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Liver, Secondary

This information should not be used for self-diagnosis or in place of a qualified physician's care.

Revised 2015

The basics
  • Guidelines for treating this cancer have been developed by various BC Cancer Tumour groups, depending on where the cancer originated.
  • For health 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 & staging

Diagnosis

These are tests that may be 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 tests used to diagnose cancer, see our Recommended Websites, Diagnostic Tests section.

Types and Stages

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

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. If you do not have a family physician, please discuss this with your BC Cancer oncologist or nurse.
  • Follow-up testing is based on your type of cancer and your individual circumstances.
  • Life after Cancer focuses on the issues that cancer survivors can face.
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