Dr. Srinivas Bojanapu, Hepatologist and Liver Transplant Surgeon at Dhaara Liver Clinic, Bangalore, treats Liver Metastases (Secondary Liver Cancer) with 16+ years of specialist experience. With a team performing 60+ liver transplants per year, Dr. Bojanapu offers both medical and surgical management including robotic and laparoscopic techniques.

What is Liver Metastases (Secondary Liver Cancer)

Liver metastases, also known as secondary liver cancer, is not a type of cancer that starts in the liver. Instead, it is cancer that has spread (metastasized) from another part of the body to the liver. This is one of the most common ways cancer spreads, especially from cancers that begin in the colon, stomach, breast, lungs, or ovaries.

When cancer spreads, it can travel through the bloodstream or the lymphatic system. The liver is a common destination for cancer to spread to because of its role in filtering blood from the digestive system. Once the cancer cells reach the liver, they can grow and form new tumours.

In India, liver metastases are a significant concern, especially in cities like Bangalore, where advanced diagnostic tools and specialized care are available. Dr. Srinivas Bojanapu, a leading hepatologist and liver transplant surgeon in Bangalore, has extensive experience in diagnosing and treating patients with liver metastases, helping them understand their condition and the best possible treatment options.

Causes and Risk Factors

Liver metastases are not caused by lifestyle or diet alone, but by the presence of cancer in another part of the body. The most common cancers that spread to the liver include:

• Colorectal cancer (cancer of the colon or rectum)
• Breast cancer
• Lung cancer
• Ovarian cancer
• Pancreatic cancer
• Stomach cancer

If you have been diagnosed with any of these cancers, your doctor will be more likely to check for signs of liver metastases. In some cases, the cancer may be found in the liver before it is even detected in the original part of the body.

Risk factors for developing liver metastases include:

• A personal or family history of cancer
• Age – liver metastases are more common in adults over the age of 50
• Being overweight or obese
• Smoking
• Heavy alcohol consumption
• Poor nutrition
• Lack of physical activity

It’s important to note that having one or more of these risk factors does not mean you will develop liver metastases, but it may increase your chances.

Symptoms and Warning Signs

In the early stages, liver metastases may not cause any symptoms. However, as the tumours grow, they can cause various signs and symptoms that may be similar to those of primary liver cancer. Some of the most common symptoms include:

• Abdominal pain – especially in the upper right part of the abdomen
• Weight loss – unexplained and sudden
• Loss of appetite
• Nausea and vomiting
• Fatigue – feeling very tired all the time
• Jaundice – yellowing of the skin and eyes
• Enlarged liver or spleen – which may be felt during a physical exam
• Swelling in the legs or abdomen (ascites)

These symptoms can also be caused by other conditions, so it’s important to see a doctor if you or a loved one experiences them. Dr. Srinivas Bojanapu in Bangalore uses advanced imaging techniques and laboratory tests to determine whether these symptoms are due to liver metastases or another condition.

How is it Diagnosed

Diagnosing liver metastases involves a combination of tests and procedures to confirm whether cancer has spread to the liver. Your doctor may start with a physical examination and then order a series of tests, which may include:

• Blood tests – such as liver function tests and tumour marker tests (like CEA or CA 19-9) that can help detect cancer
• Imaging tests:
• Ultrasound – a painless test that uses sound waves to create images of the liver
• CT scan – a detailed X-ray that can show the size, shape, and location of tumours
• MRI – a test that uses strong magnets and radio waves to create detailed images
• PET scan – helps detect cancer cells in the body
• Biopsy – a small sample of liver tissue is taken and examined under a microscope to confirm the presence of cancer cells

In Bangalore, patients have access to some of the most advanced diagnostic tools in the country. Dr. Bojanapu and his team use these tools to make an accurate diagnosis and to plan the best possible treatment.

Treatment Options

Treatment for liver metastases depends on several factors, including the type and stage of the original cancer, the size and number of tumours in the liver, and the patient’s overall health. The goal of treatment is to control the cancer, relieve symptoms, and improve quality of life.

Some of the most common treatment options include:

Surgery

Surgery may be an option if the cancer is limited to a few areas in the liver and the rest of the liver is healthy. In some cases, a liver transplant may be considered if the cancer is isolated to the liver and the primary cancer has been successfully treated. However, liver transplants are not commonly used for liver metastases, as they are typically reserved for patients with primary liver cancer or other liver diseases.

Ablation

Ablation is a minimally invasive procedure that uses heat, cold, or other energy sources to destroy cancer cells in the liver. This is often used for small tumours.

Embolization

Embolization is a procedure that blocks the blood supply to the tumour, causing it to shrink. This is often used when surgery is not an option.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. It may be given directly into the liver (called hepatic artery infusion) or throughout the body, depending on the type of cancer.

Radiation Therapy

Radiation therapy uses high-energy rays to kill cancer cells. In some cases, a type of radiation called radioembolization may be used to target cancer in the liver.

Targeted Therapy and Immunotherapy

These are newer treatments that target specific genes or proteins in cancer cells. They are often used in combination with other treatments.

Dr. Srinivas Bojanapu in Bangalore is experienced in recommending the most effective treatment plan based on the individual patient’s condition. He often works with a team of specialists to ensure that patients receive the best possible care.

When is Liver Transplant Needed

Liver transplant is a major surgical procedure in which a diseased liver is replaced with a healthy one from a donor. While liver transplants are not typically used for liver metastases, there are rare situations where it may be considered.

In general, liver transplants are more commonly used for patients with primary liver cancer, such as hepatocellular carcinoma (HCC), or for patients with severe liver failure due to other conditions like cirrhosis.

However, in very rare cases, liver transplants may be considered for patients with liver metastases if:

• The cancer is limited to the liver and has not spread to other parts of the body
• The primary cancer has been completely treated and is not likely to return
• The liver is the only site of cancer
• The patient is otherwise healthy and can tolerate the transplant

It’s important to note that liver transplants for liver metastases are not common and are only considered after a thorough evaluation by a team of experts, including hepatologists, oncologists, and transplant surgeons like Dr. Srinivas Bojanapu.

In Bangalore, Dr. Bojanapu is one of the few hepatologists who has experience in evaluating and managing patients for liver transplants, even in complex cases. He ensures that patients understand the risks, benefits, and long-term outcomes of liver transplantation.

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Liver metastases can be a challenging diagnosis, but with the right care and treatment, many patients can live longer and enjoy a better quality of life. If you or a loved one has been diagnosed with liver metastases, it’s important to seek care from a specialist like Dr. Srinivas Bojanapu, who is committed to providing compassionate, expert care in Bangalore, India.