By Samuel J. Greene, M.D.
Metastatic liver cancer, also known as secondary liver cancer, occurs when cancer from another part of the body — including the colon — spreads to the liver.
In some cases, the tumors in the liver may be able to be surgically removed, but often, when the disease is in an advanced stage, they are inoperable.
However, while a diagnosis of metastatic liver cancer can be overwhelming, there is hope.
At Penn Medicine Princeton Cancer Center interventional radiologists are using minimally invasive, targeted treatments to help slow the progression of metastatic liver cancer, manage symptoms and improve quality of life.
Colorectal Cancer One of Most Common to Spread
Metastatic liver cancer originates from cancer cells that break away from their primary site and travel through the bloodstream or lymphatic system to the liver.
Colorectal cancer is one of the most common cancers that spread to the liver. In fact, research indicates that at least 25% of patients with colorectal cancer will develop metastatic liver cancer.
In addition to colorectal cancer, metastatic liver cancer is most often associated with breast, lung, esophageal, stomach, pancreatic, kidney and melanoma skin cancers.
When cancer spreads to the liver it can impair liver function and cause a range of symptoms including:
- Abdominal pain
- Jaundice
- Weight loss
- Bloating
- Fatigue
- Fever
- Itchy skin
Advanced Treatment Options
Patients with inoperable metastatic liver cancer that has not responded to traditional chemotherapy and radiation, have access to advanced treatment options at Princeton Cancer Center, including ablation, chemoembolization and radioembolization.
For patients with single tumors or tumors that are generally five centimeters or smaller and located along the periphery of the liver, ablation may be an option.
Ablation uses thermal energy — either very, very hot or very, very cold — to burn or freeze the tumors and kill the cancer cells. With this procedure, the radiologist uses CT imaging to guide a thin needle through the skin into the tumor to ablate it.
Patients are under general anesthesia for the procedure, which is performed through a small nick in the skin that requires little more than a Band Aid afterward.
Patients normally return home the same day of the procedure with few or no side effects.
During chemoembolization, chemotherapy drugs are injected through a catheter into the artery that supplies blood to the tumor in the liver. The artery is then blocked off (embolized) to help destroy the cancerous cells.
Radioembolization is performed in a similar way. A catheter is inserted into the hepatic artery and used to deliver tiny beads containing radioactive isotopes directly into the tumors.
This enables doctors to deliver a high dose of radiation to the tumors while sparing healthy tissue.
Radioembolization is a two-step process. During the first visit, radiologists use imaging to chart the liver’s blood supply and then inject a contrast dye to help them identify and block blood vessels to the gut to protect it from the radiation.
A small dose of radiation is delivered to ensure it is being delivered precisely to the tumors.
During the second visit, radiologists access the liver through the femoral artery near the groin. A catheter is then guided through the artery into the liver and the radiation is delivered. The entire process takes about 90 minutes and patients are usually under general anesthesia.
Most patients return home the same day of the procedure. Side effects of both chemoembolization and radioembolization are typically mild and may include flu-like symptoms such as fatigue and nausea that normally resolve within a week.
Treatment for metastatic liver cancer depends on a multitude of factors so it is important to talk with your doctor about an approach that is right for you.
And while not a cure, treatment for metastatic liver cancer can improve liver function for many patients and improve survival.
Prevention and Early Detection Key
Prevention and early detection of primary cancers are key to preventing metastatic liver cancer. Be sure to visit your regular health care provider for an annual checkup and to discuss your cancer risk.
Additionally, talk with your doctor about routine screening for colorectal and breast cancers as well as screening recommendations for lung and other cancers. It’s important to note that screening colonoscopy remains the gold standard for the detection and prevention of colon cancer.
By following your doctor’s recommendations for screening, you can detect cancer in its early stages when it’s easier to treat.
To find a physician with Penn Medicine Princeton Health, call (888) 742-7496 or visit www.princetonhcs.org.
Samuel J. Greene, M.D., specializes in diagnostic and vascular and interventional radiology. He is a member of the medical staff at Penn Medicine Princeton Health.
