Liver Metastasis - Causes, Symptoms, Diagnosis, and Treatment

Introduction

Liver metastasis is a cancerous condition where cancer from other body parts spreads to the liver. Secondary liver cancer is another name for this condition. Primary liver cancer occurs in the liver, mainly affecting individuals with a higher risk factor, such as hepatitis or cirrhosis. Mostly, the cancer of the liver is secondary or metastatic.

What Is Liver Metastasis?

Liver metastasis is a type of cancer originating in some other organ and spreading to the liver. For the metastasis of many cancers, the liver is a common site. Cancers that spread to the liver are often colorectal cancers or cancers of the gastrointestinal tract, esophagus, stomach, pancreas, lungs, kidneys, breast, ovaries, uterus, and skin. The cancer cells found in the metastatic liver tumor are not liver cells. They are the cells from parts of the body where primary cancer began (for example- a cancerous colon, breast, or lung cells). The initial symptoms of metastasis cannot be ruled out specifically. Some of the symptoms include

• Weight loss.

• Pain or discomfort in the right upper quadrant.

• Hepatomegaly or primary tumors are the primary factors for liver metastasis.

What Are the Symptoms of Liver Metastasis?

Initially, metastasis of the liver can be asymptomatic. Later on, swelling and obstruction of bile and blood can be seen. It shows some other symptoms, which are as follows:

• Loss of appetite.

• Dark-colored urine.

• Abdominal swelling or bloating.

• Feeling tired or weak.

• Fever.

• Anorexia.

• Nausea.

• Vomiting.

• Confusion.

• Itchy skin.

• Sweating.

• Weight loss.

• Enlarged or tender liver.

• Hepatomegaly (an enlarged liver that is bigger than normal).

• Leg swelling.

• Bloated belly.

• Yellowing of the whites of the eyes or skin (jaundice).

• Discomfort or pain in the upper right part of the abdomen (belly).

• If the number of metastases is more and the liver cannot work well, there is a condition called hepatic encephalopathy (it is a nervous system disorder caused by severe liver disease)

• This can result in confusion, sleepiness, and even coma.

When Should One Get Medical Help?

Some symptoms requiring immediate medical attention that indicate more serious problems are:

• Persistent vomiting more than twice a day.

• Vomit with blood in it.

• Unexplained continuous loss of weight.

• Black bowel movements.

• Having trouble swallowing.

• New abdominal or leg swelling.

• Jaundice or skin that is yellowing.

What Is the Process of Liver Metastasis?

Most cancers follow this process. It is a six-step process which is as follows-

• Local Invasion: Cancer cells move from the primary site into the nearby normal tissue.

• Intravasation: Cancer cells move through the walls of the nearby lymph vessels and blood vessels.

• Circulation: Cancer cells migrate to other body parts through the lymphatic system and bloodstream.

• Arrest and Extravasation: Cancer cells stop moving when they reach a distant location. Then, they travel through the walls of capillaries (small blood vessels) and invade the surrounding tissue.

• Proliferation: Cancer cells grow at distant locations and create small tumors called micrometastases.

• Angiogenesis: Micrometastasis triggers the formation of new blood vessels, which supply the nutrients and oxygen required for tumor growth.

How Is Liver Metastasis Diagnosed?

Liver cancer is suspected if the liver is enlarged or tender on examination. The following tests can be performed to check the condition of the liver.

• Liver Function Tests (LFT): A liver function test is done to check the functioning of the liver. It is a blood test. Liver enzyme levels are frequently raised when there is an issue. LFT can help to distinguish between primary liver cancer and liver metastasis.

• CT (Computed Tomography) Scan of the Abdomen: It is an X-ray that takes images of the soft tissue. Cancerous tissue appears like a moth-eaten image.

• Ultrasound of the Liver: This technique is also known as sonography. With the help of high-frequency sound waves passing through the body, abnormalities are detected in the liver.

• MRI (Magnetic Resonance Imaging): Magnetic resonance imaging is a test that gives a clearer vision of the organs.

• Angiogram: Dye is injected into the arteries. When images of the body along that artery’s pathway are taken, high-contrast images of internal organs are created.

• Laparoscopy: A small incision is made, a narrow tube with a bulb on top is inserted, and a biopsy (tissue sample) is collected for microscopic examination.

• Staging Cancer: If cancer spreads to the liver, it is likely in stage four. The stages of cancer range from stage one to four. It is categorized based on the severity of the disease.

What Is the Treatment for Liver Metastasis?

The treatment of liver metastasis can be done in various ways. Treatment of liver metastasis is primarily palliative. Palliative is the treatment in which symptoms are controlled, and life expectancy is prolonged but does not likely result in curing. The treatment regime generally depends on the following:

• The age of the person.

• Stage of cancer.

• The size, location, and number of tumors metastasized.

• The type of cancer treatment the patient had in the past.

1. Systemic Therapies-

These therapies treat the whole body through the bloodstream. These therapies include-

• Chemotherapy: In this therapy, cancer cells are killed using certain drugs. It targets the cells that grow and multiply quickly, including some healthy cells.

• Biological Response Modifier (BRM) Therapy: It is a therapy that uses antibiotics, growth factors, and vaccines to restore or boost the immune system. This helps the immune system to fight against cancer. BRM therapy usually does not have side effects like other cancer therapies.

• Targeted Therapy: This therapy also kills cancer cells, like chemotherapy, but it can differentiate between healthy and cancer cells. The targeted therapy drugs kill the cancer cells and leave the healthy cells. It can have certain other side effects that include diarrhea and fatigue.

• Hormonal Therapy: This therapy is used to kill some types of tumors that depend on hormones to grow, such as breast and prostate cancer.

6. Localized Therapies:

Localized therapies target only tumor cells and nearby tissues. These therapies are effective when the tumor is localized and small in size.

7. Radiation Therapies:

These therapies can use high-energy radiation to kill cancer cells and shrink tumors.

What Is the Prognosis for Liver Metastases in the Long Term?

A primary cancer is almost always incurable once it has metastasized to the liver. Modern therapies can help reduce symptoms and increase life expectancy. Depending on the origin of the primary cancer and the extent of metastasis to the liver, the efficacy of the therapy will be determined.

Is There a Way to Prevent Liver Metastasis?

The prevention of liver metastases is not always practicable. Liver metastasis may occur before a person is diagnosed with primary cancer. The possibility of cancer spreading to the liver can be reduced by proper and effective treatment for primary cancer. However, it is not true in all the cases because there are chances liver metastasis may occur years after a treatment plan is effective. To help avoid cancer, people should adhere to a healthy lifestyle. Avoiding smoking and alcohol drinking can help individuals to maintain their health. Moreover, exercising regularly and consuming nutrient-rich and balanced food can help improve people's general health.

Conclusion

This article gives details of liver metastasis, a type of secondary liver cancer that spreads to the liver from some other organ’s cancer. The symptoms of liver metastasis include fever, anorexia, nausea, vomiting, itching, etc. It can be diagnosed by CT scan, MRI, etc. Treatment options include chemotherapy, radiotherapy, etc.