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Understanding liver cancer and liver metastases

Former President Jimmy Carter recently was diagnosed with advanced cancer after having liver surgery.

Theodore Welling III, M.D., Neehar Parikh, M.D., and Tracy Licari, PA-C, discuss a patient in the U-M Multidisciplinary Liver Tumor Clinic.

Theodore Welling III, M.D., Neehar Parikh, M.D., and Tracy Licari, PA-C, discuss a patient in the U-M Multidisciplinary Liver Tumor Clinic.

While we don’t know the origin or extent of his cancer, it’s possible that the cancer had spread to his liver from another part of the body. We sat down with the directors of the U-M Comprehensive Cancer Center’s Liver Tumor Program, Neehar Parikh, M.D., medical director, and Theodore Welling III, M.D., surgical director, to learn more about liver cancer and liver metastases.

What does it mean when cancer is found in the liver but it’s not liver cancer? What’s the difference?
It means that the cancer is a secondary (not primary) liver cancer which is the result of spread from other sites in the body. The cancer cells spread and implant into the liver—eventually growing into a mass within the liver. Primary liver cancer arises from the cells of the liver or the bile ducts.

What types of cancer spread to the liver and why?
Virtually any kind of cancer can spread to the liver; however the most common are gastrointestinal related cancers such as colon and pancreatic cancers.  Part of the reason is the unique anatomical relationship of the liver to the gastrointestinal tract as well as the liver being a site of relative “tolerance” for the growth of cancers from elsewhere in the body.

What kind of treatment plans are there for those diagnosed with liver cancer?
The treatment plans are extremely varied and depend on several factors, including:  (1) the type of cancer, (2) the burden of cancer, (3) the anatomical location of the cancer, and (4) whether underlying liver dysfunction is present.  Possible treatments include surgery, therapies directed into specific areas of the liver, and systemic medical or chemotherapies.

How are liver metastases treated?
Liver metastases are treated by chemotherapy and occasionally surgical resection is beneficial, depending on the cancer type.  Other therapies targeted into the cancerous areas of the liver such as ablation, radiation, or chemo/radioembolization are sometimes indicated.

What are the signs or symptoms of primary liver cancer or liver metastases?
Signs or symptoms of liver cancer can often be absent.  Other times patients can have pain, a mass on physical exam, or new signs of liver dysfunction such as jaundice or ascites (abdominal fluid accumulation).

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LiverTumor_boilerplate2.fwThe University of Michigan Comprehensive Cancer Center’s Liver Tumor Program has seen thousands of patients with hepatic (liver) tumors, primary or metastatic. The program developed the radiological (imaging) criteria to more accurately diagnose primary liver tumors (where the tumor originated). It is one of the largest funded research programs in primary liver tumors in the U.S. and are worldwide pioneers in the radiation therapy for primary liver tumors.