Although only around 32,000 new cases of pancreatic cancer develop each year, the cancer has a deadly track record, with a five-year survival rate of only 4 percent, according to the Robert Freelove, M.D. of the University of Kansas. At the time of diagnosis, around 50 percent of the cases have spread to other areas. Elevated serum alkaline phosphatase levels may occur if you have pancreatic cancer, but elevated levels of this enzyme also occur in other disorders when pancreatic cancer is not the diagnosis.
Definitions
Alkaline phosphatase, sometimes abbreviated to ALP, is an enzyme found in large amounts in bone, liver and bile duct tissue. Normally, levels of ALP in the blood range from 44 to 147 IU/L. Because the pancreas attaches to the bottom half of the bile duct, while the liver attaches to the top half, disease in either organ can cause a rise in ALP levels.
Significance
You may develop very high levels of ALP in pancreatic cancer if a blockage develops in the bile duct. Cancer that develops in the head of the pancreas causes obstructive jaundice in 80 to 90 percent of patients, according to the Merck Manuals Online Medical Library. Metastasis of the cancer to the liver can also cause an elevation in ALP. In a Thai study conducted by the Chulalongkorn University and reported in the August 2001 issue of "BMC Family Practice," both cancerous obstruction of the bile ducts and liver cancers commonly caused ALP levels over 1,000 IU/L.
Symptoms
When ALP rises with pancreatic cancer, you may develop symptoms such as jaundice, a yellowing of the skin and whites of the eye. Increased levels of conjugated bilirubin in the stool, urine and skin tissues cause your urine to turn dark and your skin to itch. Your stool may also become clay colored. Pancreatic cancer can also cause weight loss and severe upper abdominal pain that radiates to the back. Between 25 and 50 percent of people with pancreatic cancer also develop high blood glucose levels, the Merck Manuals reports.
Considerations
Jaundice and high ALP levels occur in many disorders, including hepatitis and other liver disorders. While a useful preliminary tool, ALP levels do not diagnose pancreatic cancer. Imaging tests such as computed tomography or magnetic resonance imaging are needed to diagnose pancreatic cancer.
References
- "American Family Physician"; Pancreatic Cancer: Diagnosis and Management; Robert Freeman, M.D. et al.; February 2006
- Merck Manuals Online Medical Library; Pancreatic Cancer; Elliot Livstone, M.D.; December 2007
- MedlinePlus; ALP; David Dugan, M.D.; May 2009
- "BMC Family Practice"; High Serum Alkaline Phosphatase Levels, A Study in 181 Thai Adult Hospitalized Patients; Viroj Wiwanitkit; August 2001
