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Topic: High alkaline phosphatase lab

Forum: DCIS plus HER2-positive Microinvasion —

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Posted on: Apr 25, 2020 12:05PM

Tammark123 wrote:

Greetings from an almost 5-year survivor in Central California.

After having normal bloodwork for the entirety of my journey, last week I had a high ALP reading. A little unhealthy googling led me to bone mets.

Oncologist had me come in for a re-test, and now I’m awaiting the new results. Went back and looked at my old results and the ALP has been trending upward for a year. Six months ago was on the high side of normal.

Anyone had a high alkaline phosphatase result and everything turned out fine?

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Apr 25, 2020 07:24PM Moderators wrote:

Hi Tammark, and welcome to Breastcancer.org. We know it's not the place anyone wants to be, but we're really glad you've found us!

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Apr 26, 2020 07:58AM SpecialK wrote:

Yes, I did at 9 years out from treatment. I had routine labs done ahead of my annual oncology apt and had a high calcium result. Re-tested and that was normal but had high kidney function results. Felt like whack-a-mole, because every re-test a new thing was high and the original thing was again normal. Re-tested again, kidney function was normal and the ALP was quite high - well above the high end of the range. My MO suggested a bone scan, but I asked to wait 6 weeks and re-test. The result at that point was 20 points lower, but still above the high end of the range. I had some invasive dental work done and had read this could have an impact on ALP, so I called my oral surgeon. He felt that I was too far out from those procedures (an extraction, bone graft, six months later a screw implanted in my jaw for an implant and a platelet rich plasma injection into the jaw) for the ALP to be affected six months after the last invasive aspect. I let the situation ride for another six months, because I am often an outlier - which was a gamble - but when had routine labs again in Feb of this year the ALP was totally normal, not even at the high end of the range. If you can handle the wait, how does your MO feel about a watch and wait, with interval re-tests?

BMX w/ TE 11/1/10, ALND 12/6/10. 15 additional surgeries. TCHx6 2/17-6/2/11. Herceptin until 1/19/12. Femara 8/1/11, Arimidex 6/20/12, back to Femara 6/18/13-present. Dx 9/27/2010, IDC, Right, 2cm, Stage IIB, Grade 3, 2/14 nodes, ER+/PR+, HER2+ (IHC) Dx 9/27/2010, DCIS, Stage 0, Grade 3
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Apr 26, 2020 01:48PM Tammark123 wrote:

Thank you for the reply, SpecialK. My oncologist is amazing and will always follow my lead regarding testing. My mom passed away two years ago from bone mets after an initial breast cancer diagnosis seven years ago, so this one hits close to home for me, and the wait-and-see approach will be more than I can shoulder.

That being said, I know, although I’m only 50, that I have osteoporosis and imagine the arimidex is making that worse. I did read that bone loss as well as bone cancer can be picked up on the ALP. I’m going to hang my hat on that hope for now! Who knew I’d be wishing for just bone loss???

Hoping for blood test results this week so we can move forward to the next diagnostic step. Did I mention I start a new job tomorrow? Something to keep my mind off going to the dark side

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May 7, 2020 08:32AM claireinaz wrote:

I thought about this yesterday, and wondered how much Vit D you are taking, if any? My MO told me two years ago (she monitors my Vit D levels) to stop taking so much (I was taking 5000 IUs per naturopath) because my levels were up in the low 80s. She said it could skew APL, which could lead to a false concern about bone mets.

I have a lab test coming up next week before my bi-annual check up the week after, and have stopped taking my D and calcium supplements now so that levels reveal a more accurate reading. Still terrified of the labs and appt, but that's normal for me.

9/29/11 ILC, 2 c. stage II grade 1, ER/PR+ HER2-, 6/11 nodes, lumpectomy, DDAC x 4, Taxol x 12, 33 rads, Tamoxifen/arimidex/aromasin, BMX/immed recon 7/3/13 "In the midst of winter, I found in me an invincible summer.” Albert Camus
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May 18, 2020 12:18PM footloose wrote:

Tammarak: a high ALP can be related to liver problems such as hepatitis or gall stones. Do you maybe have either of these?

Footloose

Dx 1989, IDC: Papillary, Left, <1cm, ER+/PR- Dx 6/2002, DCIS, Right, <1cm, Stage 0, ER+/PR-, HER2- Dx 11/2005, DCIS, Right, Stage 0, Grade 3, ER+/PR- Dx 12/18/2018, IDC, Right, 1cm, Stage IIA, Grade 3, 1/13 nodes, ER+/PR+, HER2- (DUAL) Dx 1/28/2019, IDC, Right, 1cm, Stage IIA, Grade 3, 1/12 nodes, ER+/PR-, HER2- Dx 1/28/2019, IDC, Right, <1cm, Stage IIA, Grade 3, 1/13 nodes, ER+/PR-, HER2+ (DUAL)
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May 18, 2020 02:02PM Tammark123 wrote:

Thank you! I’ll check on that.

Had both a CT scan and bone scan. Both were completely normal!! My oncologist said that sometimes the ALP levels are just high because of the phase of the moon, because many times he can’t find a reason after testing. So at this point I’ll take a deep breath and wait for the the results of the blood work in three months. It’s always interesting being a survivor!!

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May 18, 2020 02:36PM ctmbsikia wrote:

It's always interesting being a survivor!!


You can say that again! Never heard about the phase of the moon thing! Mine has only been slightly elevated. Not enough for my MO to be concerned I guess. As mentioned, it could be a liver thing too. I started Prolia late last year having OS and taking the AI so I just go down the list of readings and just hope nothing is too far over/under. Even when it is, hopefully there's another explanation. It's hard once you've had a cancer diagnosis that everything isn't associated with it.

Glad those scans were normal!

Dx 12/14/2017, DCIS/IDC, Left, 4cm, Stage IIB, Grade 2, 1/2 nodes, ER+/PR+, HER2- Dx 1/16/2018, LCIS, Right Surgery 1/31/2018 Lumpectomy: Left; Lymph node removal: Sentinel Radiation Therapy 4/11/2018 Whole-breast: Breast Hormonal Therapy 6/25/2018 Arimidex (anastrozole)
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May 20, 2020 06:17PM Elderberry wrote:

Tammark123: I always have my ALP come back from the lab with the number highlighted. My MO doesn't think it is all that big a deal. I guess he doesn't consider a bit over as being TOO HIGH. All my other blood work is good. What were your numbers.? Normal is <120


Yeah - I looked it up too and freaked out about bone mets but my PETs scan has never shown any. Phases of the moon? Really? Smile



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) Targeted Therapy Perjeta (pertuzumab) Chemotherapy Taxol (paclitaxel)

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