Liver Metastases

The liver is a common site for metastases from many cancer types. Cancers that spread to the liver most often are colorectal cancer, as well as breast, esophageal, stomach, pancreatic, lung, kidney, and melanoma skin cancers.

Symptoms of liver metastases

Cancer in the liver can cause different symptoms based on how much of the liver is involved. Some common symptoms include

• Loss of appetite
• Feeling tired or weak
• Fever
• Itchy skin
• Yellowing of the whites of the eyes or skin (jaundice)
• Bloated belly
• Leg swelling
• Pain in the upper right part of the abdomen (belly) (less common)

If there are a lot of metastases in the liver and it can’t work well, people can get a condition called hepatic encephalopathy. This can cause confusion, sleepiness, and even coma.

Treatment of liver metastases

Surgery to remove the metastases may be an option if there are a small number of tumors in the liver and they are not in areas that would affect normal liver function. A different procedure called ablation might also be an option. In ablation, a thin needle is put into the tumor.  The treatment (such as a high energy current) is passed through the needle to destroy the cancer cells.

Radiation therapy may also be an option for treating liver metastases. This may involve radiation to the whole liver. Or if there are a small number of metastases, a specialized procedure called stereotactic radiosurgery may be used.

Chemotherapy may be used for certain kinds of cancer. This may be given into a vein in your arm or right into a blood vessel leading to the liver.

Sometimes a procedure can be done to block the blood supply to the cancer. This is called embolization.

If a person has hepatic encephalopathy, treatment will depend on how severe symptoms are.  A person who is confused, sleepy, or in a coma will likely be treated with medicines such as lactulose, lactitol, or rifaximin. These medicines decrease the level of one of the toxins (ammonia) that can build up in the blood.