Metastatic Liver Cancer (Liver Secondaries)
This is cancer that has started somewhere else in the body and has spread to the liver. This happens when cancer cells migrate via the blood into the liver, which acts as a filter for all the blood in a person’s body.
This cancer is different from primary liver cancer, which is a cancer arising from the liver cells. Metastatic liver cancer is more common than primary liver cancer.
Symptoms are usually very vague and non-specific. By the time cancer cells spread to the liver, the cancer is usually very advanced. Common symptoms include loss of appetite, weight loss, nausea and tiredness.
Patients may notice a vague discomfort in the upper abdomen due to enlargement of the liver. Such discomfort will be more prominent on the right upper abdomen.
If the bile duct becomes blocked by the enlarging tumours in the liver, bile will flow back into the bloodstream, causing jaundice. This will make the skin and whites of the eyes turn yellow and make the skin itchy. Other signs of jaundice are dark-coloured urine and pale stools.
Sometimes, fluid builds up in the abdomen and causing abdominal swelling. This is known as ascites. If the amount of fluid is high, it can impair the breathing of the patient, causing him to be breathless.
Because the common symptoms of metastatic liver cancer are very non-specific, many patients delay seeing a doctor until they are very sick. By then, treatment options usually become very limited.
You should consult your doctor if you have:
- unexplained weight loss or appetite loss
- prolonged tiredness
- progressive abdominal swelling
Patients with metastatic liver cancer have stage 4 cancer. This is usually the terminal stage, and cure is seldom possible.
However, with the advances in medical science, long-term survival is sometimes still possible in some types of cancers. The treatment will be a combination of surgery to remove part of the liver where the tumour is found, chemotherapy, radiotherapy and biological therapy.
This approach is called a multi-modality approach, and it requires a multi-disciplinary team (a team made up of specialists with different skills who come together to discuss and put forth a customized treatment plan for each patient). You can read more about Nexus Surgical multi-disciplinary team in Nexus Surgical Cancer Centre.
One example of a cancer in which cure may still be possible even when the cancer has spread to the liver is colon cancer (colorectal cancer). In the past, for patients with stage 4 colon cancer, the chance of a patient living beyond 5 years is not more than 5%. Now, with modern treatment which includes liver surgery and chemotherapy, the chance of living beyond 5 years is about 30 to 40%. There are even 10-year survivors.
Other cancers that may also show good survival after treatment despite having spread to the liver includes:
- Neuroendocrine cancer
- Ovarian cancer
For patients with incurable cancers, they met benefit from a consolation with a specialist in Palliative Medicine. The palliative specialist will ensure that such patients do not suffer in their last days, but continue to enjoy a good quality of life.