Liver metastases are metastases or daughter tumors of malignant tumors, which are located in other parts of the body. This distinguishes the term from liver carcinoma, which arises directly as a cancerous tumor in the liver.
What are liver metastases?
The term liver metastases is used to describe liver tumors that are metastases from other tumors in the body. They often develop because of colorectal cancer. The malignant cancer cells enter the organ through the lymphatic or blood vessels, multiply, and give rise to liver metastases. Most cancers in the liver are secondary to liver cancer. Another cancer site in the body, the primary cancer, has spread, creating a cancerous focus in the liver. Apart from tumors in the intestine, other cancers may also be responsible for this development. These include stomach or colon cancer, breast cancer, and lung cancer. If the causative cancer has metastasized to the liver, the disease is in an advanced stage. How the further course of the disease liver metastases depends crucially on the primary cancer.
Causes
The causes of liver metastases vary. Often, the affected person already has a cancerous tumor in the intestine, which thus triggers the secondary liver cancer by spreading metastases. The classic features for malignant tumor growths are spread to other tissues and organs and the development of metastases. Daughter tumors in the liver are liver metastases. Almost 45% of all cancer cells in the liver are liver metastases. Most often they originate in primary tumors in the gastrointestinal tract to which colon cancer, stomach cancer and esophageal cancer belong. Sporadically, other malignant tumors such as ovarian cancer, lung cancer, pancreatic cancer, thyroid cancer, uterine cancer, malignant skin cancer, and breast cancer can also be the cause of liver metastases.
Symptoms, complaints and signs
At the beginning of the disease, there are usually no health problems. Only as the liver metastases grow do symptoms appear, such as nausea and loss of appetite or the characteristic pressure pain in the right upper abdomen. A palpable swelling may occasionally be noticed under the costal arch. This feels noticeably hard and is painful to the touch. It may be accompanied by general symptoms of illness such as fever and fatigue. Affected individuals usually lose weight and, in the later stages of the disease, have a sickly appearance that is manifested by pale skin and sunken eye sockets, among other symptoms. As a result of the tumors, bile stasis can also occur. This is manifested by typical symptoms of jaundice, but can also lead to a severe feeling of illness. In the most severe cases, liver metastases cause serious functional disorders of the liver, which can ultimately result in organ failure. The symptoms of liver metastases usually develop gradually and may appear over the course of months or years. If no treatment is given, the symptoms lead to failure throughout the body and ultimately to the death of the sufferer.
Diagnosis and course
If liver metastases are suspected, various examinations are performed on the affected person. Frequently, these metastases lead to liver damage, which can be detected by a liver function test or blood test. Other diagnostic methods used to detect the cancerous tumor include ultrasound, a CT scan, and magnetic resonance imaging of the liver. A biopsy or examination of the fine tissue can confirm the diagnosis. If it is not known where the tumor originated, further examinations of the organism are performed. This may involve a colonoscopy, for example, since colon cancer is the most common cause of liver metastases. The further course of the disease and life expectancy depend on the underlying disease. In addition, the extent to which the liver has already been penetrated by metastases is decisive. Individual metastases can be easily removed by a surgeon, giving them the best prognosis. The chances of cure decrease rapidly with greater extent of liver metastases.
Complications
Usually, liver metastases lead to the death of the patient.In this case, treatment is only possible to a limited extent, so that the life expectancy of the affected person is significantly reduced and limited by the disease. Patients suffer first and foremost from a severe loss of appetite and thus also from a significant loss of weight. It is also not uncommon for vomiting and permanent nausea to occur. The loss of appetite also leads to various deficiency symptoms, which have a negative effect on the patient’s health. The liver complaints usually lead to jaundice and severe abdominal pain. At night, liver metastases in most cases also lead to sweating and thus to a significant reduction in the quality of life of the affected person. In many cases, treatment is no longer possible for liver metastases. In this case, the affected person suffers death. The course of the disease also depends strongly on the primary cancer, which is why it cannot generally be predicted. Furthermore, many patients are also dependent on chemotherapy, which is usually associated with side effects.
When should you see a doctor?
If there is pain in the upper body, located at the level of the stomach or in the area of the ribs, and swelling should be examined by a doctor. In particular, changes in the right side of the upper abdomen should be presented to a doctor. If pain spreads or increases in intensity, a physician is needed. If a loss of appetite sets in, there is unwanted weight loss, or the usual level of performance decreases, the changes are considered worrisome. Yellow discoloration of the face, eyes or skin should be presented to a doctor. The abnormalities of the skin appearance indicate a disorder of the liver activity, which should be investigated. Increased fatigue, internal weakness, a general feeling of malaise, and apathy are considered signs of a present disease. A visit to the doctor should be made as soon as the complaints persist over several weeks or increase. A change in the usual memory, abnormalities in mood and sleep disturbances should be discussed with a physician. Since patients with liver metastases can have a fatal course of the disease without early treatment, a visit to the doctor is recommended as soon as possible at the first irregularities. In addition, every adult should participate in offered medical check-ups and preventive examinations to enable early detection and rapid diagnosis in case of disease.
Treatment and therapy
How liver metastases are treated depends on the number of metastases. In principle, there are different therapeutic approaches. Curative treatment pursues a cure of the disease. If the chances of this are hopeless, palliative therapy is considered. This is intended to alleviate the symptoms and improve the quality of life. Individual metastases can be removed by surgery. In this surgical procedure, the doctor completely removes the liver metastases from the tissue of the organ. Sometimes, removal of part of the liver is also necessary. If only a few liver foci exist in the organ, so-called local therapy methods can be used as an alternative or in addition to surgery. These allow direct and targeted treatment of the malignant tissue. Furthermore, the healthy tissue surrounding the tumor is largely spared. Among the methods of local therapy procedures is cryotherapy, also known as icing. Other procedures include interstitial laser coagulation, percutaneous ethanol injection, and radiofrequency ablation. If palliative treatment was chosen, surgery was no longer possible because of the large spread. However, chemotherapy for liver metastases may prove to prolong life.
Prospect and prognosis
Liver metastases usually have an unfavorable disease course and thus a poor prognosis. The more advanced the disease, the poorer the prospects for recovery. Without medical treatment, the cancer cells continue to spread in the organism via the blood system. Further metastases are formed and the cancer spreads. In the further course, multiple organ failure and thus premature death sets in. If the metastases in the liver can be completely removed by surgery, the prognosis improves.If the cancer has not spread further in the organism, this is also an encouraging circumstance for further development. Cancer therapy is associated with numerous risks and restrictions on quality of life. Nevertheless, it is currently the best option for successfully managing liver metastases. If the liver is already very heavily affected by metastases, organ transplantation may help under certain circumstances. If the patient’s immune system is stable and no further metastases have developed in the human body, a donor organ can contribute significantly to the prospect of a cure. If the difficult surgical procedure proceeds without complications and the body accepts the new liver well, this can lead to the patient’s recovery.
Prevention
No specific measures exist to prevent liver metastases. In general, the risk of developing a cancerous tumor can be reduced by a healthy lifestyle. This includes a low-fat, varied diet and avoiding nicotine and alcohol. Personal body defenses can further be strengthened by regular physical activity, which reduces the chance of developing liver metastases.
Follow-up care
After every cancer, follow-up care becomes necessary. What type this requires depends on the outcome of the initial therapy. If the liver metastases could not be removed at all, could not be removed completely, or could be removed inadequately, aftercare consists mainly of palliative aspects. The aim here is to accompany the patient to the end of his or her life in such a way that he or she experiences no or hardly any discomfort. In addition to providing medication, the physician may also prescribe psychotherapy or refer patients to pastoral care personnel to discuss life issues. If the metastases can be removed, life expectancy increases. Doctors then try to realize this positive outlook as part of follow-up care. This is done by monitoring to treat neoplasms as early as possible. Initially, scheduled follow-up examinations take place every few months. Then the interval between appointments widens. If there are no new cases after the fifth year, annual follow-up is sufficient. The attending physician agrees a detailed examination schedule with his patient. He also informs about further therapy offers and medications to be taken. Sometimes a rehabilitation measure can be useful after an operation. An examination usually includes a detailed physical assessment, an ultrasound image, an X-ray and a blood sample.
Here’s what you can do yourself
Patients with liver metastases have been suffering from cancer for some time. In most cases, they are undergoing cancer therapy and are in poor health. In everyday life, it is especially important for these patients not to lose their courage to face life. They should overcome themselves every day to pursue various activities as far as possible according to their individual physical capabilities. Motivational measures are significant and should be applied. In addition to mental coaching, methods such as yoga or meditation help. These strengthen the patient’s emotional state and help reduce stress. In addition, a good diet is of particular importance. Meals should be rich in vitamins and well-balanced, since the weakened physical condition can allow pathogens to enter the organism more quickly. The immune system can be supported through food intake in order to have sufficient defenses available. Leisure activities help to strengthen the well-being. Together with friends or relatives, close interaction should take place to ensure participation in social life. Conversations with other people are important and helpful in reducing fears or distracting the patient from his or her own situation. In self-help groups or in direct contact with other sufferers, unanswered questions can be clarified or tips for improving the quality of life can be given.
