Metastatic Liver Cancer

Metastatic liver cancer happens when cancer from one area of your body spreads to your liver. Healthcare providers may use the term metastasis, which is the process that cancer cells use to spread to your liver. Metastatic liver cancer is also known as secondary liver cancer or liver metastases.

Colorectal cancer that spreads to your liver is the most common form of this condition. Other cancers that can spread to your liver include breast, lung, pancreas and stomach cancer. Oncologists may call these primary cancers.

Your oncologist may diagnose secondary liver cancer at the same time they diagnose the primary or original cancer. But metastatic liver cancer may develop months or years after you finish treatment for the primary cancer.

This condition may cause different symptoms. One common early symptom is losing weight without trying. Later, you may have pain in your upper right belly. Oncologists may use different types of chemotherapy, ablation and surgery to treat liver metastasis.

Symptoms of metastatic liver cancer

This condition may not cause symptoms right away. When they appear, common symptoms include:

• Loss of appetite
• Unexplained weight loss
• Fever
• Pain in your upper right belly
• A yellowish tint to your skin and the whites of your eyes from jaundice
• Swollen belly

Metastatic liver cancer causes

This type of cancer happens when cancerous cells break off from a tumor in another part of your body. The cells can float in your bloodstream or lymphatic system to travel to your liver:

• Every day, your liver filters more than 250 gallons of blood. The steady flow of blood increases the chance that cancerous cells will travel through your blood to your liver.
• Cancer may also travel to your liver via vessels that carry lymph throughout your body.

Like other forms of metastatic cancer, the cancerous cells in your liver are cells from the original tumor. The cells don’t change. They’re just growing in a new place.

Complications

Cancer in your liver may keep it from getting rid of toxins in your blood. The toxic buildup causes hepatic encephalopathy, a serious illness that affects your brain.

How doctors diagnose metastatic liver cancer

A healthcare provider will do a physical exam that focuses on your belly. They’ll ask about your symptoms and your medical history. They may do blood tests, imaging tests and a liver biopsy:

• Blood tests: A provider may do liver function and tumor marker tests. Liver function tests check for damage to your liver. Tumor marker tests check for substances that may be signs of cancer.
• Imaging tests: You may have CT, MRI and PET scans. Your provider may do a liver ultrasound.
• Liver biopsy: This test gets tissue samples from your liver. A medical pathologist will identify the primary cancer. For example, the biopsy may find breast cancer cells in your liver. Knowing the cancer type helps your provider plan treatment.

How is metastatic liver cancer treated?

Oncologists typically treat this condition with anti-cancer medications, treatment that cuts off the tumor’s blood supply or directly destroys cancer cells, or surgery. Your specific treatment will depend on where the cancer started, the location and how much cancer the liver has. Your treatments may include:

• Ablation therapy: This treatment uses extreme heat, cold or high-energy ultrasound waves (histotripsy) to destroy tumors in your liver. Your oncologist may use it to eliminate tumors that measure less than 1 inch (3 centimeters).
• TACE: Transarterial chemoembolization cuts off the blood supply to tumors in your liver.
• Radioembolization: This treatment delivers radiation to the tumor in your liver while also blocking the tumor’s blood supply.
• Radiation: High-energy X-rays target the tumor in your liver.
• Chemotherapy: You may have chemotherapy that reaches all areas of your body. Other treatments involve sending chemotherapy directly into your liver
• Targeted therapy: This is medication that targets the genetic change that turned healthy cells into cancerous ones. The drugs may destroy the cells or block genetic changes.
• Immunotherapy: This treatment helps your immune system to fight the cancer.
• Surgery: A surgical oncologist removes the part of your liver that cancer affects. They may combine chemotherapy and surgery, known as conversion therapy. Synchronous or simultaneous surgery is another option. It involves a single operation to remove the tumor in your liver and the tumor that has spread to your liver.
• Liver transplant: Some cancers, like colorectal cancer with only liver metastases, can be managed with a liver transplant. This is something that a specific team of specialists — including liver surgeons, oncologists and hepatologists — needs to manage.

When should I seek care?

Talk to a healthcare provider if you lose weight without trying, have pain in your upper right belly or notice changes in the color of your skin or the whites of your eyes, especially if you have a history of cancer. Having these symptoms doesn’t mean you have liver metastasis. Other liver diseases may cause them.

If you have metastatic liver cancer, talk to your provider if your symptoms change or get worse. For example, feeling confused and drowsy all the time may be symptoms of hepatic encephalopathy.

Is metastatic liver cancer curable?

Medical researchers are focused on treatments to slow down cancer, ease your symptoms and help you live longer with liver metastasis. Sometimes, treatment can remove all the tumors in the liver.

How long can you live with metastatic liver cancer?

How long you may live depends on factors including:

• The type of cancer that’s spread to your liver
• How that cancer responds to treatment
• How the cancer in your liver responds to treatment

Understandably, you may want to know how long you’ll live with cancer. This may be a tough question to ask and to answer, and your oncologist is your best source of information. They’ll explain what you may expect, given your circumstances.

Is there anything I can do to feel better?

Living with metastatic liver cancer often means managing symptoms and treatment side effects. Palliative care may help. Specialists can recommend treatments to ease your symptoms and side effects. They can also offer emotional support. Here are some other things you can do:

• Eat well: Cancer and cancer treatment can make meals challenging. Make the most of your meals by choosing foods that support your liver. Ask to speak with a dietitian for more ideas.
• Consider cancer survivorship: These programs offer different services to help you live well with this condition.
• Connect with others: It can be lonely living with an incurable disease like metastatic liver cancer. Your friends, family or co-workers may not know what to say or how to say it. There may be local or online support groups you can join. Your cancer survivorship or palliative care team will have suggestions.