Secondary liver cancer has spread to the liver from another organ or system, the primary cancer site. One indication of the primary site is that the liver cancer behaves like cancer in the organ or system from which it originates. For instance, secondary liver cancer might behave like lymphatic cancer, if the original site is the lymphatic system. Besides the primary cancer origin, secondary liver cancer treatment will depend on three factors, all taken into consideration: the original organ or system site, which parts of the liver are affected, and whether other systems or organs beyond primary and secondary sites are involved. Treatments may be given according to two overall objectives; the goal may be to cure the cancer in some patients, whereas in other patients, the reduction of symptoms and control of the cancer’s progression may be the focus.
Surgery can be curative as secondary liver cancer treatment when the area of liver and number of cancer cells affected is small and when the primary cancer is eradicated as well. Resection can remove small tumors in these cases, or if tumors are large, or cancer cells are located throughout the liver, a liver transplant might be the indicated treatment. Nearly 50 percent of secondary liver metastases patients have colorectal cancer as the primary site; these are primarily cured or controlled through surgeries. In primary colorectal cancer, surgeries can be combined into one operation removing tumors from both primary and secondary sites at once, reducing the time and recuperative discomforts of two successive surgeries. Some patients have laparoscopic surgery, for which a tube with camera can guide inserted surgical instruments in cell or tumor removal.
Secondary liver cancer treatment can be chemotherapies administered either systemically or regionally. Regional administration is sometimes done in a procedure called hepatic arterial infusion (HAI): a pump inserted beneath the skin in the lower abdomen feeds into the hepatic artery system and injects drugs periodically. These pumps can be infused with additional drugs on an outpatient basis. Chemotherapies are used for those for whom surgery is not an option or for those who need to have their tumors reduced to excisable size. The use of chemo and surgery in combination brings about curative results in at least one-third of patients, who survive without recurrence past five years.
Secondary liver cancer treatment can also occur through uses of radiologic methods, aiming radiation directly at tumors and away from healthier surrounding tissues. One option, called intensity-modulated-radiation-therapy (IMRT), uses varying intensities of beams molded to the size and shape of the tumor, using three-dimensional (3-D) scans from computer tomography (CT) scanning devices with great precision. Radiation therapies cannot cure, but they can relieve symptoms and shrink tumors for other treatments to be administered.
Another form of secondary liver cancer treatment using a CT scan is hepatic ablation. In ablation, a CT device can guide the insertion of needles into tumors or insertion of a catheter into the hepatic blood supply to administer heat or chill to kill liver metastases. There are three thermal ablation modes: cryoablation, which freezes tumors, radio waves, superheating tumors, and microwave, where microwaves heat the tumor cells to point of destruction. These ablation treatments in conjunction with chemo are often used on those who are not surgery candidates. Ablation therapies can also be used in conjunction with biologic therapies that disrupt a tumor’s blood supply as secondary liver cancer treatments.