Cancer is a disease that results when cells change and become abnormal. These abnormal cells grow out of control. Liver cancer is cancer that begins in the liver, the largest internal organ. The liver is an important vital organ that has several functions including blood detoxification and protein synthesis. Metastatic liver cancer is cancer that originates in the liver and spreads to other parts of the body like the lungs or colon. Liver cancer is a common type of cancer in certain parts of the world, but in the United States it is less common than other types.
Liver cancer is more commonly seen in those who have had liver damage due to the hepatitis B or C virus, fatty liver disease, alcoholism, or other factors. There may be other factors linked to the development of liver cancer such as obesity and diabetes. It is more commonly seen in men 40 years and older, although anyone may develop the illness including children.
In the case of metastatic liver cancer, depending on the advancement of the metastases, the goal may be to attempt to cure the cancer, however when this is not a possibility, the treatment goal may involve prolonging life and improving the well-being of the patient.
Symptoms of Metastatic Liver Cancer
Metastatic liver cancer does not have very many symptoms in the earlier stages, however in the later stages the disease becomes symptomatic. Sometimes symptoms can be vague and do not necessarily point to liver cancer right away. Symptoms can include weight loss for no obvious reason, swelling in the abdominal region, appetite loss, fatigue or weakness, vomiting, nausea, abdominal pain, and jaundice (yellow discoloration of the skin).
The liver is enlarged in many cases, and it may feel tender. Usually the spleen is enlarged as well. Jaundice develops when the cancer begins to block the bile ducts. As the disease progresses, the jaundice becomes worse and worse. One late stage symptom of the disease is drowsiness due to toxins accumulating in the brain, which is known as hepatic encephalopathy.
Metastatic Liver Cancer Diagnosis
Liver cancer is often difficult to diagnose. This is due to the reduced severity of symptoms until some of the latest stages of the illness. However liver function tests can be done to test if the liver is working properly, and these are simple blood tests. Other tests that can be used to diagnose liver cancer include ultrasonography, magnetic resonance imaging (MRI), and computed tomography (CT). These scans are not accurate all the time because in the very early stages some of the tumors might be very small. Metastatic liver cancer is usually late stage (stage IV) and thus more symptomatic.
If tests show that there may be cancer present, a liver biopsy is performed to confirm the presence of cancer. A liver biopsy involves the removal of a small amount of tissue that is examined under a microscope to confirm the presence of cancer cells. Laparoscopy can be used to guide this process, which is a viewing tube inserted into the abdomen. CT or ultrasonography may be used by the doctor to help direct the biopsy needle.
Metastatic Liver Cancer Treatment
If liver cancer is diagnosed early, a patient will have a great chance of successful treatment. There are several treatments available for liver cancer including the more common treatments of chemotherapy, radiation, and surgery. Chemotherapeutic drugs are used to shrink the tumor but they do not cure the cancer, and these drugs may be injected into the main artery of the liver. If the cancer has metastasized, whole body chemotherapy may be used.
Radiation therapy is not shown to be highly effective in the case of liver cancer and metastatic liver cancer except for some cases in which it reduces pain for some patients. Surgery is typically performed if there up to a few tumors found in the liver, and this option is considered in a case by case basis.
Other options that may be considered for treatment include minimally invasive techniques such as radioembolization, which delivers a high concentration of radiation directly to cancer tumors in the liver that has shown to improve survival time, radiofrequency ablation, which works by heating and destroying cancer cells when surgery is not a good option for a patient.
Minimally invasive treatment methods such as laparoscopic surgery or liver transplantation may be considered as well as alternative options. New treatments are always being developed for liver cancer and other types of cancers, and experimental options may be available.
Metastatic Liver Cancer Prognosis
In Stage I of liver cancer, the cancer is only located in the liver and hasn’t invaded any nearby blood vessels. In Stage II, the cancer has invaded nearby blood vessels or there are multiple tumors seen in the liver. In Stage III, the tumors may have grown to be larger, or it can be a single large tumor that has invaded the main vein of the liver or nearby organs. In Stage IV of liver cancer, it has metastasized to other organs and parts of the body.
Prognosis of metastatic liver cancer depends on how much the cancer has metastasized or spread. The prognosis depends on the stage of the cancer, if and how much the cancer has metastasized, the liver’s functionality, the patient’s general health, and several other factors. In some cases the cancer can be cured through surgery or through other treatments, in other cases these treatments are not as effective.
Prognosis is shown to be statistically poor in the later stages of the disease, however each individual case is unique. If surgery is an option to remove the cancer, the 5 year survival rate for the cancer increases. Survival rates are the highest with a liver transplant. The best results are seen when a transplant is performed in the early stages of the disease. Typically transplantation is not an option after the cancer has become metastatic due to the risk of cancer spreading from other parts of the body back to the liver. Prognosis is always determined by a licensed physician.