What is liver
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
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).
Other names for this condition include:
- liver metastases
- metastases to the liver
- stage IV or advanced cancer
of the liver
To understand liver metastasis, it’s important to understand
the role of the liver in your body. The liver is the largest organ inside the
body, and it’s vital to life. The liver divided into two lobes and is located
under the right ribcage and lung.
The liver’s jobs include:
- cleansing the blood of toxins
- making bile, which helps in
- making many types of proteins
used throughout the body for fuel and cell regeneration
- making enzymes that initiate
and participate in numerous body metabolic functions
- storing glycogen (sugar),
which the body uses for energy
The liver is one of the most important organs in the body.
It’s impossible to live without a functioning liver.
Symptoms of liver metastasis
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
- jaundice, a yellowing of the
skin or the whites of the eyes
- pain in the right shoulder
- pain in the upper right
- sweats and fever
- enlarged liver
When the liver is enlarged, a lump can be felt on the right
side of the abdomen below the ribcage.
to seek medical attention
It’s important to see your doctor right away if you have any of the symptoms
described above. The following symptoms indicate a more urgent and serious
- persistent vomiting, meaning
vomiting more than twice a day for more than one day
- blood in vomit
- recent, unexplained weight
- black bowel movements
- difficulty swallowing
- new swelling in the legs or
- jaundice or yellowing of skin
You should see your doctor immediately if you develop symptoms of liver
metastasis. If you’ve ever had any type of cancer, you should be seeing your
doctor regularly for checkups.
of liver metastasis
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:
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.
There are six steps in the metastasis process. Not all
cancers follow this process, but most do.
- Local invasion: Cancer cells move from the
primary site into nearby normal tissue.
- Intravasation: Cancer cells move through the
walls of nearby lymph vessels and blood vessels.
- Circulation: Cancer cells migrate through the
lymphatic system and the bloodstream to other parts of the body.
- Arrest and extravasation: Cancer cells stop
moving when they reach a distant location. They then move through the capillary
(small blood vessel) walls and invade nearby tissue.
- Proliferation: Cancer cells grow at the distant
location and create small tumors called micrometastases.
- Angiogenesis: Micrometastases stimulate the
creation of new blood vessels, which supply the nutrients and oxygen needed for
Diagnosis of liver
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
CT scan of the abdomen
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
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
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.
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.
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
If your cancer has spread to the liver, it’s mostly likely
stage IV. Staging assigns a number — 1 through 4) — to the cancer. Staging
ranges from a localized tumor (1) to systemic metastases (spreading of cancer)
to the bloodstream, lymphatic system, and other organs (2 through 4).
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
- the person’s age and overall
- the size, location, and
number of metastatic tumors
- location and type of the
- the types of cancer treatment
the patient had in the past
Systemic cancer therapies treat the whole body through the
bloodstream. These therapies include:
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 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 can slow or stop the growth of certain
types of tumors that rely on hormones to grow, such as breast and prostate
Localized therapies target only tumor cells and nearby
tissue. They can be used when the liver tumors are small in size and number.
This therapy uses high-energy radiation to kill cancer cells
and shrink tumors. It may come from:
- radiation machines, such as external
- radioactive materials placed
in the body near cancer cells, known as internal radiation
- radioactive substances that
travel through the bloodstream
Radiofrequency ablation (RFA)
RFA is commonly used to treat primary liver cancer and can
be used to treat liver metastasis. RFA is a procedure that uses high-frequency
electrical currents to create heat that destroys the cancer cells.
Surgical removal is possible when there are a small number
of tumors that affect only a small area of the liver.
outlook for liver metastasis
In nearly all cases, once a primary cancer has spread or
metastasized to the liver there is no cure. However, current treatments can
help to improve life expectancy and relieve symptoms.
The relative success of treatment depends on the location of
the primary cancer and how much of it has spread to the liver.
Current research is looking for new ways to fight and kill
cancer cells, such as hyperstimulating the immune response and disrupting
individual steps in the metastatic process.