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School of Medicine
Colorectal Cancer that has Spread to the Liver
What is colorectal liver metastasis?
Colorectal liver metastasis is Stage IV cancer that did not start in the liver, but instead has spread there from the colon or rectum. Colorectal cancer is one of the most common cancers in the United States. When colon or rectal cancer has spread to the liver, it is a serious disease; however, patients can still be cured if treated appropriately.
What are the symptoms of colorectal liver metastasis?
Colorectal liver metastases are often found during routine screening examinations following previous surgery that removed the colon or rectum. Sometimes the cancer is found to have spread to the liver at the same time the colon or rectal cancer is diagnosed. Although many patients may not have symptoms, you may present with symptoms that include:
- Weight loss
- Blood in the stool / change in the size of your stools
How is colorectal liver metastasis diagnosed?
When you see your physician, you will have a routine examination. Your doctor will ask you questions about your general health and your family history of cancer and liver disease. You will also be asked about your lifestyle and habits, including drinking and smoking.
Your physician may order the following tests:
- Blood work. Blood tests may include a complete blood count, hematocrit, platelet count, liver function tests, and Carcinoembriogenic antigen (CEA), which may be elevated in patients with colon cancer.
- CT scan. This test identifies the tumor(s) and pinpoints their size and location in the liver, as well as their relation to the vascular / biliary structures. It also helps the doctor to determine the overall health of the liver.
- MRI. This test identifies the tumor(s) and pinpoints their size and location in the liver, as well as their relation to the vascular / biliary structures. It also helps the doctor to determine the overall health of the liver. A doctor will determine whether to do a CT scan, an MRI or both.
- PET scan. This is a whole body scan that looks for evidence of active cancer throughout the body.
- Liver biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. The sample removed from the biopsy is analyzed by one of our expert pathologists. Depending on the size of the tumor or mass, your physician may recommend the biopsy be taken one of several ways:
a.By using a minimally invasive surgical technique known as laparoscopy
b.By fine needle or thick needle aspiration (a core biopsy), using a computed tomography (CT or CAT) scan or ultrasound to guide the needle placement.
What is the treatment for colorectal liver metastasis?
Treatment for colorectal liver metastasis includes a combination of the following:
- Surgery to remove the tumor(s). At our Center, our surgeons perform both traditional, open surgeries, as well as minimally-invasive laparoscopic surgeries.
- Ablative techniques. This may involve either a surgery or may be done as a procedure in radiology
- Radiation therapy to the rectal cancer
What is the prognosis for colorectal liver metastasis?
Your team of physicians will create an individualized treatment plan for you.
Visit the Johns Hopkins Medicine Colorectal Cancer for more information on colorectal cancer.