Cancer in the liver: understanding liver metastases

Cancer cells can travel through blood or lymphatic channels and settle in the liver. These deposits remain the same cancer type as the original tumour: bowel cancer that reaches the liver is still bowel cancer, not primary liver cancer. This distinction affects which medicines and procedures may work. Liver metastases may cause no symptoms and be discovered on a scan. When symptoms occur, they can include discomfort under the right ribs, reduced appetite, nausea, fatigue, weight loss, abdominal swelling, itching, dark urine, pale stools, or yellowing of the eyes and skin.

The team first confirms where the cancer began and maps disease inside and outside the liver using imaging, blood tests, previous pathology, and sometimes a biopsy. They consider the deposits' location, liver function, previous treatment, general health, and whether all visible disease can be treated safely. Options may include systemic therapy that works throughout the body, liver resection, tumour ablation, radiotherapy, or symptom-focused care. More than one approach may be used in sequence. Bring a current medicine list and earlier scan or pathology reports to appointments if they are held by another hospital.

Contact the cancer team promptly for new yellowing of the skin or eyes, increasing abdominal swelling, worsening right-sided upper abdominal pain, persistent vomiting, or a clear decline in eating and drinking. Seek urgent care for confusion, fainting, severe breathlessness, vomiting blood, black stools, sudden intense abdominal pain, or fever while receiving treatment. These symptoms can reflect complications that need rapid assessment; they do not identify the cause on their own. Follow the oncology team's specific instructions for treatment-related fever or infection concerns.

Ask which original cancer is present in the liver, whether disease appears elsewhere, and whether biopsy or additional tumour testing would change the plan. Request a clear explanation of the treatment goal: removing or destroying visible deposits, controlling disease, easing symptoms, or a combination. It is also useful to discuss how each option may affect liver function, recovery, daily activities, nutrition, and the timing of other cancer treatment.