What is Liver Metastases?
Liver metastases is a tumour of cancerous kind which spreads to the human liver from other part of the body where the cancer has initially started. This is why liver metastases is also referred to as secondary liver cancer. The primary type of liver cancer is the cancer that originates from the liver and it mostly affects people with high factor of risk like cirrhosis and hepatitis. In most cases liver cancer is metastases. Cancer cells that are found in your liver metastases are not the liver cells. These are cells that come from other part of the human body where the primary cancer started. This other place can be the colon, the breast or the lung cells.
Causes of Liver Metastases
Is we have seen earlier. Liver metastases are caused by cancerous cells in other organs of the human body. To know fully the cause of metastases, we need to know the process involved. Let us look at the metastasis process. There are six steps in this process and it should be noted that not all cancers follow this process but most do. The first step is the local invasion. In this step, cancer cells mover from the primary place into a nearby normal place.
The second step is the intravasation step here the cancer cells flow through the walls of the nearby lymph vessels and blood vessels. The third step is the circulation step. In this step, cancer cells migrate through the lymphatic system and the bloodstream to other body parts. The fourth step is the arrest and extravasations step where the cancer cells stop moving when they reach a distant location. The cancer cells flow through the capillaries and invade the nearby tissue.
The fifth step is the proliferation step and in this step the cancer cells grow at a distant location and create small tumours that are known as micro metastases. The last step is thee angiogenesis which involves the micro metastases stimulating the creation of new blood vessels which supply the nutrients and oxygen needed for tumour growth.
What Cancer Spreads to the Liver and Cause Liver Metastases?
The location of the original cancer is the main determinant of whether cancer will extend to the liver and cause liver metastases. Primary cancers that are likely to extend to the liver include: breast cancer, colon cancer, rectum cancer, kidney cancer, oesophagus cancer, lung cancer, skin cancer, ovary cancer, uterus cancer, pancreas cancer and stomach cancer. It is important to note that liver metastases can occur years later even after the primary cancer has been removed.
Symptoms and Signs of Liver Metastases
Sometimes doctors recognize liver metastases before it shows any symptoms. This happens during the diagnosis of the primary cancer. In rare cases people experience the initial signs from liver metastases rather than primary cancer. The liver is one big organ that can work perfectly well even when most of it is damaged by malignant tumor. The first symptom of liver metastases that most people experience is feeling unwell or very fatigue. These are symptoms that are very prevalent in complications and it is quite difficult for someone to recognize that it is due to liver metastases. These symptoms can either be a result of cancer treatment or other illnesses. When you experience these symptoms, you should not just assume it is liver metastases. It is advisable that you seek medical attention.
Symptoms of liver metastases include: appetite loss, loss of weight, dark coloured pee, abdominal bloating or swelling, jaundice which is the yellowing of the skin, right shoulder pain, upper right abdominal pain, vomiting, confusion, nausea, fever and sweating, enlargement of the liver. You can know that your liver is inflated when you experience a lump on the right part of your abdomen under the ribcage.
There are more signs that indicate urgent and serious problems and when experiencing these symptoms, one is advised to get to the doctor urgently. The following are some of these symptoms: when one has persistent vomiting that comes more than twice a day for more than a day, when one is vomiting blood, when there is recent and sudden loss of weight, black color stool, problem when swallowing, swelling of the abdomen or legs, jaundice or yellowing of the skin.
Tests to Diagnose Liver Metastases
There are many tests to diagnose liver metastases including a liver function test, CT scan or PET scan and ultrasound scan.
Treatment for Liver Metastases
There are different aims for treating liver metastases. Some people are treated to remove the cancer and other individuals it is to reduce the liver metastases signs. This is referred to palliative treatment. In most cases of liver metastases the treatment is palliative. The palliative treatment helps in reducing the symptoms of liver metastases and increase the life expectancy of the patient. Surgery for liver metastases is advised only if the cancer affects a small region of the liver.
Stages of Liver Metastases
The stages for liver metastases help in choosing the treatment options and predicting the outlook of the patient. The stage is the description of how widespread the cancer is when it is diagnosed. The stages are determined based on the results of the physical exam, imaging tests and other tests as well as the results of surgery if it has been carried out. Different doctors use different staging systems. Below are the most commonly used stages of liver metastases:
Stage 1 Liver Metastases: There is a singular tumour that has grown in the blood vessels. The malignant growth (cancer) has not advanced to neighbouring lymph nodes.
Stage 2 Liver Metastases: There is either a single tumour or several tumours that are 5cm or less and the malignant growth has not advanced to neighbouring lymph nodes.
Liver Metastases Stage 3A: There is more than one tumour and at least larger than 5cm across and the malignant growth has not advanced to neighbouring lymph nodes.
Liver Metastases Stage 3B: There is at least one tumour that is growing into a nearby organ or a tumour has already grown into the outer covering of the liver. The malignant growth has not yet advanced into the neighbouring lymph nodes.
Liver Metastases Stage 3C: A tumour is growing into nearby organ or a tumour may have grown into the outer covering of the liver. The malignant growth has not yet advanced into the neighbouring lymph nodes.
Liver Metastases Stage 4A: Tumours in your liver can be any size or any number and they may have grown into nearby organs or blood vessels. The malignant growth has advanced to neighbouring lymph nodes but has not spread to faraway sites.
Liver Metastases Stage 4B: The malignant growth has also advanced to other organs of the human body.
Can you Live with Liver Cancer?
Around 20% of adults with primary liver cancer have lived for at least one year after diagnosis and one in 20 people live for five years or more. This bases on statistic cancer research UK. So the answer is yes, there is a possibility for survival if diagnosed well.
How Long Can A Person Live With Liver Cancer?
A person can live with liver cancer for more than 5 years or less depending on how they treat their situation.
Survival Rate of Liver Metastases
Survival rates does not tell you how long you will live with liver metastases but rather how likely you are to live. This is the accurate way to estimate the effect of cancer on survival. Survival rates are higher in people who have surgery to remove their cancer. Liver metastases has 5 years relative survival rate. Different people will be able to survive longer or lesser depending on stage of liver metastases and their natural immunity.
Prevention of Liver Metastases
Liver metastases can be prevented by limiting exposure to cancer causing chemicals, treating thoroughly the areas infected with cancer and going for regular checkups even after the primary cancer is treated just to make sure that cancer cells are not spreading to the liver.
Risk Factors for Liver Metastases
There are many risk factors for liver metastases. When someone has cancer in the above mentioned places, it is possible for the cancer to extend to the liver. Studies also suggest that the pre-operative positivity for the lymph node involvement, serum tumour markers and the intestinal histotype are some of the factors of risk for the liver metastases after a gastric cancer radical surgical operation. Postoperative measures of the serum tumour therefore may be useful for an early diagnosis of hepatic recurrence during a follow-up.
Complications of Liver Metastases
Patients with liver metastases will have the following complications
- Bile flow blockage.
- Low or no appetite.
- Running temperature.
- Complete liver failure in case of stage 4 liver metastases.
- Loss of weight.
Prognosis/ Outlook for Liver Metastases
Prognosis or outlook for liver metastases depends on different factors. It depends with medical history, type of cancer, stage and characteristics of the cancer. The outlook or prognosis is not so good at this point of scientific development. However what the doctors can do is reduce the size of the tumor, help in symptom relief and increase the life expectancy of the patient.