What are liver metastases?
Cancers of the liver are not always “true” (primary) liver cancer. Liver metastases often occur when tumor cells detach from malignant tumors in other organs and eventually settle in the liver. Doctors refer to this cancer of the liver as “secondary” liver cancer.
In addition to colorectal cancer, other tumors can also form metastases in the liver.
However, other cancers can also lead to liver metastases, such as
If a tumor has formed metastases, this is a criterion that the disease has reached an advanced stage.
Liver metastases usually only lead to symptoms at a late stage. However, the increase in the size of the liver can lead to pain (so-called capsule pain). General symptoms such as weight loss are typical of cancer and it is often not possible to clearly differentiate between liver metastases and the underlying disease.
The diagnosis is made using imaging techniques such as ultrasound, computer tomography or magnetic resonance imaging. In some cases, the attending physician discovers the liver metastases earlier than the underlying cancer – for example during an ultrasound examination of the upper abdomen. It is then important to find the original tumor quickly and to tailor further diagnostics and therapy precisely to it. Sometimes it is not possible to find out which cancer has caused the liver metastases (so-called CUP syndrome: cancer of unknown primary).
Specialized center at the USZ
Liver metastases are treated at the University Hospital by highly qualified specialists in collaboration with all medical departments. These include liver surgery, hepatology and gastroenterology, oncology, radiotherapy and radiology. The USZ offers the latest and most effective treatment options for liver tumors and is also a certified liver cancer center. The treatment of all patients is embedded in the structures of the Liver Tumor Center at the Comprehensive Cancer Center Zurich (CCCZ) and the Swiss Center for Liver, Pancreas and Biliary Tract Diseases (Swiss HPB Center). Patients with liver tumors are discussed with all medical disciplines at a tumor board specially set up for liver tumors. The optimal and individual treatment is determined for each patient. In addition, the USZ enjoys an excellent reputation in Switzerland and worldwide in the treatment of liver tumors and is a world leader in many scientific areas.
Liver metastases: Definition
Liver metastases occur when malignant tumors such as colon cancer “spread” to the liver. Liver metastases are metastases (metastases) of tumors that are located in another organ – for example in the intestine.
If a cancerous tumor in the liver develops directly from degenerated liver cells, it is not a liver metastasis but a primary liver cancer – also known as liver carcinoma.
Around 45 percent of all malignant tumors of the liver are liver metastases. In nine out of ten cases, liver metastases are caused by colorectal cancer (colon and rectal cancer, colorectal carcinomas). But also tumors from the gastrointestinal tract such as stomach cancer and esophageal cancer (esophageal carcinoma) or other malignant tumors such as
- Pancreatic cancer (pancreatic carcinoma),
- Lung cancer,
- Breast cancer (breast carcinoma)
- Or black skin cancer (malignant melanoma)
- Neuroendocrine tumors
- Prostate cancer
- Thyroid cancer,
- Ovarian cancer,
- Uterine cancer,
can form liver metastases.
Liver metastases: Symptoms
Liver metastases usually only become noticeable at a late stage. In addition, the early symptoms are relatively unspecific – in other words, they are symptoms that can also occur in the context of other illnesses.
- Weight loss,
- Loss of appetite,
- Heavy sweating at night
- and nausea
- Signs of jaundice: itching, discoloration of the stool, brownish discolored urine, yellowing of the skin and eyes (sclera)
may indicate liver metastases, but may also be caused by the underlying (primary) cancer.
In addition, liver metastases are occasionally accompanied by pressure pain in the right or middle upper abdomen, jaundice and gastrointestinal complaints such as diarrhea.
Liver metastases: Diagnosis with us
If the doctor detects liver metastases, those affected are often already undergoing oncological treatment. This is because liver metastases are usually a sign that the cancer is already advanced.
With many malignant tumors, the first typical symptoms only appear at a late stage – when metastases have already formed. This is why early detection and preventive examinations are very important in order to detect and treat cancer in good time.
Anyone suffering from a malignant tumor is regularly examined during treatment and afterwards as part of aftercare. If it is suspected that liver metastases have formed, various targeted examinations can be used to make a diagnosis. These include:
If the original tumor (primary tumor) of the liver metastases is not known, various examinations are necessary for the diagnosis. We can find the primary tumor using colonoscopy, for example, because colorectal cancer is a very common cause of liver metastases. We can also take a tissue sample(biopsy) from the tumor in the liver and have it examined.
CUP syndrome
In rare cases, it is not possible to find the underlying tumor that is causing the liver metastases. Doctors then speak of CUP syndrome. CUP stands for “cancer of unknown primary”, i.e. cancer with an unknown primary tumor. Two to four percent of all cancer patients suffer from CUP syndrome. The symptoms, course and treatment of this disease depend on how the metastases have spread. A CUP syndrome does not necessarily have to be associated with liver metastases. Metastases in other organs such as the lungs, skeleton or lymph nodes can also be typical.
Liver metastases: Course and prognosis
In the case of liver metastases, the course and prognosis – and therefore also the life expectancy – depend on the underlying cancer. Another decisive factor is the extent to which the liver is affected by metastases. Single metastases that can be completely removed by surgery have the best prognosis. The more extensively the liver is affected, the worse the chances of recovery.
Prevent
There are no known specific measures you can take to prevent liver metastases. A healthy lifestyle supports the body’s defenses and helps to reduce the general risk of cancer and disease:
- Varied, low-fat diet
- Abstaining from nicotine and alcohol
- Regular sport
Liver metastases: Treatment
The treatment and prognosis of liver metastases depend on
- the number, size and localization of the metastases,
- the type and spread of the original tumor
- and the patient’s general state of health.
Details of the treatments