Raised levels of ALP

Hallo, I had blood tests yesterday as my Oncologist was changing my meds from Letrozole to Anastrozole because the stiffness and joint pain were so debilitating.

Today I have received the results of the blood tests and my ALP is through the roof and out of range at 192 - it has increased by 79 :face_with_spiral_eyes:. I have read that high ALP can be an indication of breast cancer having metastasised to the bones or liver and am panicking.

I have just spoken to the Breast Care Nurses, and also to my Oncologist who says he is not unduly concerned but will book me a CT scan within the next couple of weeks.

Has anyone else ever experienced such increased ALP? And was it ok?

Hi Fran! I had rising ALP levels from the month after I started treatment lasting a year or so. I went from a very nice 59 to a barely high 129 but it was high enough to scare the living crap out of me. First of all my oncologist told me that unless ALP numbers rise two levels over the upper limit (and for them my upper limit is 110 so two levels over than would be 220) then they don’t do scans. I mean they would have if I insisted but they don’t think it’s warranted since when bone mestastates are involved they tend to be much higher. So yes you are out of range but you’re not two times the normal limit. Secondly high ALP numbers can be caused by many thing including just a high fat meal. Did you eat something super fatty before testing? Are you blood type O? For blood types O intestinal ALP levels can rise considerably with a fatty meal messing up ALP levels. Shoot, even tremendous exercise before a blood test can cause them to rise substantially.

But say you have none of these like me. Well the other thing that can cause ALP number to rise is just bone loss consistent with aging, Especially in the first year after starting AI’s. Mine was that. I had one zoledrenic acid infusion in December and at my last blood test a month ago it had dropped back down to 75. At this point, with your issues, that is a way more likely scenario than bone mets.

Thank you so much for your reply Kay. You can feel so alone in this jolly breast cancer journey sometimes.

My Oncologist said that he wasn’t “unduly concerned” as my other levels weren’t high, and that it may have been caused by other things. I think that if the CT scan comes back clear, it will be a MASSIVE sense of relief as I wouldn’t normally be offered one, and it will reassure me that for now, I am ok. At the moment, I’m trying not to go there about if it is not clear


I am blood type “O” so thank you very much for that info - I only had a piece of buttered toast before I had the blood tests so don’t think that would be high in fat.

Hopefully, it just bone loss consistent with aging and is AI related (I’m 60), and hopefully this awful wait for the scan and the results will be manageable.

I wish you well and very much appreciate your helpful reply xx

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