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Liver Mets

Liver Metastasis: The 3rd Most Common Site

The liver is the third most common site for metastases. The symptoms of liver metastases, which are often quite subtle, don’t begin to occur until after the cancer has taken up a lot of room in the liver, and that can take some time to happen.

The symptoms are common—weight loss, loss of appetite, nausea, gastrointestinal symptoms, and pain or discomfort under your right rib cage. You may have some pain in the right upper quadrant of your liver, which occurs when the liver’s covering tissue is stretched out.

A diagnosis of liver metastasis is often suspected from blood tests and confirmed by CT, MRI, PET scanning or, on occasion, ultrasound. The major treatment for extensive liver disease is chemotherapy, especially if your liver function blood tests are elevated. Hormone therapy can work well on hormone-sensitive and slower-growing liver metastases, and the decision to use it usually depends on the extent of damage present in the liver.

In certain kinds of cancer, like colon cancer, liver metastasis can be a single lesions or just a few, and thus on rare occasions can be cut out. But with breast cancer there is usually more than one spot involved and surgery becomes impossible. In the uncommon exceptions when there is only one spot, your surgeon will be able to remove part of the liver to relieve symptoms or use radiation therapy. But this is really a last resort when the patient has a large and painful liver that is not responding to chemotherapy.
There are also new techniques for a small number of liver metastases that involve putting hot (hyperthermia) or cold (cryosurgery) probes into the tumors and burning or freezing them. This can help the obvious spots but must be followed with systemic therapy to control the rest of the micrometastatic liver disease.

If you are in a lot of pain, your doctor may recommend that your liver be radiated, to shrink it. This is only typically done for particularly severe symptoms that are not responding to systemic therapy or for the rare case of a woman whose only apparent disease is in the liver. Another option may be to put chemotherapy directly into the liver through a catheter in the artery leading into the organ. This is typically done to treat metastases if the cancer doesn’t respond to more comfortable forms of chemotherapy. Liver transplants do not work in this situation because the disease is usually more extensive, and not just in the liver.

Source: DrSusanLoveResearch.org; retrieved September 2016