Can Liver Metastases Be Reversed?
Metastatic liver cancer is a tumor that, from another part of the body, has spread to the liver. The first symptoms can be loss of weight and appetite.
The diagnosis is based on the results of blood tests and commonly on a biopsy. Chemotherapy and radiation therapy can help relieve symptoms, but unfortunately they do not cure cancer.
Liver metastases have their most frequent origin in the lungs, breast, colon, pancreas or stomach. Leukemia (a cancer of the white blood cells) and lymphoma (a cancer of the lymphatic system), especially Hodgkin’s lymphoma, can affect the liver.
Malignant tumors invade the liver because this organ filters most of the blood from the rest of the body, and when the tumor cells separate from the primary cancer, they frequently reach the bloodstream and travel through it. In some cases, the first sign of the primary tumor in a patient occurs after discovering a metastatic liver cancer.
Symptoms of Liver Metastasis
Often the initial symptoms are fuzzy. Among them, it can be mentioned weight loss and appetite and, occasionally, fever. Normally the liver increases in size and consistency. It can be sensitive and often lumpy. Sometimes, the spleen is enlarged, especially when the cancer originates in the pancreas. At first, unless the lesion causes a blockage of the bile ducts, jaundice does not occur (yellowing of the skin and the sclera). Later, the abdomen may be swollen (distended) and filled with fluid (this is called ascites).
Weeks before death occurs, jaundice progressively worsens. Mental confusion and drowsiness may occur due to the action of toxic substances that accumulate in the brain, because the liver is too damaged to effectively perform its function of removing them from the blood. This disorder is called hepatic encephalopathy.
Diagnosis of Liver Metastasis
Liver Imaging Tests
The doctor may suspect a metastatic liver cancer in people that lose weight very fast and that present an increase in their liver volume or in those cases that have a malignant tumor with a tendency to metastasize into the liver. However, it is often difficult to diagnose cancer until it reaches an advanced stage.
If doctors suspect that liver cancer may occur, liver function tests (which are simple blood tests) are done to evaluate how well the liver is working. The results may be abnormal, as they are in many disorders. Therefore, this finding does not confirm the diagnosis. Ultrasound is often useful, but computed tomography (CT) and magnetic resonance imaging (MRI) of the liver are usually more accurate in detecting cancer. Before performing CT or MRI, a contrast agent is usually injected into a vein. This dye helps make the abnormalities, if present, easier to see. However, diagnostic imaging tests do not always allow seeing small tumors or differentiating cancer from cirrhosis or other alterations.
If the diagnosis is not clear after the diagnostic imaging tests or if more information is needed to help decide the treatment, a liver biopsy is done (obtaining a sample of liver tissue with a needle for examination under a microscope). To increase the likelihood of obtaining tumor tissue, the doctor uses ultrasound or CT to guide the location of the biopsy needle.
Treatment of Liver Metastasis
Treatment depends on the extent of the cancer and the type of primary tumor. The options include the following:
- Antineoplastic Drugs (Chemotherapeutic Drugs): These drugs can be used to temporarily reduce the size of the tumor and prolong life, but do not cure cancer.
- Liver Radiation Therapy: This treatment sometimes reduces the severe pain caused by advanced cancer, but apart from this it has few beneficial effects.
- Surgery: If a single tumor or a few tumors are found in the liver, they can be surgically removed.
If the cancer has spread widely, usually the only thing the doctor can do is relieve the symptoms. Many deadly diseases are accompanied by similar symptoms, such as pain, choking, digestive disorders, incontinence, skin deterioration and exhaustion. The affected individual can specify their advance directives in case they are subsequently unable to make the appropriate decisions about medical care.