I write to you gentlemen when I need any ray of hope or thread of optimism to hold on to.
Our oncologist stopped Zytiga and prednisone after 14 days only due to overall weekness and high liver enzymes. We were admitted to hospital w fever and discovered that there is liver metasis now 
it's pretty tough.
Anyone out there survived stage4 bone and lover mets? I am sorry for sounding desperate but you are the only group that I count on for support.
God bless u all
Have you bee on Xtandi? It goes easy on the liver. I got horibbile weakness for the first week but it has subsided pretty much. Can take with or without food. Best to take at night.
Thomas
Sorry to hear about the liver metastases. Some here have gone on Carboplatin chemotherapy for liver mets and had success. It's something you could discuss with your doctor.
Here's an arcticle about it, there are more available if you do a search.
ncbi.nlm.nih.gov/pmc/articl...
From your first post, he had a PSA nadir of 40 and you were talking about him getting a biospy. I'm wondering what they found and if there were a significant amount of cells that had neuroendocrine characteristics. Those are the type of cells that would typically metastasize to the organs and soft tissue.
He can also get a blood test for Chromogranin A which is a tumor marker for neuroendrocrince (small cell) prostate cancer.
Here's a quote from the article above:
Poorly differentiated neuroendocrine prostate cancer (small-cell carcinoma, initially referred to as ‘anaplastic’) is a frequently under-recognized late manifestation of prostate cancer. Recognizing this subtype, which is considered to be a mCRPC, may be challenging. On the basis of autopsy series and other studies, neuroendocrine prostate cancer may represent ~25% of late-stage prostate cancers (12). The diagnosis of neuroendocrine cancer is associated with clinical features not considered characteristic of prostate cancer, such as visceral involvement, lytic bone metastases and low or undetectable PSA levels; this subtype is also associated with a castration-resistant profile. Loriot et al(7) included patients who had mCPRC and in whom standard treatment with first-line docetaxel had failed. In the Fléchon et al(8) study, the patients had mCRPC with anaplastic characteristics, as defined by ≥1 of the following criteria at trial entry: Visceral metastases (lung, liver, or lymph node involvement, excluding bone metastases) or elevated neuroendocrine marker serum levels (neuron-specific enolase and/or chromogranin A).
I would consider genetic testing to see if there are any gene mutations (BRCA2, TP53 and others) that have targeted treatments available.
I am not a doctor so these are things to discuss with your doctor.
With liver mets, chemo is certainly the next step.
Hi, sorry to hear about disease progression. But that's why we all here.
Way too early to say that I have survived, but docetaxal is certainly helping my liver mets. I commenced ADT in Apr 2017 with PSA of 7.5, by Christmas it was 47. Bone scan was clear but PET scan showed 5 nodes in my liver and numerous spots in mysentery. My MO put me on docetaxal immediately and warned that it may not work, but after 2 rounds I experienced a big drop down to 7.5. Had 4th round yesterday, and still waiting for results from Round 3.
Of course if docetaxal doesn't work there are other options. Lutetium-177 is showing a lot of promise - my MO said that he would put me on the local trial if I saw no benefit from docetaxal but with my welcome results this has been deferred. And as already mentioned by Greg, there is carbo-platin.
So there are still treatments to run with, don't give up yet.
I have been on Docetaxel and Carboplatin along with prednisone and ADT for 14 months. The latest bone and CT scans show that the mets in my bone, liver and lungs have stabilized or reduced in size. Chemo every 3 weeks is no fun but it works for me. The regimen seems to be the MSK standard treatment for patients with mets to bone and liver.
My husband begins Carboplatin and Docetaxel tomorrow at MSK. His PC journey sounds very much like yours ( I wouldn’t be surprised if we had the same doctor) I’m so anxious about side effects ( I’m so anxious about EVERYTHING!) He is so weak from the 10 rounds of radiation he just had for the spinal compression he was suffering ( tumor on base of spine that went undetected until he lost bowel/bladder control- I rushed him to Urgent Care where they finally gave him an MRI and found it) I wish he wasn’t starting chemo in such fragile condition ( though she is starting him on Carboplatin alone 3 weeks on, 1 week off for first cycle and then introducing Docetaxel in same way for 2nd cycle so she can give him more “gentle” doses to ease him into this) We we’re doing so well for the last 4+ years on ADT, prednisone and Zytiga ... until we weren’t. I’m hoping ( to put it mildly) that he does well and regains strength and that we find our “new normal” again because this has really pulled the rug out from under us. I’m trying to stay optimistic and hopeful but I’m mostly terrified for the unknowns that we start facing as of tomorrow afternoon... I’m sure I’ll see you in the treatment room sometime soon 🌿
Good Saturday Morning NG17,
Have been in this battle almost 6 years (please see bio for complete treatment history).
No bone mets, but plenty of lymph nodes and 20+ lesions in liver found in 9/2017. PSA was 10.8. Immediately began Docetaxel/Carboplatin chemo combo.
After 6 cycles, PSA is .4 and liver mets are smaller. Currently on chemo break since 1/9 with monthly blood work and every 2 months liver MRI. Looks like chemo will always be in my future.
Check out Radium 223 for bone mets, and as another poster replied, SIR-Spheres for a future attack on liver cancer. My Med Onc has used it with several prostate cancer patients and it is done at Piedmont Hospital in Atlanta.
Best wishes. Never Give In.
Mark, Atlanta
My husband has been on Carbo Platin since last September. His disease is stable. As soon as we stopped Chemo - he had a break of five weeks - the mets were growing again. So it looks like he will be on Chemo for life now. Unless of course there are other options.
For us the side-effects are manageable. He feels tired a lot of the time, particularly in first week after infusion, but other than that fine.
Good luck
Mel.
thank you for your kindness, my best wishes to you Mel and your husband, may God send his healing and blessings your way
What now, coach? (PCa has spread to liver within 3 months of starting Eligard.)
Elevated liver enzymes
Zytiga and elevated liver enzymes 
Zytega hurting my liver
