In 2002, Alcano began to make a name for himself, and began competing in major events in the US. He won five tournaments in the Joss Tour and was awarded Rookie of the Year for 2002 by azbilliards.com.
Alcano returned to the East, for the 2005 WPA Asian Nine-ball Tour, winning the Manila tournament (11-6 versus Yang Ching-shun), and qualifying for the world championship.
Coming in as an underdog, Alcano upset German Ralf Souquet in the finals, 17 to 11 at the 2006 WPA Men's World Nine-ball Championship. ESPN commentator Gerry Forsyth said, "the only way to stop Alcano is to put a rattlesnake in his pocket, then ask him for a match" about Alcano's performance. He thus became the second Filipino (excluding 2004 winner Alex Pagulayan, as he represented Canada at that time) to become World Champion in this event after Efren Reyes won the title in 1999. In the November 2006 tournament, Alcano had been on the brink of elimination in group play before taking advantage of a soft break. He won just 1 of 3 group matches and scraped through as the 64th and final seed. Alcano then defeated local favorite Reyes and defending champion Wu Chia-ching in the knockout stages, proceeding to the final. For winning the tournament, Alcano won US$100,000 which is the largest first prize ever won in the world nine-ball championship.
In 2007, Alcano won the WPA World Eight-ball Championship by defeating his compatriot Dennis Orcollo in the final match 11-8.