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03-08-2016, 09:04 AM
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#1
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Senior Member
Join Date: Mar 2014
Posts: 44
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high ALK PHOS TOTAL on metabolic lab test
I have an elevated ALK PHOS TOTAL level of 237 on my latest metabolic panel. All other results are normal. Has anyone else had this experience? I take omeprazole daily and tylenol occasionally. I really do not have any symptoms of liver or gallbladder problems.
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Laurie in Idaho
IDC, Her2+++, PR- ER- diagnosed Feb 2014 1 month before 53rd bday
2.6 cm mass right breast with lymph node involvement
THP-FEC neoadjuvant chemo regimen
THP (taxotere, Herceptin, perjcta) every 3 weeks for 4 doses started 3/27/14
BRCA negative
bilateral mastectomy with lymph node dissection done June 2014 15 lymph nodes removed all negative for cancer, breast tumor gone
FEC (5-FU, epriubicin, Cytoxan) every 3 weeks for 4 doses, Herceptin every 3 weeks for a year, then
radiation for 6 weeks
New Years Eve 2014 completed radiation
September 2015 Latissimus Dorsi Flap reconstruction
March 2016 rib fractures under implant
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03-08-2016, 11:39 PM
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#2
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Senior Member
Join Date: Jan 2010
Location: Thousand Oaks, California.
Posts: 199
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Re: high ALK PHOS TOTAL on metabolic lab test
I am on Kadcyla and my Alk Phos is elevated, but I only just started so it is slightly above normal. It is a sign that the liver is having to deal with all the drugs we are taking. I do not take any pain meds. I am looking for a way to reduce my levels. My ALT and AST are still normal, but I am taking Milk Thistle, which I am pretty sure helps.
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Breastfeeding when diagnosed with Her2+ May 2008
Oct 2008 Double mastectomy 22/28 lymph nodes positive
Decline chemotherapy (decision I regret)
Nov 2009 Mets to lungs and bones.
Dec 2009 Start Taxotere and Herceptin, T1, T3 heal completely and lungs are clear, T2 and first rib have lytic lesions. First rib becomes sclerotic. Considered stable.
May 2011, Onc calls progression and I cross over from comparison arm of clinical trial to TDM-1
Brain scan in Sept 2011 showed small tumor in right cerebellum, did Novalis radiation.
Feb 2013 < 1cm tumor in left frontal lobe. Did Novalis in March and latest scan shows no sign of brain metastasis.
Aug 2013 did 36th round of TDM-1 Due to TDM-1 side effects, shortness of breath, and difficulty getting my balance when getting out of bed, agreed with my oncologist to stop TDM-1.
Took a six week break, bone scan showed small uptake on left first rib. CT showed hypodensities in liver (too small to biopsy) and small nodule in lungs (mediastinal).
Started Navelbine weekly. Did one round with Herceptin.
Skipped next 2 rounds, due to neutropenia. Next chemo 7th Nov - have had 3 Neupogen shots, so WBC should look better... Did not tolerate Navelbine well.
December 2013 scans show no sign of active cancer.
March 2014 - currently only on Herceptin - brain MRI clear, PET/CT two nodules in right lung show uptake
May 2014 - stop Herceptin.
Sept 22, 2014 Brain MRI clear :) PET/CT Progression in lungs.
Sept 2014, Xeloda, Tykerb and Herceptin.
Nov 2014 - Decide to take a break from all treatment.
May 2015 - Brain met radiated with Novalis
July 2015 - Have progression in right lung.
Sept 2015 - Perjeta and Herceptin alone after a 9 month break from all treatment.
Nov 2015 - Thoracentesis 1500ml removed from right lung.
Dec 2015 - Two tiny 1mm brain mets radiated in right cerebellum.
Feb 2016 - Thoracentesis 2200ml drained from right lung
Feb 2016 - Stopped Perjeta and Herceptin and started back on Kadcyla as I had no previous progression on it. After 1 cycle of Kadcyla markers begin to drop. On second cycle add Keytruda.
March 2016 - Thoracentesis 1650ml drained from right lung.
April 2016 – Thoracentesis 1500 ml drained from right lung.
June 2016 – CT scan shows progression in right lung, as well as moderate pleural effusion requiring Thoracentesis.
June 2016 – Decide to stop Keytruda, and will do chemosensitivity test through Rational Therapeutics. Plan to continue on Kadcyla for next two cycles.
July 2016 - Start weekly Abraxane with Herceptin. WBRT with hippocampal sparing, Taking Namenda. 15 sessions over 3 weeks.
Aug - Dec 2016 - 2 infusions of Navelbine, very hard on my body and still dealing with anasarca (generalized edema) 1 infusion of Havalen
My doctor wants to put me on hospice.
Dec 23rd 2016 - I am granted compassionate use of Neratanib.
May 31st 2017 - still on Neratinib, feeling good.
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03-09-2016, 11:46 AM
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#3
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Senior Member
Join Date: Mar 2014
Posts: 44
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Re: high ALK PHOS TOTAL on metabolic lab test
Saw my oncologist today. Scheduled for a bone scan next week. I will look into milk thistle thanks waterdreamer ��
__________________
Laurie in Idaho
IDC, Her2+++, PR- ER- diagnosed Feb 2014 1 month before 53rd bday
2.6 cm mass right breast with lymph node involvement
THP-FEC neoadjuvant chemo regimen
THP (taxotere, Herceptin, perjcta) every 3 weeks for 4 doses started 3/27/14
BRCA negative
bilateral mastectomy with lymph node dissection done June 2014 15 lymph nodes removed all negative for cancer, breast tumor gone
FEC (5-FU, epriubicin, Cytoxan) every 3 weeks for 4 doses, Herceptin every 3 weeks for a year, then
radiation for 6 weeks
New Years Eve 2014 completed radiation
September 2015 Latissimus Dorsi Flap reconstruction
March 2016 rib fractures under implant
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03-13-2016, 12:14 PM
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#4
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Senior Member
Join Date: Jun 2014
Location: Monarch Beach, CA
Posts: 88
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Re: high ALK PHOS TOTAL on metabolic lab test
My ALK level has remained in range since I was first dx in 2013 but my ALT and AST have gone high a few times. Being a stage IV HER2 patient I still receive vitamin H & P every 21 days. I have a liver specialist whom I have consulted with and she feels these levels are not alarming. I would consider consulting a liver specialist. If you do, bring all of your labs (metabolic panel results) so he/she can see where you began and where you are.
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*October 2013 mammogram suspicious lump right breast
*Oct. 2013 Breast MRI reveals 2.5 cm tumor right breast 6-7 nodes positive
*Nov 2, 2013 PET/CT tumor right breast, 6-7 nodes include right axilla and one above clavicle, 3.5 cm lesion on dome of liver
*Nov 4, 2013 meet oncologist: schedule port placement
*Nov 5, 2013 baseline echo 65%
*Nov 13, 2013 start THP six cycles every 21 days
*Nov 20, 2013 blood counts now coming back quickly start neulasta following next treatment, no pain and it worked!
*Jan 19, 2014 syncope, ambulance ride to hospital, cracked a tooth and chipped three, six stitches in chin, CT scan shows brain is ok but am required to follow up with neurologist.
*Jan 28, 2014 PET/CT shows great response to THP
*Jan 28, 2013 echo, all is good 60-65%
*Feb 2014 brain MRI, no missing parts and no extra parts, all clear
*Feb 27, 2014 last treatment with taxotere
*Apr 22, 2014 PET/CT shows complete pathological response to THP amen!
*Apr 22, 2013 echo 60%
*continue vitamin H and P every 21 days until...eternity?
*May 2014 emotional melt down, demand port be removed.
*May 22 2014, biopsy of original tumor rt. breast, no cancer cells in 8 tissue samples, amen
*June 2, 2014 Port removed, happy dance! Just couldn't tolerate the port any longer; it never worked properly and was extremely uncomfortable
*July 24, 2014 echo 60%
*August 28, 2014 PET/CT all clear NED
*Oct 29, 2014 echo 65%
*Feb 4, 2015 PET/CT NED!!!
*Feb 4, 2015 Echo 65-70%
*May 19, 2015 mammogram all clear
*May 19, 2015 Brain MRI all clear!
*August 18, 2015 PET/CT NED!!! amen!
*March 8, 2016 CT w/contrast NED
*March 10, 2016 Echo normal
*June 2016 Echo normal
*September 7, 2016 CT scan w/contrast NED
*September 8, 2016 Echo normal
* still receiving infusions every 21 days of Perjeta and Herceptin with no end in sight......
*March 2017 CT scan NED and echo normal
*May 2017 mammogram all clear!
*November 2017 CT scan NED and echo normal
*May 2018 echo normal
*December 2018 ct scan with contrast and nasty drink-all clear!
"Better pass boldly into that other world, in the full glory of some passion, than fade and wither dismally with age."
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04-08-2016, 05:29 PM
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#5
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Senior Member
Join Date: Mar 2014
Posts: 44
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Re: high ALK PHOS TOTAL on metabolic lab test
Here is an update on my elevated Alk Phos blood level. I had a couple of spots on my ribs right under my breast implant that lit up on my bone scan. My oncologist ordered a bone biopsy. When I went in for the biopsy the radiologist decided to do a CT scan first to determine if he would be able reach the biopsy spot under the implant. The CT scan showed 2 rib fractures under my implant. I'm not totally sure how I fractured my ribs but I did have a terrible cough and cold that lasted a couple of months. I got a second opinion on the rib fracture diagnosis just to be safe.
__________________
Laurie in Idaho
IDC, Her2+++, PR- ER- diagnosed Feb 2014 1 month before 53rd bday
2.6 cm mass right breast with lymph node involvement
THP-FEC neoadjuvant chemo regimen
THP (taxotere, Herceptin, perjcta) every 3 weeks for 4 doses started 3/27/14
BRCA negative
bilateral mastectomy with lymph node dissection done June 2014 15 lymph nodes removed all negative for cancer, breast tumor gone
FEC (5-FU, epriubicin, Cytoxan) every 3 weeks for 4 doses, Herceptin every 3 weeks for a year, then
radiation for 6 weeks
New Years Eve 2014 completed radiation
September 2015 Latissimus Dorsi Flap reconstruction
March 2016 rib fractures under implant
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