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Topic: Elevated Alkaline Phosphates

Forum: Stage I Breast Cancer — Meet other members with a Stage I breast cancer diagnosis to share information and support.

Posted on: Jun 4, 2010 01:59PM

Susie123 wrote:

Has anyone with early stage BC had elevated alkaline phosphates? Mine were 156 a month ago, now they're 153. The onco wants to recheck them in a month and if they're still elevated do a bone scan and liver CT. I'm really freaking out, I've only had BC for 6 months. I was so grateful for a stage 1 grade 1 diagnosis, my nodes were clear. Could I already have mets? Has anyone had any experience with alk phos levels that were elevated?

Dx 12/22/2009, IDC, 1cm, Stage IA, Grade 1, 0/8 nodes, ER+/PR+, HER2-
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Jun 4, 2010 02:04PM Enjoyful wrote:

Hi, Susie -

Sorry you're having an area of concern, and so soon after your Stage I diagnosis!  My old onco told me that if both calcium and alkaline phosphatase are elevated, it's an indication of bone mets.  An indication, not a definitive.  It's good that your onco is following you closely.

Since you're stage I, I'm guessing you did not have chemo?  My levels were skewed like crazy when I was on chemo but it turned out to be nothing.

Are you on an aromatase inhibitor like Aromasin, Arimidex, or Femara?  I just read today that Arimidex can cause elevated AP levels.

Hang in there, and please keep us posted!

E

BENGHAZI! Dx 9/2004, IDC, 1cm, Stage IIIA, Grade 2, 4/14 nodes, ER+/PR+, HER2- Dx 8/28/2009, IDC, 2cm, Stage IV, Grade 2, ER+/PR-, HER2-
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Jun 4, 2010 02:20PM Susie123 wrote:

Yes, Thank You So Much for the quick response. I am taking Arimidex and my calcium levels were not elevated. I didn't do chemo, my oncotype score was low. I've been crying all afternoon. Seeing that Arimidex can cause that gives me hope...

Dx 12/22/2009, IDC, 1cm, Stage IA, Grade 1, 0/8 nodes, ER+/PR+, HER2-
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Jun 4, 2010 02:31PM Enjoyful wrote:

You're welcome!

Here's a link to an Astra-Zeneca publication about Arimidex.  It lists elevated AP levels as a possible, but infrequent, side effect.  Maybe print it out and take it to your onco?  If they don't see it very often, they might not expect it as a side effect.

http://www1.astrazeneca-us.com/pi/arimidex.pdf

I'm glad I saw this today!

Take a deep breath, and have a glass of wine.  :-)

Please keep us posted!

E

BENGHAZI! Dx 9/2004, IDC, 1cm, Stage IIIA, Grade 2, 4/14 nodes, ER+/PR+, HER2- Dx 8/28/2009, IDC, 2cm, Stage IV, Grade 2, ER+/PR-, HER2-
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Jun 4, 2010 10:02PM SusieMTN wrote:

Susie123   I have elevated Alk Phos (about 149) it has been elevated since about Jan.  I had locally advanced BC.  I was told that medications can cause an elevation and not to be concerned as it isn't high enough.  I have taken both Arimidex and Aromasin.  I just had a bone scan and will now have an MRI as I did have areas with increase "uptake" BUT I have arthritis and issues that existed prior to BC. 
When I grow up I STILL want to be an old woman.....Mets and ALL! Dx 7/22/2008, ILC, 6cm+, Stage IV, 2/3 nodes, mets, ER+/PR+, HER2+
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Jul 13, 2010 09:27AM karenz01 wrote:

Hi.  I hope you got good news on your elevated ALP.  I too had early stage BC and my ALP is at 134 and is steadily rising.  I was on Femara but stopped it in May.  I'm very scared!!!

Dx 5/25/2009, IDC, 1cm, Stage I, Grade 2, 0/4 nodes, ER+/PR+, HER2-
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Jul 14, 2010 06:14AM Susie123 wrote:

Mine did come down, but it took 3 months. It's very scary. I didn't stop taking the Arimidex so that must not have been it.  I was afraid to take anything, even tylenol for a headache, because I was afraid that could be elevating it. Hopefully yours will start dropping as well. I'm learning to dread onco visits.Frown
Dx 12/22/2009, IDC, 1cm, Stage IA, Grade 1, 0/8 nodes, ER+/PR+, HER2-
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Jul 14, 2010 06:57PM karenz01 wrote:

I absoulately dread the doc visits and almost have a panic attack in the waiting room.  Well, perhaps the drugs are doing it but it levels itself out eventually?  I'll keep my fingers crossed and I am very happy you are okay.  Hang in there!

Dx 5/25/2009, IDC, 1cm, Stage I, Grade 2, 0/4 nodes, ER+/PR+, HER2-
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Jul 17, 2010 12:44AM - edited Jul 17, 2010 12:49AM by aussieched

Hi Susie123

I had IDC diagnosed may 07, with positive sentinal node, and my alkaline phosphatase has been elevated for at least the last 2.5 years.  I totally freaked out about the result, with my reading being in the 150+ for most of that time as I had also read that an elevated result could be a sign of bone mets.  I still really don't have any definite advice from my oncologist as to what can be causing it.  He said he will just watch it at this stage and basically asked if I have pain anywhere. I have lots of pain everywhere, however don't know if it is being caused by the oophrectomy and femara or from bone mets.  At this stage he is happy just to wait and watch, while I stress out about it and basically has not done any testing such as MRI, Pet or bone scans since my diagnosis.  We don't get all the testing here in Austraila that other ladies in other countries seem to get as routine.  It is a scary ride out here, not sure why, because I do have private cover, so that is not the problem.

Dx 5/11/2007, IDC, 2cm, Stage IIA, Grade 1, 1/30 nodes, ER+/PR+, HER2- Surgery 5/30/2007 Lumpectomy: Left; Lymph node removal: Left, Underarm/Axillary; Prophylactic ovary removal Radiation Therapy 8/15/2007 Hormonal Therapy 9/27/2007 Femara (letrozole)
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Jul 20, 2010 07:35AM karenz01 wrote:

I was told that if it is elevated because of mets, your calcium would be elevated too if that's any comfort.

Dx 5/25/2009, IDC, 1cm, Stage I, Grade 2, 0/4 nodes, ER+/PR+, HER2-
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Jul 20, 2010 11:47AM SusieMTN wrote:

My MRI was normal.  But wanted to mention this, there is a test that can be done that will determine if the alkaline phosphatase is coming from bone or liver.  I personally wonder for myself if it was the Aromasin. I was put on Tamox. and having far less side effects.  You girls that are showing and elevation in alkaline phosphatase, have your doctors done scans?  It can be a relief to know that everything is OK and if not one wants to know ASAP right? 

Wishing you all well!  Smile

When I grow up I STILL want to be an old woman.....Mets and ALL! Dx 7/22/2008, ILC, 6cm+, Stage IV, 2/3 nodes, mets, ER+/PR+, HER2+
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Jul 20, 2010 02:28PM Susie123 wrote:

I also heard that if it was elevated because of bone mets your calcium would be elevated too, and mine was not. If mine had not came down I was ready to do the scans, scared to death, but ready. I'm trying to live a little more "fear free" these days. I actually signed a 2 year contract recently when I had got to the point that I was afraid to commit to anything, for fear that I might not be here that long. I'm trying to move beyond the "fear" mindset. Has anyone else had a problem with that?

Dx 12/22/2009, IDC, 1cm, Stage IA, Grade 1, 0/8 nodes, ER+/PR+, HER2-
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Jul 20, 2010 02:49PM somanywomen wrote:

Susie123, last week I went to doc for back pain, you know how our minds work these days, I was thinking "could it be bc related?"....It was just a strain..I think we will be questioning every little ache, but to stay on top of this we have too....I'm sure they will watch your levels, but there probably is an non-bc answer for this....probably a meds issue....

“There must be some way out of here,” said the joker to the thief, “There’s too much confusion, I can’t get no relief."....All Along the Watchtower..Bob Dylan Dx 9/28/2009, IDC, 1cm, Stage I, Grade 2, 0/2 nodes, ER+/PR+
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Jul 30, 2010 02:27PM wrsmith2x wrote:

I have had elevated ALP the entire time.....nothing to worry about....some of us are just that way.  Keep the faith!  Namaste'.

1st dx, 2007, IDC, Stage 1 (1.2cm), grade 3, 0/1 node, TriNeg.....2nd dx, 2011, IDC, Stage 2 (3.2cm & 1.5cm) grade 3, 0/1 node, Tri-Neg......BMX with DIEP 2/16/12......3rd dx, lung mets, Stage IV, 7/24/14. Dx 11/16/2007, IDC, 1cm, Stage IA, Grade 3, 0/3 nodes, ER-/PR-, HER2- Chemotherapy 1/3/2008 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 3/24/2008 Breast, Lymph nodes Dx 12/19/2011, IDC, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2- Dx 7/24/2014, IDC, 3cm, Stage IV, Grade 3, 0/3 nodes, mets, ER-/PR-, HER2-
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Nov 22, 2014 10:12AM glojakab wrote:

Do you have an update for me. The same has happened to me. My bone scan was perfect. My alkaline phosphates keep going up and my calcium. I think it is the anastrozole that I have been taking for 14 months. I am 68 and had stage 1 BC

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Nov 22, 2014 01:04PM Moderators wrote:

glojakab, you ask a good question. We notice that this topic is a few years old. Perhaps you should start a new one with your question.

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Nov 22, 2014 10:45PM Susie123 wrote:

hi glojakab,

I wanted to let you know that I am the one who started this thread in 2010and had elevated alp for years before they returned to normal. Actually the blood work at my 4 year check up was the first normal alkaline phosphates results I have had. I'm almost 5 years out now, doing well, with no reoccurrence. My onco said he sees a few patients each week with no issues other than elevated alp that he doesn't understand why. I too have stage 1. Susie

Dx 12/22/2009, IDC, 1cm, Stage IA, Grade 1, 0/8 nodes, ER+/PR+, HER2-
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Mar 19, 2017 11:05AM AEC wrote:

Hi Susie123,

Thank you for sharing about your ALP level increase and the good news you had. I have had 2 raised levels in a week 128 and 155 after a normal level for another doctor just 3 weeks ago! They ran a GGT that was 15 and normal. My calcium is within range too. I see my doctor tomorrow, and this weekend has been so hard. Everything I've read says that the GGT rules out a biliary reason for the rise, and so it must be bone. But that calcium should be elevated with bone mets. I'm on Arimidex now for 2 years almost. Could that be the reason for the sudden increase? I know I'm heading for tests and I was just getting past the PTSD of having gone through the breast cancer the first time. Its been a hard year, can stress do this? Well anyway, thanks for your words, they really helped. AEC

2/15 stage1a grade1 0/1nodes lumpectomy and radiation started arimidex JUNE 2015
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Mar 19, 2017 01:01PM Moderators wrote:

Hi AEC,

Welcome to the BCO community forums.

Just letting you know that this thread has been inactive since 2014 so you may not receive many or any responses here. You can however, create your own brand new topic here if you would like to start up a conversation on this topic again or join more active threads.

Let us know if you need help with this!

The Mods.

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Jul 15, 2017 01:23PM mahometmom62 wrote:

Hey Everyone!


Thread not dead yet! I have elevated ALP 3 yrs after chemo.... then it went down, I Have had 3 bone scans for my back and all were clear and normal GGT. They have been normal till 3 weeks ago up to 135..... GGT normal Calcium Normal, and they did the break down test that shows where its coming from, it was liver. Doc wants a ultra sound on Monday.... omg I hate this!!!!!! Freaking out


Dx 7/14/2010, IDC, 1cm, Stage IIA, Grade 2, 2/12 nodes, ER+/PR+, HER2-
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Sep 19, 2017 05:40PM Jojo0529 wrote:

hope to revive this thread! All of my blood work was great except for the one number that matters: alp. I feel like it is coming from bone because my other liver markers are good. This is my first blood test since starting armindex 1.5 yrs ago. Any thoughts

ONCO 17 ....ki-67 25% miotic 1. Dx 7/30/2015, IDC, Right, 2cm, Stage IIA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 8/20/2015 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic mastectomy: Left Chemotherapy 9/3/2015 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 12/1/2015 Arimidex (anastrozole) Surgery 1/11/2016 Prophylactic ovary removal; Reconstruction (left): Silicone implant, Tissue expander placement; Reconstruction (right): Silicone implant, Tissue expander placement
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Sep 19, 2017 06:14PM Jojo0529 wrote:

ma how was the ultrasound

ONCO 17 ....ki-67 25% miotic 1. Dx 7/30/2015, IDC, Right, 2cm, Stage IIA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 8/20/2015 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic mastectomy: Left Chemotherapy 9/3/2015 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 12/1/2015 Arimidex (anastrozole) Surgery 1/11/2016 Prophylactic ovary removal; Reconstruction (left): Silicone implant, Tissue expander placement; Reconstruction (right): Silicone implant, Tissue expander placement
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Jan 7, 2020 08:51PM Kdubyahoppa wrote:

mine was elevated on 12/12/19 I wonder but my calcium was fine. I was diagnosed with Stage 3A Feb 18, 2019. 1/16 lymphnodes positive. ER/PR positive, Her2 negative. 5 cm tumor 1 cm after 4 cycles of Taxotere & cytoxan. I had double mastectomy. Mentally beating the cancer is going to be hard. I’m so grateful for these forums I feel not alone when I read these. I was 25 when diagnosed. Had given birth to my 1st child before was diagnosed. He was 6 weeks old. He’s now a healthy happy 1 year old.2019 was a bittersweet year

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May 7, 2020 05:40PM Lulu44 wrote:

Hi everyone. I’m kinda freaked out bc my ALP gets checked every 3 weeks and it just keeps increasing. This week it was 194, (up 30 points from 3 weeks prior) and I’ve been having groin pain on the left side accompanied by numbness to my upper, back/lateral thigh for almost 3 weeks. The sports medicine dr thinks it s stress fracture to the hip from jogging and has me on crutches but my shoulder and armpit are still too sore and weak from radiation to use them. I had an X-ray of the pelvis, femur & lumbar spine on Tuesday and have a telemedicine appointment tomorrow with sports med for the results. I’m thinking it can’t be bad or she would’ve called but who knows. Im halfway through Kadcyla and have been on aromasin 2 months, had my ovaries out in Jan. I’m worried it’s bone Mets but none of the doctors or nurses seem concerned. Not sure if they’re bullshitting me so I’m not scared, what 44 year old breaks a hip jogging? I was barely jogging, being so careful...The MO ordered a liver ultrasound but I had Kadcyla today. Anyone else have anything like this

Dx 6/28/2019, IDC, Left, 2cm, Stage IIB, Grade 3, 1/5 nodes, ER+/PR+, HER2+ (IHC) Targeted Therapy 7/16/2019 Herceptin (trastuzumab) Chemotherapy 7/16/2019 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 7/16/2019 Perjeta (pertuzumab) Surgery 12/16/2019 Lumpectomy: Left; Lymph node removal: Sentinel Targeted Therapy 1/1/2020 Kadcyla (T-DM1, ado-trastuzumab) Surgery 1/21/2020 Prophylactic ovary removal Radiation Therapy 1/27/2020 Whole-breast: Breast, Lymph nodes Hormonal Therapy 3/6/2020 Aromasin (exemestane)
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Jun 27, 2020 09:15AM RMC19 wrote:

how are you doing? I am a similar DX and dealing with this too.

Dx 7/10/2019, LCIS/DCIS/ILC/IDC, Right, 3cm, Stage IIB, Grade 3, 3/21 nodes, ER+/PR+, HER2- (FISH)
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Jul 16, 2020 09:48PM Tammark123 wrote:

I had an elevated alp three months ago. Subsequent bone scan and ct scan were clear. Headed in a couple weeks for a follow-up blood test. Suppose it’s time to start worrying for no reason again! My oncologist did say he sees many patients with high alp levels that have not had a reoccurrence. It’s just one of those levels that can be raised for no apparent reason.

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Aug 23, 2020 04:40PM RMC19 wrote:

how did your follow-up go? I'm still dealing with this

Dx 7/10/2019, LCIS/DCIS/ILC/IDC, Right, 3cm, Stage IIB, Grade 3, 3/21 nodes, ER+/PR+, HER2- (FISH)
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Aug 24, 2020 08:15AM - edited Aug 24, 2020 08:17AM by KMom57

This Post was deleted by KMom57.
Dx 10/2019, ILC, Left, 2cm, Stage IIIA, Grade 2, 8/11 nodes, ER+/PR+, HER2- Hormonal Therapy 11/6/2019 Femara (letrozole) Surgery 2/14/2020 Prophylactic ovary removal Surgery 5/17/2020 Lymph node removal: Left; Mastectomy: Left; Prophylactic mastectomy: Right Chemotherapy 7/30/2020 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Aug 26, 2020 07:26AM Elderberry wrote:

LuLu40: All my blood work is just great but my ALP hovers around 140 - 150. I mention it to my MO every single time but he doesn't seem worried. He just said "some people just do" I tried to take comfort in that but I worry all the time that it mean something. I have liver mets so the higher ALP could just being showing that my liver has been under assault. Apparently taking too much Tylenol can elevated ALP. Glad to stumble upon this revived thread.

De Novo - this isn't a "brave battle" - it is a "furious struggle" Dx 3/6/2019, IDC, Left, 5cm, Stage IV, metastasized to liver, HER2+ Targeted Therapy Herceptin (trastuzumab) Chemotherapy Taxol (paclitaxel) Targeted Therapy Perjeta (pertuzumab)
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Aug 26, 2020 12:13PM moth wrote:

Elderberry, tylenol can really wreak havoc on livers! I have heard doctors talk about previously healthy young people who are in hospital with liver failure due to tylenol OD. "acetaminophen toxicity is the most common cause of acute liver failure and the second most common cause of liver failure requiring transplantation" https://www.uspharmacist.com/article/acetaminophen-intoxication-a-criticalcare-emergency

It's one of those trick questions on hepatology rounds; everyone guesses alcohol or fatty liver disease but it's tylenol....

My pathophysiology prof was adamant that it was one of the most dangerous drugs on the shelf and that it should not be available OTC.

My amateur opinion is that anyone with liver problems should try to avoid acetaminophen (& other liver stressors) as much as possible.

Seriously???? “Sometimes the future changes quickly and completely and we’re left with only the choice of what to do next." nevertellmetheodds2017.tumblr.... Dx 12/2017, IDC, Left, 1cm, Stage IA, Grade 3, 0/5 nodes, ER-/PR-, HER2- (IHC) Surgery 12/11/2017 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 2/13/2018 AC + T (Taxol) Radiation Therapy 8/12/2018 Whole-breast: Breast Dx 2/2020, IDC, Stage IV, metastasized to liver/lungs, Grade 3, ER-/PR-, HER2- Chemotherapy 3/17/2020 Taxol (paclitaxel) Immunotherapy 3/18/2020 Tecentriq (atezolizumab)
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Aug 27, 2020 02:18PM Elderberry wrote:

moth: I stopped using Tylenol many years ago. As for other "liver stressors" --- I admit it, it is hard to give up my Friday martini. Nerdy



De Novo - this isn't a "brave battle" - it is a "furious struggle" Dx 3/6/2019, IDC, Left, 5cm, Stage IV, metastasized to liver, HER2+ Targeted Therapy Herceptin (trastuzumab) Chemotherapy Taxol (paclitaxel) Targeted Therapy Perjeta (pertuzumab)

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