Liver Metastasis

Liver metastasis is also known as secondary liver cancer or stage IV cancer of the liver. In this condition, the cancer spreads to the liver from another part of the body. Liver metastasis is the most common type of liver cancer. In metastatic liver, the tumor cells found are the cancer cells from the primary site of cancer.

Cancer cells, having the tendency to spread aggressively, travel through the bloodstream or lymphatic system and attack nearby tissues or other regions of the body. Because of the liver’s rich blood supply and body fluids promoting cell growth, the liver provides a platform for metastatic spread.

Causes 

Whether cancer spreads to the liver largely depends on the site of the original tumor. The cancers most likely to spread to the liver are those that begin in the;

• breast
• colon
• rectum
• kidney
• oesophagus
• lung
• skin
• ovaries
• uterus
• pancreas
• stomach 

Liver metastasis may develop years after the primary cancer has been treated or removed.

Types

Metastasis of liver can spread to any region of the liver. People can get any number of liver metastases in the lobes of the liver; sometimes, only one liver metastasis may be present. The most common types of cancer that cause liver metastasis are:

• Colon Cancers
• Cancer of the Rectum
• Pancreatic Cancers
• Stomach Cancers
• Esophagus Cancers
• Breast Cancers
• Lung Cancers
• Melanoma
• Ovarian Cancers
• Neuroendocrine Cancers

The risk of metastatic spread depends on the actual site of the cancer. Gastrointestinal cancers usually spread to the liver because the blood supply from the intestine directly drains through the liver.

Process of Metastasis

The metastasis is a six-step process, which includes:

• Local invasion: Cancer cells from the site of origin grow and attack nearby healthy tissues.
• Intravasation: In this step, the cancer cells proceed through the walls of nearby lymph nodes and blood vessels.
• Circulation: Cancer cells travel through the lymphatic system and the bloodstream to other regions of the body.
• Arrest and Extravasation: At the distant location, the cancer cells stop moving and attack nearby tissues through small blood vessels.
• Proliferation: The cancer cells create tumors, which are small in size, called micrometastasis.
• Angiogenesis: The small tumor triggers the development of new blood vessels, supplying oxygen and nutrients for tumor growth.

Symptoms

Liver metastasis may not show any noticeable symptoms in the beginning, as the liver can function normally even if it contains cancer. Symptoms of metastasis spread differ depending on the location and number of tumors in the liver. When the tumor advances in the liver, there is inflammation of the liver causing obstruction to the blood and bile flow. At this stage, an individual may have symptoms such as:

• Loss of appetite
• Nausea/Vomiting
• Fatigue
• Weight loss
• Fever
• Yellow skin and eyes
• Dark colored urine
• Itchy skin
• Pain in the abdomen
• Ascites
• Swelling of the ankles

Diagnosis 

In order to diagnose secondary liver cancer and understand how far the cancer has spread, the doctor may recommend one or more of the following tests: 

1. Blood tests
2. Imaging tests
3. Biopsy 

1. Blood tests may be done for tumor markers, which are substances that cancer cells produce. Liver enzyme levels will also be checked because abnormally high enzyme levels can indicate that there has been injury to cells in the liver.

2. Imaging tests help identify the precise location of the tumor and assess the health of the organ, nearby tissues, and blood vessels.

Imaging tests allow doctors to anticipate how a tumor may respond to various treatments and assist surgeons and interventional radiologists during procedures.

To diagnose liver metastases, doctors may use the following imaging tests alone or in combination:

• MRI
• CT scan 
• ultrasound test 
• PET scan

3. A biopsy is very important because it tells how extensive your tumor is and what types of cells it contains. In a biopsy, cells or tissues are taken out to be examined under a microscope. A core needle biopsy involves using a large, hollow needle to extract a cylindrical tissue sample from a tumor or abnormal growth. This is the most commonly used biopsy..

A laparoscopic biopsy may also be used.

Treatment

In liver metastasis, as the cancer spreads from another part of the body, a right approach may help reduce the symptoms and increase life expectancy. The treatment approach depends upon:

• The Age
• The type of primary cancer
• The number and size of metastatic tumors in the liver
• The spread of cancer cells around the liver
• Overall health condition.

The treatment plan for liver metastasis includes:

• Chemotherapy – It is used when the cancer has spread to the liver and other parts of the body. Chemotherapy helps reduce the growth of cancer cells or shrink the tumor before surgery, or kill the cancer cells to stop its spread to other parts of the body.
• Targeted Therapy – This therapy uses drugs to stop or slow the growth and spread of cancer cells by blocking the growth substances.
• Ablation Therapy – This therapy involves heat, chemicals, or electricity to remove or destroy cancer cells or tissues of liver metastasis
• Liver Resection – In liver metastasis, this method of surgery is used to remove one or a few areas of the liver which is attacked by cancer cells.
• Radiation Therapy – Radiation therapy targets liver tumors to lower the risk of liver damage.
• Hormonal Therapy – This type of therapy acts on cancer cells that require hormones for growth
• Liver Transplantation – Transplant is a treatment option in conditions where the liver tumor is too big to be removed from the body, the liver tumor is hard to remove, or if many tumors have spread all over the liver.

Prevention

It is not always possible to prevent liver metastasis. Liver metastasis happens when cancer from another part of the body spreads to the liver. It is possible that for some people, this happens even before there has been a primary cancer diagnosis.

In some instances, cancer may take months or even years to reach the liver.

If the primary cancer has been treated, it can help reduce the risk of the cancer spreading. However, liver metastases may still arise long after treatment, so there is no absolute guarantee.

Healthy living guidelines must be followed to help prevent cancer, which include avoiding drinking excess alcohol and smoking. People must maintain a moderate weight through diet and exercise.

An early detection of any cancer often gives the best chance of successful treatment. It’s important to schedule routine medical checkups and inform your doctor about any abnormal symptoms.

Life Expectancy

People diagnosed with liver metastasis usually face a challenging prognosis and reduced life expectancy. This is because liver metastasis indicates an advanced-stage cancer. Survival rates are influenced by factors like:

The origin of the primary cancer

• Whether the liver metastasis can be surgically removed
• The scope of the metastasis: is it limited to the liver or has it spread to other organs?
• Treatment options include surgery, chemotherapy, targeted therapy, or immunotherapy. 

Treatments can help shrink the tumor and improve life expectancy, and relieve symptoms. A doctor can estimate life expectancy only after evaluating a person’s unique situation. It is possible that a person may live far longer or shorter than expected.

WHY Rela Hospital?

Rela Hospital, established with the aim of providing exceptional patient care, provides advanced treatment options in the field of oncology. Rela Hospital has the world’s largest liver ICU, a dedicated liver ambulance, a 24/7 liver helpline, and a highly experienced team, making it one of the best liver cancer treatment hospitals in Chennai.

Patients at Rela Hospital are evaluated accurately and receive the most appropriate treatment by our doctors, who are the top liver cancer specialists in the region. With all three major departments of cancer care – medical oncology, surgical oncology, and radiation therapy under one roof, Rela Institute is the destination for patients with liver metastasis.

A wide range of treatment options is available to treat metastatic liver cancer; however, liver transplant is the most successful method used to save patients with advanced liver cancers. Under the visionary Dr. Mohamed Rela, Rela Hospital has the most competent liver transplantation surgeons in India.