Bowel Secondaries

Secondary Liver Cancer from Primary Colorectal Cancer

Cancer of the large bowel (colon and rectum) is common and affects 20,000 - 30,000 people in the UK. Secondary spread to the liver remains the major problem in these patients. Approximately 25% of patients undergoing surgery for these cancers have secondary disease in the liver. At the time of death secondary liver cancer is present in 40% - 70% of these patients. Thus nearly half the patients with cancer of the bowel will eventually progress to develop cancer of the liver.

After successful removal of a primary cancer of the bowel, patients are followed up to look for the development of secondary cancer. To help pick up secondary tumours earlier a blood test for CEA (carcino-embryonic-antigen) may be helpful. Assessment of all possible sites of disease may be carried out by a CT (computerised tomography) scan of the chest, abdomen and pelvis.Where there is doubt PET (Positron Emission Tomography) scanning is used to look for secondary tumours.

Secondary liver cancer produces few symptoms until it is well advanced.Further scans including an MRI scan (Magnetic Resonance Imaging) and a CT scan of the liver will be necessary to accurately stage the tumours.

If left untreated secondary liver cancer will eventually take the life of the patient. Approximately half of the patients receiving no further treatment for their liver cancer will be alive 6 months later. Fewer than 1 in 100 will live for 5 years after the liver becomes involved.

Survival Chart

Surgery to remove liver tumours will provide nearly 50% of patients with a prospect of 5 year survival and 30% of patients may live 10 years.

Unfortunately many patients are either not considered for surgery or are referred for surgery too late in the evolution of their cancer.With advances in liver surgery (see Surgery ) many tumours previously classed as inoperable would now be considered operable by experienced liver surgeons.