Dear Edward: In general increases in ALT, AST and alkaline phosphatase values reflect damage to organs where these enzymes or substances are found in the body. Tissue damage can be caused by various things not only cancer, for example, certain medications can cause temporary elevations. These tests are not specific enough to be used as the sole gauge of the progress of treatment. It is not unusual for there to be substantial liver involvement by tumor yet the liver function tests still can be normal.
In terms of the ct scans, there can be quite a bit of difference between ct scans done from one institution to another. A slight improvement in the scans is good news, meaning that the cancer is being controlled at this point.