Secondary cancer in the liver
This information is about cancer that has spread from the part of the body where it started, called its primary site, to the liver.
Secondary cancer in the liver occurs when cancer cells spread from the original cancer through the blood stream or lymphatic system and settle in the liver.
This type of spread is called metastasis, secondary cancer or secondaries. It is not the same as having primary liver cancer.
The liver sits on the right-hand side of your upper abdomen (belly) just under your ribs. It is made up of different sections called lobes and is surrounded by a capsule. It is close to a number of other organs, including the bowel, the diaphragm and the right kidney.
The liver makes bile to help digest food. It also changes food into heat and energy and stores glucose and vitamins. It breaks down harmful substances, such as alcohol and drugs. It also produces vitamins and protein that help your blood clot. The liver is a large organ and can often carry on working even when part is affected by cancer.
Secondary cancer in the liver may not cause any symptoms for a long time. Sometimes, routine tests, such as blood tests, can point to a problem and further tests are needed.
Common symptoms include:
- loss of appetite
- weight loss
- a high temperature and feeling shivery
- vague discomfort in the upper right abdomen sometimes described as feeling like stitch. Sometimes there is pain in the shoulder tips because the diaphragm is irritated. Occasionally pain is felt in parts of the body far away from the cancer that is causing it. This type of pain is called referred pain.
When the bile duct becomes blocked bile will flow back into the blood stream causing jaundice. Signs of jaundice are yellow skin and eyes, dark urine and pale bowel motions.
Ascites is swelling in the abdomen from a build-up of fluid. This is because the cancer cells have spread to the lining of the abdomen (peritoneum) irritating it and making fluid leak out of the tissue. If this happens a tube can be put into the abdomen to drain the fluid, or the fluid can be removed with a special needle.
- abdominal examination
- blood test
- Liver ultrasound – a painless test where sound waves are used to make a picture of the inside the liver.
- Abdominal CT scan – a series of cross-sectional pictures of the liver are taken to build up a very accurate picture of any secondary cancers. A contrast dye may be used to enhance detail. The dye may give you a brief feeling of being hot all over.
- MRI scan – a scan that uses magnetic resonance to detect abnormalities.
Treatment is aimed at reducing symptoms and controlling the cancer for as long as possible.
The choice of treatment depends on:
- where the cancer has spread from (where the primary cancer was)
- which part of the liver is affected
- whether other parts of the liver is affected
- whether other parts of the body are affected, for example, the lungs.
Chemotherapy is the main treatment for secondary cancer in the liver.
Surgery is used for a small number of people, usually those whose liver cancer has spread from the bowel. This will be considered if there are only a few secondary tumours in one part of the liver and the primary cancer is controlled. A liver transplant is not possible for people who have secondary cancer in the liver.
Ablation (technique for destroying tissue) – small tumours can sometimes be removed by heat (diathermy), cold (cryotherapy), alcohol, radio frequency, microwaves or laser.
For some types of cancer that have spread to the liver, for example, breast cancer, hormonal or immunotherapy may be offered.
Monoclonal antibodies – these drugs are sometimes used. Examples are trastuzumab (Herceptin) for breast cancer that has spread to the liver and bevacizumab (Avastin) for bowel cancer that has spread to the liver.
In addition, expert symptom management often using a combination of drugs and supportive therapies, such as relaxation and massage, will be helpful. You may be referred to a palliative care service.
If you are diagnosed with secondary cancer in the liver you may experience a range of emotions, including anger, fear, anxiety, resentment, and sadness. You may find it helpful to talk over how you are feeling with others, such as family, friends, your doctor, cancer care team or a counsellor.
The Cancer Society offers a range of support and information services to assist those diagnosed with secondary cancer in the liver. Phone the Cancer Information Helpline 0800 CANCER (226 237) to speak to our cancer information nurses.
Your local Cancer Society’s can offer you a free copy of Advanced Cancer/Matepukupuku Maukaha.
Cancer Society libraries have these books to borrow. Phone 0800 CANCER (226 237) to request them.
- American Cancer Society. Quick Facts. Advanced Cancer. USA: American Cancer Society, 2008.
- Holland, Jimmie, and Lewis, Sheldon. The Human Side of Cancer: Living with hope, coping with uncertainty. USA: HarperCollins, 2000.
- Lynn, Joanne, and Harrold, Joan. Handbook for Mortals: Guidance for people living with serious illness. USA: Oxford University Press, 1999.
- Moore, Thomas. Care of the Soul: A guide for celebrating depth and sacredness in everyday life. USA: HarperPerennial, 1994.
- Shinoda Bolen, Jean. Close to the Bone: Life-threatening illness and the search for meaning. USA: Touchstone Books, 1998.
- Macmillan: Coping with advanced cancer
- National Cancer Institute: When cancer returns
- Palliative Care Australia: “Asking Questions can Help” – an online booklet for patients and families – to view this click ‘publications’ to link to the booklet.
- Skylight: Skylight helps children and young people deal with change, loss and grief.
This information was written in October 2010 by the Cancer Society. It is reviewed every three years.
For cancer information and support phone 0800 CANCER (226 237).