I had my six month check up today. Ironically for the first time ever, everything is in the normal range. However, my ALP is going up like gangbusters. It was 110 today and it’s been creeping up since diagnosed although this was the biggest jump. I was 76 last time. My NCI oncologist (or her PA more specifically) is not a bit worried. She say s it’s because of my increase in weight baring exercise and I will say that has increased quite a bit in the last six months. She says it’s a sign that my bones are regenerating new cells which is good. But I’m so frightened regardless. If it goes up any higher I get a bone scan. Anyway she’s so confident she doesn’t want me back for six months but I can’t calm down. I know I’m exercising every day but I can’t imagine it affecting my ALP that much. Calcium is still well within normal range at 9.8. It’s a little higher than last time but I’m eating more dairy. Please help me calm down.
Hi dear,
Really sorry we are on this experience
I understand you perfectly, the fear is from the beginning of the diagnosis, and it is normal to be scared I’m still in the treatment period, but what I can tell you is that the oncology team and the breast cancer department were with me, and the same in your case, I would definitely insist on more investigation and information It is better to stress them with questions and be enlightened than to be restless I say press on them with all your concerns, and tell them you can’t wait another six months without peace and quiet.I’m sure you’ll find emotional support here and the girls here are wonderful, but please don’t hesitate to contact the medical team for peace of mind.You have passed the treatment, look at the good side, what was difficult has passed, you are strong and your body has succeeded, you still need time, emotionally, clearly we are all affected and this is what you are thinking,but don’t get caught up in the emotional state now, and open these topics with the medical team.
Be strong and remain positive, hugs and love 
and good luck be happy to you have a new way in front full of happiness 
@Shi hopefully you are doing well, maybe you can share your experience for more support, I know you already done your treatment, hopefully I am not wrong.
All my best and big 
please ring the number on here and speak to the bcn nurses everyone has different treatment paths and always best to discuss directly with your team but do contact bcn nurses on here they could help guide you on questions you want answering sending 
Shi xx
Hello @Kay0987
I’m so sorry you are feeling so anxious following your recent appointment, you say it yourself how ironic every test result has come back within a “normal range” except for this one.
Your concerns are very understandable (from reading your posts you appear like me to be someone who wants to know more than “just the headlines” and being told this information by your oncologist’s PA is not enough for you to understand this conclusion)
I don’t think there is any harm in going back and saying you need a further explanation as to what these results mean and why they are not a concern to your oncologist
Sending you lots of love
AM xxx
I did exactly that and got the below response.
**As discussed yesterday, elevations in enzymes within normal ranges in not abnormal; this is an enzyme so it is reactive in nature. **
**Exercise can increase alk phos, especially when exercise is completed within 24 hours of the lab draw. Even a fatty meal can increase your alk phos–something as simple as that. **
Alk phos is also not specific to bones. It is an enzyme that is found in the liver, kidneys, bone and GI system. So your alk phos being on the upper end of normal is not specific to a bone origin.
Does that sound like a good explanation to you? I did reply back and asked what else they look for besides rising Alk phos rates in regards to bone mets. And thanks to all for your kind responses and support. I am not having a good week in general. Too many tests back to back and any kind of question with them, whether the doctor has questions or not, sends me into a tailspin.
Sending you lots of hugs @Kay0987
Your concerns are entirely understandable, this cancer thing messes with our minds horribly and convinces us of all sorts and everything, and as much as we try to rationalise our thought processes at times it’s nigh on impossible
I had a difficult few weeks over the summer, I have a teenage daughter (who in all honesty is probably completely normal but I can’t help worrying about her mental health as she unloads everything on me and a husband who seemingly is a medical phenomenon with undiagnosable health issues aka stress!) after which I absolutely convinced myself that intermittent lump feeling in my throat was a tumour….I finally went to the doctor who had a good look feel and listen to my chest, she offered to refer me to an ENT specialist but I was happy that my fears were not what I was imagining. I felt like I’d wasted her time but she absolutely understood my fears. Her mum had come through a cancer diagnosis and has the same fears
I also have a good friend who had a really nasty bowel cancer diagnosis and treatment over 10 years ago and when I told her about my fears and appointment she told me that the honest truth is following a cancer diagnosis there will always be times when every little niggle pain or whatever convinces you “IT” is back. Have you been able to explain the basis of your concerns of these test results to your oncologist?
Sending you lots of love
AM xxx
I just went back into my hospital e-mail account and just let her know that I didn’t want to use her as my therapist but that I’m just frightened. And looking for her rational why it wasn’t bone mets. Maybe that will help. Maybe not. But thank you for your understanding and compassion. I’m just a wreak and I can’t yet snap out of it.
Take care lovely lady xxx
Hi Kay
This is normal to be stressed . You’ve given great advice anytime I am on. Did you fast for the bloods ? . Insist on a retest to put your mind at rest
I could if I wanted to in a few months but that’s a while for me. In the US, we can actually buy our own labs and pay for them ourselves if we want so I did that today. Was going to rush out and retest this morning but stopped myself. I had my lupron and flu shot yesterday and that in itself might affect my numbers. As much as this weighs on me I am going to wait a couple of weeks and do it then. And no I didn’t fast. They don’t require it although I have fasted for most of my tests. I did read yesterday, which I thought interesting, that people with type B and O blood can have quite elevated levels of ALP after eating peaking between 3 to 6 hours after a meal. It’s noted most with a high fat meal. I have no idea if my breakfast would count as that but I did have a bit of almond butter which is considered high fat and I’m blood type O. So anyway I’ll retest in a few weeks, fast, and see what happens then. Do they make you fast in the UK for your bloodwork?
Thank you. She responded compassionately but there’s really nothing she can say beyond that I don’t have any symptoms, feel good, so they are thinking the score was just a normal variation. Did say, for anyone looking for info in regards to blood work, that high calcium is another indicator of problem with the bones. Also, ALP isn’t only expressed by bones. It can come from liver, kidney, and intestines. So just because you have a high ALP doesn’t mean you have an issue with your bones.
I asked cause 7/8 years ago my gp rang me as my results weee very elevated. He was concerned had me retest and the next set were elevated also. Tested again 2 months later but made me fast and my results were perfect . I think it can rise due to other issues
Hello Kay,
So sorry to read your post, cancer take such a toll on us. Sounds like you are doing well, which we can’t always accept ,we don’t always trust the good news.
Take one day at a time, the comeback is always greater than the setback, I would say well done to you for getting this far, also sounds like you are getting great care from your hospital,
Try to relax, a cup of tea with that special friend, the forum is always here for you, keep posting, letting us know how you are getting on.
Big hugs Tili 
4-7-8 breathing my friend! And good for you on the workouts! Proud of you! I do not know about the science behind what you are saying, my apologies, but it does sound they have control
Maybe find some solace in what they are telling you and thank your guardian angel. That is something I realized I had never done, Knowing I have had someone looking after me all my life and never once said thank you. I do know two things that help me is essential oils and ashwaganda. Not a doctor, can’t prescribe, just stating my experiences. I truly hope you continue to improve. The situation we are can cause is a lot of anxiety don’t let it suck you in.
I’m a little better today. Thank goodness for on-line communities of people who know exactly what you’re going through. Trying to trust my doctor’s. I mean I’m getting older and had breast cancer. Things aren’t going to be black and white anymore for me and that’s really hard to live with. I don’t go back for another six months at least. They are so not concerned that they didn’t want to move my time up nor do they want to retest me unless I want to retest. Which I don’t with them. I’d rather do it myself where I feel in control of the situation a little more. Anyway, thank you so so much for your kind words and support. I am trying to trust that I am actually healthy. But I felt healthy before diagnosis, too, and it’s hard now to trust anything I feel physically.
Kay, so pleased you are feeling better, we are here so keep posting at any time.
Very best wishes to you going forward
Tili
Kay0987 be kind to yourself, I think there are lots of us who are more super vigilant after, it’s our new normal remind yourself how amazing you are because you are we all find our little ways of dealing with it all because it was never anything any of us ever expected to encounter and without Breast Cancer Now and each amazing person who shares, reaches out and supports along the way instead of feeling isolated we are 
always a post away from a safety blanket Shi xx
Hi 
, your posts were so helpful to me, when I started my journey back in March. Now that I finished the active treatment, I wonder if this journey will ever finish…I’m not saying this on a negative note because this diagnosis has had some positives… I’m happy to see that you are feeling better. I understand your anxiety and fear. I’ve had a X-ray for back pain and a colonoscopy in the last month. Every little pain, lump, or test result is a source for concern - that’s my nature and I feel more confident if I research and follow up. I joined a support group back in April and most of the women still meet on a regular basis. We are currently doing a “life after treatment” course together. But the best part is sharing experiences and support. In a world full of anger (and hate, and pain), meeting wonderful, supportive and caring humans in the group, in the forums, in hospital and at work, has been one of the positive part of this journey
I love the support we’ve found, too. And thank you for the compliment on my posts. I’m so glad they were helpful. I feel a little better right now. Undercurrent of nervousness but not overwhelmed panic anymore which is a relief. At some point I guess I’ll start trusting my body a little more.