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Liver, Secondary

Revised November 2010

This information should not be used to self-diagnose, or be used in place of a qualified physician’s care.
  • Patients with secondary liver cancers are treated by various BC Cancer Agency Tumour groups, depending on where the cancer originated.
  • For healthcare professional information on treating cancer, please see our Cancer Management Guidelines.
  • Secondary liver cancer is also called metastatic liver cancer.
  • Secondary liver cancer is cancer that has started in another part of the body and has spread to the liver through the blood stream or the lymphatic system.  This is a system by which lymphatic vessels carry lymph throughout the body.
  • For cancer that began in the liver please refer to the separate information page about primary liver cancer.
  • The liver is the body's largest solid internal organ and can weigh up to four pounds.
  • It is situated in the upper right side of the abdomen.
  • The liver removes toxins from the blood, produces bile and enzymes to help with digestion, makes proteins that help the blood clot, controls the level of cholesterol in the body, and stores glycogen (sugar) which the body uses for energy.

What causes it and who gets it?
Listed below are some of the known risk factors for this cancer.  Not all of the risk factors below may cause this cancer, but they may be contributing factors.

  • Secondary liver cancer is caused by the spread of the primary cancer through the blood or the lymphatic system.
  • Cancer easily spreads to the liver because the liver is responsible for filtering most of the blood to other organs.
  • Half of all cancers may eventually spread to the liver. It is one of the most common sites for metastatic cancer.
  • Cancers of the eye, stomach, pancreas, esophagus, lung, colon, breast and melanoma almost always spread to the liver if not stopped in their earlier stages.
  • The cancer cells that have spread to the liver look like and behave the same as cells from where the cancer started.
  • Statistics

Can I help to prevent it?

  • There is no known method of preventing secondary liver cancer.

Screening for this cancer

  • Early detection is important but it is difficult to diagnose secondary liver cancer because there are many non-specific symptoms associated with it.

Signs and Symptoms

  • Enlarged liver
  • Hard or tender liver
  • Enlarged spleen
  • Discomfort in the upper right part of the abdomen
  • Pain in right shoulder
  • Weakness in arms and legs
  • Dizziness
  • Weight loss
  • Loss of appetite
  • Fever
  • Nausea
  • Lethargy
  • Jaundice
  • Ascites (fluid build-up in the abdominal cavity)
  • In advanced disease the liver fails to eliminate toxic materials from the blood.

Diagnosis
This is a list of some or all of the tests used to diagnose this type of cancer. 

  • Biopsy - To determine whether a tumour is primary or secondary, a sample of the tumour will be examined under a microscope. If it is secondary cancer, the cells will look like abnormal cells of the tissue where the cancer originated.
  • X-ray.
  • A computerized tomography scan (CT Scan) produces a three dimensional image of the tumour. It is used to see how much the cancer has spread and what treatment should be used.
  • A magnetic resonance imaging scan (MRI) produces detailed images of the tumour.
  • Ultrasound of the liver.
  • For more information on all cancer diagnostic tests, see our Recommended Websites, Diagnosis sections.

Types and Stages
Please refer to type and staging information for the site where the cancer first developed.

Treatment
Cancer therapies can be highly individualized – your treatment may differ from what is described below.

  • The method of treatment depends on the type and origin of the primary cancer and how much it has spread.

Surgery

    • The cancer may be removed with surgery if it is confined to one area of the liver and if the tumours are few in number.
    • Most of the tumours that are considered for surgical removal originate from the colon and rectum. Tumours from other primary sites might be surgically removed if the primary tumour is cured and there is no spread outside of the liver.
    • Surgery should be performed by experienced hepato-biliary surgeons.
    • Since the liver is generally the first site that cancer spreads to, if performed early enough, surgery can result in higher survival rates.

Chemotherapy

    • Palliative chemotherapy is used when the cancer has spread to more than one section of the liver.
    • Palliative chemotherapy is used to prolong the patient’s lifespan and alleviate symptoms but usually cannot cure the cancer.
    • The choice of chemotherapy drugs and the likelihood of response depend on the primary cancer.

Other treatment

    • Radiofrequency ablation heat treatment uses imaging technology (Ultrasound, CT or MRI) to guide a needle electrode through the skin, into a cancerous tumour in order to heat and destroy cancerous cells.
    • Chemoembolization, hepatic arterial infusion, radiation with hepatic artery microspheres, alcohol injection and radio-frequency ablation are considered developmental techniques that may be useful in selected patients.

Follow-up after Treatment

  • You will be returned to the care of your family doctor or your specialist for regular follow-up.
  • Follow-up testing is based on your type of cancer and your individual circumstances.
  • The BCCA Survivorship Research Centre focusses on the issues that cancer survivors can face.

Coping with Cancer

The Coping with Cancer section of our website is a joint project among different BC Cancer Agency departments and programs. This website section provides information and links that can help cancer patients with the physical, emotional, psychological and practical aspects of care. Each cancer experience is different, but in one way or another, many cancer patients share the same needs.

The effects of cancer and its treatment can present unique challenges: from practical concerns like money and housing, to emotional concerns like anxiety and grief. If you need support with the practical and emotional impacts of cancer, or in managing symptoms and side effects you can use the information in Coping with Cancer to connect to these resources.

Search our library catalogue

  • The BC Cancer Agency Library has many resources about cancer, coping, talking to children, etc.  Please visit the Library in your Centre, call a librarian, or visit the Library online to see the many resources available.

Recommended websites 
The BC Cancer Agency has selected and evaluated these useful websites for your further information.

Recommended Websites
Websites for cancer survivors, and how to stay healthy after treatment.

Videos
View videos on cancer-related topics that the BC Cancer Agency produces.

How can I help with research at BCCA?

BC Cancer Agency patients are very helpful when it comes to the fight against cancer.  Here are a few ways that you can help:



This information has been reviewed and approved by a member of the Gastrointestinal Tumour Group.