeks ago when I had some blood work done and my alkaline phosphatase was elevated. It was normal last August when I first started chemo but then when checked in May it was higher, then higher still in August and higher again when checked on Sept. 7. Normal is up to 110 and mine is 123. My oncologist has ordered a bunch of blood work and I'm scheduled to have a bone scan and CT of abdomen and pelvis on Thursday of this week. I'll be talking to him on Friday about the results. He said this could mean either liver disease or cancer spread to bones. My breast cancer was HER2 positive and ER/PR negative, stage 2, lymph nodes were all negative. Needless to say I'm scared! I am supposed to be done with Herceptin in November and now this.

I have no symptoms of either liver disease or bone pain, but everytime I feel an ache or pain I wonder if it's a sign of cancer spread to the bones! My liver function tests were all normal except for the alk phos. Anyone have any experience with this? If it would turn out to be bone cancer what would happen next?

I put my wig away in July and have been really enjoying having my hair back, and now this. Drats!

Kitty

Comments

  • winsomebulldog
    winsomebulldog Member Posts: 117 Member
    Praying it is just a phase
    Praying it is just a phase and not an indication of something bad.

    I'm in the same boat as you: hormone neg, her2 pos, stage 2, no lymph involvement. I'm just starting my chemo, going for my second a/c treatment tomorrow. When I finish them, I'll do taxol + herceptin for 4 courses, then herceptin for another 11 months.

    I will keep you in my prayers, Kitty. Stay strong!

    Blessings,

    Jenn
  • carkris
    carkris Member Posts: 4,553 Member

    Praying it is just a phase
    Praying it is just a phase and not an indication of something bad.

    I'm in the same boat as you: hormone neg, her2 pos, stage 2, no lymph involvement. I'm just starting my chemo, going for my second a/c treatment tomorrow. When I finish them, I'll do taxol + herceptin for 4 courses, then herceptin for another 11 months.

    I will keep you in my prayers, Kitty. Stay strong!

    Blessings,

    Jenn

    they need to check, but
    they need to check, but hopefully its just a reaction to the chemo. My LFTs were elevated during chemo, one doc said i should be rescanned. I said I just had a scan a month ago, it grew that fast??? my other doc said it was too soon, turned into just my reaction to chemo. Try not to look too far ahead and take it one day at a time, Right now all you know is you need tests, so here's praying those tests are all negative!!! which is possible, hold onto that.
  • cahjah75
    cahjah75 Member Posts: 2,631
    Kitty
    I couldn't believe it when I read your post. I spent 1 hour looking online tonight about elevated liver function tests. My rheumatologist sent me for blood work right after I had surgery for bilateral mastectomy. The numbers were elevated then. I had an ultrasound that only showed some sludge in my gall bladder. The liver looked ok. 2 weeks ago my oncologist sent me for a PET scan and it was clear except for small nodes in each lung. Last week I had more blood drawn and my ALT is 58 (10-40 normal) and my Alk phos is 174 (38-126 normal). This is freaking me out. I see my PCP dr Wednesday and plan on asking him questions. I see my oncologist next Tuesday and will definitely ask him about it. I've recently regained 25#s from stress and chemo drugs. I hope I get some answers. I'm ER/PR+ and Her2-. Because I have osteoarthritis and lumbar spinal stenosis I have considerable bone pain (Neulasta shot increases it). Please let me know how you make out and if you get some answers.
    {{hugs}} Char
  • Marsha Mulvey
    Marsha Mulvey Member Posts: 597 Member
    cahjah75 said:

    Kitty
    I couldn't believe it when I read your post. I spent 1 hour looking online tonight about elevated liver function tests. My rheumatologist sent me for blood work right after I had surgery for bilateral mastectomy. The numbers were elevated then. I had an ultrasound that only showed some sludge in my gall bladder. The liver looked ok. 2 weeks ago my oncologist sent me for a PET scan and it was clear except for small nodes in each lung. Last week I had more blood drawn and my ALT is 58 (10-40 normal) and my Alk phos is 174 (38-126 normal). This is freaking me out. I see my PCP dr Wednesday and plan on asking him questions. I see my oncologist next Tuesday and will definitely ask him about it. I've recently regained 25#s from stress and chemo drugs. I hope I get some answers. I'm ER/PR+ and Her2-. Because I have osteoarthritis and lumbar spinal stenosis I have considerable bone pain (Neulasta shot increases it). Please let me know how you make out and if you get some answers.
    {{hugs}} Char

    kitty
    Don't blame you for being scared, but don't let this consume you. Until you get through the diagnostics, stay positive! Please keep us posted and best wishes.
    Marsha
  • greyhoundluvr
    greyhoundluvr Member Posts: 402
    Kitty -
    I know that you are scared but try to hold on until you get all the answers. From what I understand, elevated alk phosphatase can also mean nothing at all especially with all of the other liver function tests being normal (my daughter, grandson and I all had elevated alk phos levels back before cancer came into the picture). We were told then that anything that stresses the bones can cause this test to rise - losing calcium from drugs or low vitamin levels, gaining calcium, etc. I think one of darnedest parts of this disease is that every thing that crops up brings up a "what if" scenario in our minds and the doctor's minds. There's no way around this but I will keep sending you positive thoughts and prayers that this turns out to be nothing more than a temporary glitch in your lab work.
  • Kittycat15
    Kittycat15 Member Posts: 8 Member

    Kitty -
    I know that you are scared but try to hold on until you get all the answers. From what I understand, elevated alk phosphatase can also mean nothing at all especially with all of the other liver function tests being normal (my daughter, grandson and I all had elevated alk phos levels back before cancer came into the picture). We were told then that anything that stresses the bones can cause this test to rise - losing calcium from drugs or low vitamin levels, gaining calcium, etc. I think one of darnedest parts of this disease is that every thing that crops up brings up a "what if" scenario in our minds and the doctor's minds. There's no way around this but I will keep sending you positive thoughts and prayers that this turns out to be nothing more than a temporary glitch in your lab work.

    Thank you!
    Thank you all for your kind words of encouragement. What you all say makes so much sense and you were very informative too! I really have to focus on just what I know and need to do right at this time - get the tests done and then move on to the next step of finding out the results and what, if anything, I have to do next. I sometimes get too ahead of myself!! Bad habit LOL. This week I've been so busy at work that I hardly have time to think about it. That's a good thing. As you all know, we go through so much with this BC stuff that when something comes up we wonder - can we handle more?? Somehow we do and just keep looking forward. I will be sure to let you know what the results are. Thanks for all the prayers!!!

    TTFN,
    Kitty
  • cahjah75
    cahjah75 Member Posts: 2,631

    Thank you!
    Thank you all for your kind words of encouragement. What you all say makes so much sense and you were very informative too! I really have to focus on just what I know and need to do right at this time - get the tests done and then move on to the next step of finding out the results and what, if anything, I have to do next. I sometimes get too ahead of myself!! Bad habit LOL. This week I've been so busy at work that I hardly have time to think about it. That's a good thing. As you all know, we go through so much with this BC stuff that when something comes up we wonder - can we handle more?? Somehow we do and just keep looking forward. I will be sure to let you know what the results are. Thanks for all the prayers!!!

    TTFN,
    Kitty

    Kitty
    My onco nurse today said Tylenol can do it. I've been taking Tylenol the weekends after my Neulasta shot. I see my PCP tomorrow and look forward to hearing what he has to say.
    Char
  • Kittycat15
    Kittycat15 Member Posts: 8 Member
    cahjah75 said:

    Kitty
    My onco nurse today said Tylenol can do it. I've been taking Tylenol the weekends after my Neulasta shot. I see my PCP tomorrow and look forward to hearing what he has to say.
    Char

    Got results
    Today I got the results of my bone scan and my CT of abdomen and pelvis - both were negative for metastatic cancer!!!! Hooray! My liver did show some sort of scar and the oncologist wants to review the films to get a better look. He said we can talk about it at my next appointment with him which is on Oct. 1. Overall very good news and I can breathe a sigh of relief.

    Kitty
  • carkris
    carkris Member Posts: 4,553 Member

    Got results
    Today I got the results of my bone scan and my CT of abdomen and pelvis - both were negative for metastatic cancer!!!! Hooray! My liver did show some sort of scar and the oncologist wants to review the films to get a better look. He said we can talk about it at my next appointment with him which is on Oct. 1. Overall very good news and I can breathe a sigh of relief.

    Kitty

    kitty that is awesome news.
    kitty that is awesome news. big sigh of relief! congratulations.
    I forgot about the tylenol did not take it when my LFTs were elevated.
  • Katz77
    Katz77 Member Posts: 598

    Got results
    Today I got the results of my bone scan and my CT of abdomen and pelvis - both were negative for metastatic cancer!!!! Hooray! My liver did show some sort of scar and the oncologist wants to review the films to get a better look. He said we can talk about it at my next appointment with him which is on Oct. 1. Overall very good news and I can breathe a sigh of relief.

    Kitty

    Yipee
    Sighhh of relive. Keep updating on labs. Happy so far so good. Katz
  • Marsha Mulvey
    Marsha Mulvey Member Posts: 597 Member
    Katz77 said:

    Yipee
    Sighhh of relive. Keep updating on labs. Happy so far so good. Katz

    thumbs up
    These results certainly get a thumbs up! Good luck on 10-1.
    Marsha
  • mikerey
    mikerey Member Posts: 1 *

    Hello Kittycat15, after reading this older post I saw similarities to my own situation. I hope you are well and that things are better for you. My alkaline phosphate generally runs 200 up to 240 and ALT is 54 so a little high. I was on a nuclear submarine and was exposed to ionic radiation. At least 2 guys maybe 3 that were on the very same sub contracted Myeloid Leukemia. We all had radiation burns on our arms and legs that worked near the reactor. Plus right after I got out I had a host of body changes like choking on food, skin problems etc. My bones always hurt and just not sure what to think. Thankfully the head of Rheumatology noticed what I’ve seen for years is this elevation in especially Alk Phos is concerning so after my next blood test will be looking deeper if still elevated. Which is likely the case since it’s been so for years. I also have Sarcoidosis which also I find interesting. I had lived near a neighbor who also had it. He told me, him being half Japanese, said his grandmother contracted cancer. She being near Hiroshima when the bomb went off is what a doctor told him his Sarcoidosis originated from. I put two and two together. Realizing that I was near radiation ☢️ as well and now clusters grow in my lungs (sarcoidosis) as well as he. Kinda makes sense and I don’t have to be a doctor to see the similarities. All the best to you, Mike