Treatment for secondary cancer in the liver

Treatment for secondary cancer in the liver usually aims to control the cancer for as long as possible and reduce any symptoms.

The treatment you have depends on:

• where the cancer has spread from (the primary cancer)
• which parts of the liver are affected
• whether other parts of the body are affected.

We understand that having treatment can be a difficult time for people. We're here to support you. If you want to talk, you can:

• Call the Macmillan Support Line on 0808 808 00 00. 
• Chat to our specialists online. 
• Visit our secondary liver cancer forum to talk with people who have been affected by secondary liver cancer, share your experience, and ask an expert your questions. 

Only a small number of people can have surgery. It is usually only possible for bowel cancers or neuroendocrine tumours that have spread to the liver. But it may occasionally be an option for other types of cancer.

Your doctor will tell you if surgery is an option for you. For surgery to be possible, the surgeon needs to be able to remove all of the cancer in the liver. There also needs to be enough liver left behind for you to stay well afterwards. Sometimes you may have surgery with another treatment, such as ablation. Or the surgery may be done in stages.

Targeted therapy drugs are sometimes used to treat secondary cancer in the liver. The drugs target things specific to the cancer cells that make them different from normal cells and help them to survive. Targeted therapy drugs may be used with other treatments, such as chemotherapy and surgery.

Where the cancer started in your body (the primary site) will affect:

• whether targeted therapy drugs are suitable for you
• which types of targeted therapy drugs you may have.

For example, if you have bowel cancer that has spread to the liver, you may have targeted therapy drugs that are used to treat bowel cancer.

Before doctors can give you some types of targeted therapy drug, they need to test your cancer cells. This is to find out if the drug is likely to work for you.

If you know the name of your targeted therapy drug, you can use our list of treatments to find out more about it.

Tumour ablation means destroying the tumour by applying heat or cold directly to it. It is most commonly used to treat cancer that has spread to the liver from the bowel or breast. But sometimes it is used for other types of cancer. It may also be offered as part of a clinical trial. Your cancer doctor can explain if this type of treatment may be suitable for you.

Doctors may use ablation in combination with other treatments, such as chemotherapy.

It is most often used to treat small tumours, when surgery is not possible. It is also sometimes done during surgery. Some people have ablation more than once.

If your doctor thinks ablation may help you, they can refer you to a hospital that does this treatment. Ablation treatments are only available in some specialist hospitals, so you may have to travel for treatment.

There are different types of ablation including:

• microwave ablation
• radiofrequency ablation
• cryotherapy
• laser ablation
• irreversible electroporation (IRE).

Radiotherapy treats cancer by using high-energy rays to destroy cancer cells, while doing as little harm as possible to normal cells. Sometimes people have a type of radiotherapy called stereotactic radiotherapy for secondary liver cancer.

Stereotactic radiotherapy (SABR) gives targeted treatment to the tumour. It is sometimes used if surgery or ablation are not suitable. A specially adapted radiotherapy machine delivers beams of radiotherapy from many different angles. This allows the doctor to give a very high dose to the tumour, while keeping the dose to surrounding tissues very low. 

Stereotactic radiotherapy is only available in a few specialist centres. Your specialist can give you more information.