The liver is one of the largest organs in the body. It’s located under the rib cage on the right side of your abdomen. It’s important for many different functions, including metabolizing food, filtering blood and making bile, and producing blood-clotting proteins.
Metastatic liver cancer is when a primary tumor from another part of the body spreads to the liver. Most often, it’s from cancers that start in the gastrointestinal tract, such as colonic carcinoma (also called adenocarcinoma), pancreatic cancer, and colorectal adenocarcinoma. Other types of cancers that can metastasize to the liver include lung cancer, breast cancer, and hepatocellular carcinoma (HCC).
Doctors diagnose metastatic liver cancer with imaging tests, such as a CT scan or MRI. They may also order a biopsy to confirm the diagnosis and find out what kind of cancer it is, which can help with treatment plans.
If liver metastases are suspected, the doctor may do blood tests to measure the levels of enzymes in the blood that help the body break down and use food, such as alkaline phosphatase, gamma-glutamyl transpeptidase, and lactate dehydrogenase. But these tests aren’t specific for metastatic liver cancer, and the results can vary widely between people. The most accurate diagnostic test is a liver biopsy, which can be guided by imaging tests.
Surgery is usually the first line of treatment for metastatic liver cancer. The surgeon can remove the tumor or a small portion of the liver, called a wedge resection. If the surgery isn’t possible, a chemotherapy drug or immune therapy may be used. The surgery may be followed by a medication that blocks the growth of new blood vessels to the cancer (angiogenesis inhibitors) or reduces the activity of certain genes in the cancer cells to stop them from growing (tumor necrosis factor-alpha inhibitors).
Other medications are available for people with advanced liver disease who cannot have surgery or when other treatments don’t work. These include the targeted drugs regorafenib (Stivarga) or cabozantinib (Cabometyx), and immunotherapy medications such as pembrolizumab (Keytruda) and nivolumab (Opdivo).
The liver can’t be completely removed from the body because it supplies a major blood supply to the digestive tract, spleen, and other organs. But a new procedure allows doctors to remove more of the liver while preserving function. It involves placing a thin tube, called a catheter, into the hepatic artery that supplies blood to the liver. The doctor then sends tiny beads that are coated with a radioactive substance down the catheter, which stick to the tumor and deliver a dose of radiation. This can cause the cancer to die and also block the flow of blood to other parts of the liver that might be damaged by surgery or other treatment.
Talk to your doctor about the best options for you and your unique situation. You can ask questions about your care and discuss your preferences with your doctors through a process called shared decision-making. It’s important to take the time to understand your options and feel confident about your decisions.
