Liver Metastasis

What is a Liver Metastasis?

A liver metastasis is a cancerous tumor that has spread to the liver from a cancer that started in another place in the body. It’s also called secondary liver cancer. Primary liver cancer originates in the liver and most commonly affects individuals who have risk factors such as hepatitis or cirrhosis.

Most of the time, cancer in the liver is secondary, or metastatic.

The cancer cells found in a metastatic liver tumor are not liver cells. They are the cells from the part of the body where the primary cancer began (for example, cancerous breast, colon, or lung cells).

Symptoms

There may be no symptoms in the early stages of liver metastasis. In later stages, cancer can cause the liver to swell or obstruct the normal flow of blood and bile. When this happens, the following symptoms may occur:

  • loss of appetite
  • weight loss
  • dark-colored urine
  • abdominal swelling or bloating
  • jaundice, a yellowing of the skin or the whites of the eyes
  • pain in the right shoulder
  • pain in the upper right abdomen
  • nausea
  • vomiting
  • confusion
  • sweats and fever
  • enlarged liver

Causes

The risk that cancer will spread, or metastasize, to the liver depends on the location of the original cancer. Primary cancers that are most likely to spread to the liver are cancers of the:

  • breast
  • colon
  • rectum
  • kidney
  • esophagus
  • lung
  • skin
  • ovaries
  • uterus
  • pancreas
  • stomach

Even if the primary cancer is removed, liver metastasis can still occur years later. If you’ve had cancer, it’s important to learn the signs of liver metastasis and get regular checkups.

Diagnosis of liver metastasis

The doctor may suspect liver cancer if the liver is enlarged on examination, if the liver surface is not smooth, or if any of the symptoms above are reported. Various kinds of testing will be needed to confirm the diagnosis. These tests include:

Liver function tests

Liver function tests are blood tests that indicate how well the liver is functioning. Liver enzyme levels are often elevated when there is a problem. Blood or serum markers are substances in the blood that are linked to cancer. When primary liver cancer is present, there may be higher levels of alpha-fetoprotein (AFP) detected in the blood. Liver function tests can help distinguish between primary liver cancer and liver metastasis. AFP markers can also be used to monitor treatment effects of primary liver cancer.

CT scan of the abdomen

A computed tomography (CT) scan is a special kind of X-ray that takes visual images of soft-tissue organs in detail. Cancerous tissue will have a moth-eaten appearance.

Ultrasound of the liver

Also called sonography, an ultrasound transmits high-frequency sound waves through the body. These sound waves produce echoes. The echoes are then used to create map-like computerized images of the body’s soft-tissue structures.

MRI

Magnetic resonance imaging (MRI) creates extremely clear images of internal organs and soft-tissue structures. It uses radio waves, a large magnet, and a computer.

Angiogram

In an angiogram, dye is injected into an artery. When images are taken of the body along that artery’s pathway, it can produce high-contrast images of internal structures.

Laparoscopy

The laparoscopy is a narrow tube with a light and a biopsy (tissue sample) tool. The laparoscope is inserted through a small incision, and biopsies are taken for study under a microscope. Laparoscopy is the most reliable minimally invasive method of diagnosing cancer.

Treatments for liver cancer

Several options are currently used for treating cancer that has metastasized to the liver. In most cases treatment will be palliative. This means that it will be used to control symptoms of the cancer and prolong life but will not likely result in cure. Generally, the choice of treatments will depend on:

  • the person’s age and overall health
  • the size, location, and number of metastatic tumors
  • location and type of the primary cancer
  • the types of cancer treatment the patient had in the past

Systemic therapies

Systemic cancer therapies treat the whole body through the bloodstream. These therapies include:

Chemotherapy

Chemotherapy is a form of treatment that uses drugs to kill cancer cells. It targets cells that grow and multiply quickly, including some healthy cells.

Biological response modifier (BRM) therapy

BRM therapy is a treatment that uses antibodies, growth factors, and vaccines to boost or restore the immune system. This helps your immune system’s ability to fight cancer. BRM therapy does not have the usual side effects of other cancer therapies and, in most cases, is well tolerated.

Targeted therapy

Targeted therapy also kills cancer cells, but it’s more precise. Unlike chemotherapy drugs, targeted treatments can differentiate between cancer and healthy cells. These drugs can kill cancer cells and leave healthy cells intact. Targeted therapies have different side effects than some other cancer treatments. Side effects, which can be severe, include fatigue and diarrhea.

Hormonal therapy

Hormonal therapy can slow or stop the growth of certain types of tumors that rely on hormones to grow, such as breast and prostate cancer.

Localized therapies

Localized therapies target only tumor cells and nearby tissue. They can be used when the liver tumors are small in size and number.