Colorectal cancer is cancer that develops in your large intestine (colon) or rectum. It’s the
Colorectal cancer can spread to other parts of your body through your bloodstream or lymphatic system. The liver is the
Read on to learn why colorectal cancer spreads to the liver and how liver involvement affects treatment.
The reason that colorectal cancer often spreads to the liver is because of the direct blood vessel connection that exists between the large intestine and the liver through the portal vein. If the cells within the walls of the colon or rectum begin to mutate and become cancerous, it’s easy for these damaged cells to get transported directly to the liver through the bloodstream.
Even though the cancerous cells originated in the colon or rectum, they can still continue to grow and spread within the liver. If these malignant cells continue to grow, they can form tumors that begin to impact the liver and make it hard for the liver to function properly.
Colorectal cancer is divided into stages I to IV depending on how advanced the cancer is. It’s known as
The primary test for diagnosing colorectal cancer is a colonoscopy with a biopsy. A biopsy is a small tissue sample of the colon lining that’s taken during a colonoscopy. The tissue sample is then sent for lab analysis to determine if it contains cancer cells. A biopsy is needed to make a definitive cancer diagnosis.
Imaging tests are used to diagnose whether the cancer has spread to the liver or another distant organ. The types of imaging tests used may include:
When you have colorectal cancer that’s spread to your liver, you may be able to have surgery to remove the cancer from both your colon and your liver. Chemotherapy is also a common treatment for colorectal cancer.
Surgery to remove cancer from the colon may include:
- hemocolectomy, which involves removing part of the colon that contains the cancer and a small section of normal colon on either side and then reattaching the colon; lymph nodes are also removed to check for cancer cells
- total colectomy, which is a less common procedure that involves removing the entire colon
You may need chemotherapy before surgery to shrink the cancer in your colon and/or liver. Chemotherapy is often administered after surgery to destroy any remaining cancer cells. This is known as neoadjuvant chemotherapy.
Your surgeon will remove as much of the cancer as possible from your colon and your liver. These surgeries may be done at the same time, or at different times. Your doctor will let you know which option is best for you.
Ablation and embolization
Small tumors may be removable with ablation or embolization instead of surgery.
- radiofrequency ablation is the most common ablation method that uses high-energy radio waves to heat and destroy cancer cells
- ethanol ablation involves a concentrated injection of alcohol into tumors to kill off cancer cells
- microwave ablation uses electromagnetic waves to heat and destroy cancer
- cryosurgery involves the use of cold gasses to freeze and destroy cancer cells
Embolization is a procedure where a substance is injected into an artery that supplies your liver. The aim of this procedure is to cut off the blood supply to the cancerous cells in the liver.
Embolization may be an option for people who have tumors that are larger than 5 cm across, that cannot be treated with surgery or ablation, and who still have adequate liver function.
Chemotherapy (chemo) is commonly used to treat colorectal cancer at all stages. It may be used in the following ways:
- As neoadjuvant chemotherapy: Chemo may be necessary before surgery to help shrink cancerous tumors. Sometimes this is done in combination with radiation. Chemo treatment at this point in time helps make the cancer easier to remove during surgery. Neoadjuvant chemo is usually given for a total of 3 to 6 months, depending on what types of chemo drugs are used.
- As adjuvant chemotherapy: In this instance, chemo drugs are given after surgery. The goal with adjuvant chemo is to destroy any cancer cells that may have been left behind after the cancer was surgically removed, or to target any cancer cells that are too small to be detected with imaging tests. Like neoadjuvant chemo, this treatment usually also lasts for
3 to 6 months.
- For advanced cancers: Chemo drugs can help shrink tumors that have spread to distant organs like the liver, lungs, brain, and other areas. Although it won’t cure colorectal cancer, it can help ease symptoms that may be causing discomfort, and can help prolong a person’s life.
Many chemotherapy options are available. According to the
- FOLFOX: folinic acid, fluorouracil, and oxaliplatin
- FOLFIRI: leucovorin, fluorouracil, and irinotecan
- CAPEOX: capecitabine and oxaliplatin
- FOLFOXIRI: leucovorin, fluorouracil, oxaliplatin, and irinotecan
As scientists continue to learn more about the changes that occur in cells that allow colorectal cancer to develop, new types of targeted drugs are being developed that can focus on those cell mutations.
Unlike chemo drugs, which destroy both cancerous cells and healthy cells, targeted therapy drugs only go after cancer cells. These targeted therapies can be used together with chemotherapy or on their own.
Another treatment area that’s expanding for colorectal cancer, including cancer that has spread to the liver or elsewhere, is immunotherapy. This involves the use of medicines to help your own immune system detect and destroy cancer cells.
The 5-year relative survival rate for colon cancer in the United States is
The 5-year relative survival is a measure of how many people with a disease are alive 5 years later compared to people without the disease.
Resources for colorectal cancer
Dealing with a colorectal cancer diagnosis can be challenging. Here are some resources you might find helpful if you or a loved one is looking for support.
Colorectal cancer can spread to other parts of your body through your blood or lymph system. The most common organ that colorectal cancer spreads to is the liver due to the rich blood supply that exists between the large intestine and the liver.
Treatment for colorectal cancer that has spread to the liver often involves a combination of surgery, chemotherapy, and targeted therapy. Many different types of chemo drugs can be used for colorectal cancer. Your oncologist will work closely with you to determine which combination of treatments is best for you.