Metastatic Liver Cancer

What is metastatic cancer?

Metastatic cancer is a cancer that has extended from the part of the body where it started (the primary site) to other parts of the body. When cancer cells break away from a tumor, they can travel to other areas of the body through the bloodstream or the lymph system (which contains a collection of vessels that carry fluid and immune system cells).

This image shows some parts of the lymph system, like lymph nodes and lymph vessels, as well as organs and tissues that contain many lymphocytes (immune cells).

If the cells travel through the lymph system, they may end up in nearby lymph nodes (small, bean-sized collections of immune cells) or they may spread to other organs. More often, cancer cells that break off from the main tumor travel through the bloodstream. Once in the blood, they can go to any part of the body. Many of these cells die, but some may settle in a new area, begin to grow, and form new tumors. This spread of cancer to a new part of the body is called metastasis.

Cancer cells have to go through several steps to spread to new parts of the body:

They have to be able to break away from the original tumor and enter the bloodstream or lymph system, which can carry them to another part of the body.
They need to attach to the wall of a blood or lymph vessel and move through it into a new organ.
They need to be able to grow and thrive in their new location.
They need to be able to avoid attacks from the body’s immune system.

Going through all these steps means the cells that start new tumors may no longer be exactly the same as the ones in the tumor they started in. This may make them harder to treat.

Even when cancer has spread to a new area, it’s still named after the part of the body where it started. Treatment is also based on where the cancer started. For example, if prostate cancer spreads to the bones, it’s still prostate cancer (not bone cancer), and the doctor will recommend treatments that have been shown to help against metastatic prostate cancer. Likewise, breast cancer that has spread to the lungs is still breast cancer, not lung cancer, and is treated as metastatic breast cancer.

What is Metastatic Liver Cancer?- Video

Sometimes the metastatic tumors have already begun to grow when the cancer is first found and diagnosed. And in some cases, a metastasis may be found before the original (primary) tumor is found. If a cancer has already spread too many places when it’s found, it may be very hard to figure out where it started. If this happens the cancer is called cancer of unknown primary. This is discussed in a separate document, Cancer - Unknown Primary.

Metastatic liver cancer is a cancer that has spread to the liver from elsewhere in the body.

Weight loss and a poor appetite may be the first symptoms.
Doctors base the diagnosis on results of blood tests and usually biopsy.
Chemotherapy drugs and radiation therapy may help relieve symptoms but do not cure the cancer.

Metastatic liver cancer most commonly originates in the lungs, breasts, large intestine, pancreas, or stomach. Leukemia (a cancer of white blood cells) and lymphoma (a cancer of the lymph system), especially Hodgkin lymphoma, may involve the liver.

Cancers spread to the liver because the liver filters most of the blood from the rest of the body, and when cancer cells break away from a primary cancer, they often enter and travel through the bloodstream. Sometimes the discovery of metastatic liver cancer is the first indication that a person has cancer.

Often, the first symptoms are vague. They include weight loss, poor appetite, and sometimes fever. Typically, the liver is enlarged and hard. It may feel tender and often lumpy. Occasionally, the spleen is enlarged, especially if the cancer originated in the pancreas. At first, unless the cancer is blocking the bile ducts, the person has mild or no jaundice (a yellowish discoloration of the skin and the whites of the eyes). Later, the abdomen may become swollen (distended) with fluid (a condition called ascites—see Ascites).

In the weeks before death, jaundice progressively worsens. People may become confused and drowsy as toxins accumulate in the brain because the liver is too damaged to remove them from the blood. This condition is called hepatic encephalopathy (see Hepatic Encephalopathy).

Doctors may suspect metastatic liver cancer in people who lose weight and have an enlarged liver or who have a cancer that tends to spread to the liver. However, doctors often have difficulty diagnosing the cancer until it is advanced.

If doctors suspect liver cancer, liver function tests, which are simple blood tests, are done to evaluate how well the liver is functioning. Results may be abnormal, as they are in many disorders. Thus, this finding cannot confirm the diagnosis. Ultrasonography is usually helpful, but computed tomography (CT) and magnetic resonance imaging (MRI) of the liver are usually more accurate in detecting the cancer. Before CT or MRI is done, a dye is injected into a vein. The dye helps make abnormalities, if present, easier to see. However, imaging tests cannot always detect small tumors or distinguish cancer from cirrhosis or other abnormalities.

Treatment depends on how far the cancer has spread and what the primary cancer is. Options include the following:

Chemotherapy drugs: These drugs may be used to temporarily shrink the tumor and prolong life, but they do not cure the cancer. Chemotherapy drugs may be injected into the liver’s main artery (the hepatic artery), delivering a large amount of the drugs directly to the cancer cells in the liver. With this method, the rest of the body is less exposed to the drugs, and thus side effects are fewer and milder.

Radiation therapy to the liver: Sometimes this treatment reduces severe pain caused by advanced cancer, but it has little other benefit.

Surgery: If only a single tumor or a few tumors are found in the liver, they may be surgically removed, especially if they originated in the intestines. However, not all experts consider this surgery worthwhile.

If the primary cancer is leukemia or lymphoma, doctors focus on treating that cancer (see Overview of Leukemia: Treatment and Hodgkin Lymphoma: Treatment and Prognosis).

If cancer has spread extensively, usually all a doctor can do is relieve the symptoms (see Symptoms during a Fatal Illness). People may prepare an advance directive (see Advance Directives) to specify the type of care they desire if they become unable to make decisions about care.

Metastatic Liver Cancer

A liver biopsy (removal of a sample of liver tissue with a needle for examination under a microscope—see Biopsy of the Liver) is done if the diagnosis is unclear after imaging tests or if more information is needed to help with treatment decisions. To improve the chances of obtaining cancerous tissue, doctors use ultrasonography or CT to guide the placement of the biopsy needle. Alternatively, doctors may insert a flexible viewing tube (laparoscope) through a tiny incision in the abdomen to better identify and obtain cancerous tissue.
Source: medicalnewstoday.com