Alkaline Phosphatase Velocity Is Predictive Of Future Distant Metastases In Men With A Biochemical Recurrence

It was reported at the AUA 2017 meeting that men, who experience a biochemical recurrence (BCR) of their prostate cancer after having a radical prostatectomy (RP) and who also have a rapid alkaline phosphatase increase in their blood have a doubled risk for developing distant metastases in the future.

Alkaline phosphatase (AP) is a known marker for bone metastases that correlates with the extent of a man’s disease burden.

This report is based on a retrospective study of 736 men who underwent an RP and then had a biochemical recurrence (BCR).  For the study’s purpose, a BCR was defined as a PSA level of 0.2 ng/mL or higher at 8 weeks or longer following the RP and followed by another PSA level of 0.2 ng/mL or higher.

The study investigator, Carolyn Salter, MD, of the National Cancer Institute (NCI) in Bethesda, Maryland calculated AP velocity as the slope of the linear regression line of all the alkaline phosphatase volumes taken after having an RP and prior to the development of measurable distant metastasis.

She defined, for the purpose of the study, that the AP velocity values for the men who were in the highest quartile (3.29 U/L/year or higher) as rapid.

She then found that those men who were in the highest quartile had a 2-fold higher risk of developing distant metastases than those men in the three lower quartiles.

Salter said that “This study demonstrated that AP velocity may be a valuable tool for prognosticating distant metastasis in men who experience BCR after RP.”

Normally, most doctors will recommend that you monitor your PSA levels post surgery on a regular basis.  Given the findings presented in this study, you should discuss with your doctor adding and then tracking your alkaline phosphatase levels.


Salter C, Cullen J, Rosner I, et al. Alkaline phosphatase velocity predicts metastasis among prostate cancer patients who experience biochemical recurrence after radical prostatectomy. [abstract] J Urol 2017;197(4S):e168-e169. Poster presented at the American Urological Association 2017 annual meeting in Boston on May 12, 2017. Poster MP14-18.

Joel T. Nowak, MA, MSW wrote this Post.  Joel is the CEO/Executive Director of Cancer ABCs.  He is a Cancer Thriver diagnosed with 5 primary cancers - Thyroid, Metastatic Prostate, Renal, Melanoma and a rare cancer, Appendiceal Cancer.