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alkaline phosphatase trending up....significance??

peterz54's picture
Posts: 345
Joined: Feb 2012

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....


John23's picture
Posts: 2140
Joined: Jan 2007

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:

•Birth control pills
•Certain diabetes medicines
•Male hormones
•Narcotic pain medicines
•Nonsteroidal anti-inflammatory drugs (NSAIDs), used for arthritis and pain)
•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
•Liver disease
•Osteoblastic bone tumors
•Paget's disease
•Alcoholic liver disease (hepatitis/cirrhosis)
•Biliary stricture
•Giant cell (temporal, cranial) arteritis
•Multiple endocrine neoplasia (MEN) II
•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,


PhillieG's picture
Posts: 4912
Joined: May 2005

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...

peterz54's picture
Posts: 345
Joined: Feb 2012

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's picture
Posts: 4912
Joined: May 2005

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...

Posts: 135
Joined: Dec 2010

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.


peterz54's picture
Posts: 345
Joined: Feb 2012

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's picture
Posts: 6352
Joined: Aug 2010

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.

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