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bloodwork has us stumped!!!

3greatkids
Posts: 45
Joined: Dec 2005

hello to everyone,
Questions, Questions, Questions, hey who knows, maybe someday we will be as smart as all of you and be the ones answering peoples questions! When Mike went for chemo in March (one week on 3 off, 5fu) they said his blood level (alkaline phosphatase) was higher than it should be. They said that 2 things can cause this to be elevated, one being cancer has spread to the bones and one being it has spread to the liver. They decided to do a bone scan, we got the results back yesterday and all was clear. He has just started chemo again yesterday, and when they did his blood work, once again his blood level was higher this time than last time. Now last time they had done a ct scan and they said that the liver was enlarged but was nothing to do with the cancer. Now because his alkaline phosphotase was higher this time, they are doing another ct scan. I have done so much research on what can happen when this is elevated, and most of the readings say that it is caused from cancer being in the liver or bones. So to say the least, I think all of this has finally caught up to Mike and he is really really scared that perhaps the cancer has spread. We are just trying to find out if there can possibly be another reason why his blood level is elevated, and hoping and praying that it has not spread. The ct scan was done in March, and showed nothing, however at that time the levels were high. I read that it can possibly be caused by scar tissue? When we were at the clinic a few weeks ago, they did an ultrasound and said that there was lots of scar tissue. Anyhow, so sorry to ramble and I hope someone can make sense of this for me, the drs. just say, "we will wait and see when the tests come back", but Mike is slowly slipping into a depression...looking for some answers as to what else may cause this.
Thanks everyone
Sylvia and Mike

Anonymous user (not verified)

You are not at all rambling. I went on and on about this kind of a similar situation for my husband Bert too, but it was with reference to his CEA. While on 5fu/leuc, his CEA never went above 1.5 and held steady for a good six months. When we switched oncologists, even though his diagnosis was stage III, he had 4 positive nodes which placed him at high risk fur recurrence and thus, the new onc added oxilaplatin to the mix. That was January 2004 and his CEA had gone from under 3 in December to 5.1 in January. While on an additional six months of the trio chemo combo, it kept rising steadily...not much, but nevertheless, up. There was one test after another, scans left and right, two separate colonoscopies, you name it, he got it and everything showed NED. By June 2004, his CEA was almost at 9. Chemo was complete and next check up three weeks off chemo CEA was 6.4. Thereafter, 3.6 and thereafter, 1.8. Now, two years post chemo and three years post surgery, CEA is 1.2 and Bert remains NED as of his latest (March 2006) scans. Point here being, ask the old timers...I drove them nuts with my anxiety over these numbers. Sometimes, there are things that effect blood work that cannot readily be explained and we as care givers read more into it than necessary because we can, at times, be even more scared than the cancer patient themself. Do not stop being vigilent by any means and I'm sure, from the sound of things, Mike's oncologist is on top of things. But just take everything one step and a time, trying real hard not to jump to conclusions. For the most part, scans are pretty accurate (not 100%, nothing is) so if all looks well, it probably is. Hold on to that thought.

Best regards,
Monika

houseofclay
Posts: 63
Joined: Nov 2004

Well, I am not sure how much help this will be but here goes...My husband had the same situation (with a couple of additional abnormal levels as well) and after a few CT scans that showed nothing more than a curvilinear line on his liver, he continued with his chemo. We decided that if there was a cancer spread, stopping chemo would cause more trouble. He also had a hepatitis test which was negative. We just waited for something to happen and what eventually happened about a month after chemo was finished, his levels returned to normal and was able to have his ileostomy reversal. So while I don't advocate a "wait and see" attitude for every situation (or even most situations with colorectal cancer), in our case it was the appropriate course of action.

One thing that our radiation oncologist said during this time was "we call it practicing medicine for a reason". As people impacted by cancer, we need to understand what is going on and need to take appropriate steps to do so but on occasion, something unexplained can happen. And it might not be a negative development such as a cancer spread. It might just be that Mike's body is responding to the chemo in a way that the vast majority of patients don't respond. Keep everyone posted!

Andrea

Jen28
Posts: 45
Joined: Nov 2005

I recently finished my 8th treatment of FOLFOX. I follow my bloodwork results and my alkaline phosphatase levels have been getting really high after each chemo. In my case, the level has been going down somewhat by the time of the next treatment. I asked my chemo nurse about it and she told me that the elevated levels are most likely because of the effect of chemo on my liver, but they're not concerned because the levels have been falling back down. I'm going to ask my oncologist about it next week, but the nurse's explanation seemed sensible--chemo can really mess with your body!

If Mike's scans are clear, it may be that the elevated levels are just from the effects of the chemo and not from any spread of the cancer.

Jen

grandma713
Posts: 105
Joined: Apr 2004

Hi, My Alkaline Phospatase has been high off and on during the past two and half years. One visit they are high, next visit they are normal. No other liver panels are abnormal. The last time this happened the drs said it can be caused from a number of things, such as possibly gall stones (which I have), virus, advil, bone fracture etc. The fact that for me these enzymes seem to return to normal within a week, we have not done any follow up. I am a stage I/II with no lymph node involvement. I received no chemo and my CEA's are 1.4 most of the time.

I guess the reason I am telling you all this is to let you know that if all the other liver enzymes are normal there is a good chance this is not about the cancer. Let me know what you hear
Franny

scouty's picture
scouty
Posts: 1976
Joined: Apr 2004

Chemo with a not so great diet can lead to high liver counts, some foods too......

You might want to get Mike to cut back on eating meat, dairy, processed foods, and sugar at least until his liver counts come down (they will). I know that sounds like a lot but he can still eat grains, fruit, veggies, fish, beans and other easily digestable foods.

The key here would be to give his liver as much of a break as he can. Did you know that what your stomach doesn't digest, the liver finishes it up. It is a phenomenal organ and needs spoiling every once in while. Eating fresh fruits and veggies give your tummy and your liver a break while also providing great nutrients. Get him to drink as much water as he can also. To flush the liver and kidneys, he should be drinking half his weight in ounces daily. A pinch of lemon is his water is even better.

Great question......

Lisa P.

tkd3g
Posts: 768
Joined: Aug 2004

I love this place.

I'm going to go get another glass of water!

Barb ( who needs to eat a lot more fruits and veggies!!)

tkd3g
Posts: 768
Joined: Aug 2004

OK, I need to eat more fruits and veggies, cut back on proteins, drink more water, take my supplements and eat my fiber and flaxseed.

So tell me, how do you get out of the house? Graphic here: Between the flatuence and frequent ( make that almost non-stop) bathroom trips, I am afraid to go out. ( might be just as well for the public :) )

I even told my colorectal guy I was REALLY worried that I might have a reoccurence. The gas and frequent ...poohs, mimic my CA symptoms.

Lucky for me it wasn't.

But seriously, does the body correct itself? Will I get past this stage? I never had this problem before while eating so healthy. THen again, I had a rectum and a couple more feet of colon.

Any suggestions?

Barb ( whose daughter said of a recent slip of gaseous wind..."It's ok mom, I'm used to it.")

Ugh.

tkd3g
Posts: 768
Joined: Aug 2004

how did that happen?

See new post, disregard this one.

NanD
Posts: 59
Joined: Mar 2006

Alkaline phosphatase goes up from so many things-but it's good to keep an eye on-if you really want to put your mind at ease about the liver met thing, ask about an MRI just of the liver. That is a more sensitive test than the CT. When I had a shadow on a CT, that's what my oncologist did. Anyway, alkaline phosphatase really is one of those enzymes that can mean a lot or mean nothing. Probably just the chemo...

HowardJ
Posts: 484
Joined: Jan 2005

Hi,

Here's a very good site for understanding lab tests--it has a good explaination of Alk Phos (and all other tests):

http://www.labtestsonline.org/index.html

Howard

KathiM's picture
KathiM
Posts: 8077
Joined: Aug 2005

Thank you SO MUCH, Howard! I have added this to my favorites!!!
Kathi

Betsydoglover's picture
Betsydoglover
Posts: 1256
Joined: Jul 2005

Howard - this is a great site!

I have some veterinary medical background and lots of texts and resources and often find myself looking at those, but of course dogs are not people and people are not dogs. This is the best human understandable lab test site I've seen.

Thanks.

Betsy

HowardJ
Posts: 484
Joined: Jan 2005

I used to be a medical technologist (30 years ago!) and while I remember some of the basic stuff, I don't remember it all. I recently found this site and thought WOW as soon as I read some of the information.

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