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Liver Metastases

Overview

Liver metastases refer to cancers that have spread to the liver from another organ. This is also called secondary liver cancer. The liver is a common site for cancer spread because it filters blood coming from many organs in the body. The most common cancers that spread to the liver include bowel (colon/rectum), breast, pancreas, stomach, lung, and ovary. Earlier, liver metastases were considered untreatable and managed only with supportive (palliative) care. Today, with advances in surgery, chemotherapy, and interventional radiology, selected patients can be treated with a curative intent.

The liver metastases can be of two types based on the origin of the cancer:

  • Colorectal Cancer Liver Metastases:
    • Originating from cancer in the large intestine (colon and rectum)
    • Very common; up to 50% of people with colon or rectal cancer may develop liver metastases during their illness.
    • Outcomes are better compared to metastases from some other cancers.
  • Other Secondary Liver Cancers:
    • Spread from the breast, pancreas, stomach, lung, or ovary.
    • Some special cancers like neuroendocrine tumours also spread to the liver but respond well to treatment.

Many people with liver metastases may not have early symptoms. When present, symptoms may include:

  • Pain or heaviness in the abdomen (upper right side)
  • Loss of appetite or unintentional weight loss
  • Fatigue and weakness
  • Yellowing of eyes and skin (jaundice, due to bile blockage)
  • Swelling in the abdomen (ascites, fluid collection)

Liver metastases occur when cancer cells from a primary tumour in another organ travel through the bloodstream or lymphatic system and lodge in the liver. Colorectal cancer is the most common source of liver metastases.

To confirm liver metastases and plan treatment, several tests are used:

  • Imaging scans: CT scan, MRI, or PET scan to map tumour location and spread.
  • Ultrasound: Sometimes used to guide procedures.
  • Biopsy: Removal of a small piece of tissue to confirm cancer type.
  • Blood tests: Liver function tests and tumour markers (like CEA for colon cancer).

Treatment is personalised and decided by a multidisciplinary team (liver surgeons, oncologists, radiologists, pathologists). Options include:

  • Chemotherapy
    • Mainstay treatment for most patients.
    • Helps shrink tumours, making surgery possible in more cases.
    • May be given before or after surgery.
  • Surgery (liver resection/hepatectomy)
    • Removal of the part of the liver affected by cancer.
    • Can range from a small wedge resection to a major hepatectomy (removing a large portion). Surgery may be done through the open technique (cut on the abdomen) or keyhole technique (minimally invasive).
    • The liver can regenerate (grow back), which makes such surgeries possible. Up to 70% of the tumour-bearing liver can be removed if the remaining liver is healthy and permits.
    • In some cases, staged liver resection (two liver operations at two different times) may be required to allow for the healthy liver to grow back.
    • Sometimes performed together with bowel surgery if colorectal cancer is the source.
  • AInterventional radiology procedures:
    • RFA (Radiofrequency Ablation): A needle delivers heat energy to destroy tumours. It can be performed as a day care procedure.
    • TACE (Trans-Arterial Chemoembolisation): Direct delivery of chemotherapy into liver tumours via blood vessels. This is done as an angiography procedure under a local anaesthetic or sedation.
    • DEB-TACE: Trans arterial chemoembolisation using drug-eluting beads
    • SIRT (Selective Internal Radiation Therapy): Uses tiny radioactive beads to target tumours.
    • Portal Vein Embolisation (PVE): Encourages growth of the healthy part of the liver before surgery.

You should consult a doctor if you have:

  • Known cancer and new liver-related symptoms (pain, jaundice, swelling).
  • Follow-up scans showing suspicious spots in the liver.
  • Any unexplained weight loss, fatigue, or abdominal discomfort.

While cancer spread cannot always be prevented, steps that may help include:

  • Regular follow-up if you have a history of cancer.
  • Early detection and timely treatment of primary cancers like colorectal cancer.
  • Healthy lifestyle to reduce overall cancer risk (balanced diet, no smoking, limited alcohol).

Patients with suspected liver metastases should consult:

  • Liver surgeon or hepato-pancreato-biliary (HPB) surgeon
  • Surgical oncologist or colorectal surgeon (if colorectal cancer is the source)
  • Medical oncologist for chemotherapy
  • Interventional radiologist (for minimally invasive procedures)
  • Radiologist and histopathologist (for diagnosis and treatment planning)

Disclaimer:

The information in this Health Library is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any questions about a medical condition or before starting any treatment. Use of this site and its content does not establish a doctor–patient relationship. In case of a medical emergency, call your local emergency number or visit the nearest emergency facility immediately.