Many recent advances in medicine and surgery have made it possible to successfully treat, and sometimes cure, cancers that were previously considered incurable. At Precision Vascular & Interventional, these advances have been incorporated into a multidisciplinary approach that can offer treatment for most patients who have developed metastatic liver lesions from malignant tumors such as colon cancer or breast cancer. Our team of specialists will work with you to provide a comprehensive treatment plan that includes the latest technology in diagnosis and treatment.
What Are Metastatic Liver Lesions
Cancer can develop in any organ and each cancer acts differently in its tendency to spread to other organs. When a cancer has spread to the liver, it is referred to as a metastatic liver lesion. Sometimes the metastatic lesion is identified at the same time as the original cancer (synchronous) and sometimes the metastatic lesion is discovered later, after the original cancer has been treated or surgically removed (metachronous). The liver has two separate sources of blood supply: the hepatic artery (provides oxygenated blood) and the portal vein (carries blood from the intestines back to the liver for extraction of nutrients). For this reason, the liver is the most common site for metastasis from gastrointestinal cancers, such as colon cancer or pancreatic cancer.
Detecting and Staging Metastases
When cancer has spread to the liver, it typically does not cause any symptoms. As a result, most patients do not notice any change in their health. Blood tests and imaging, such as CT scan or ultrasound, are important tools to detect metastatic liver lesions at an early stage, when they are most effectively treated. These tests can also be helpful in determining if the cancer has spread to areas in addition to the liver. In some patients additional testing, such as a positron emission tomography (PET) and MRI scan may be required to determine the extent of the liver metastases.
Treatment Options for Metastatic Liver Lesions
Once a metastatic liver lesion is detected, patients should undergo a rapid medical, oncologic and surgical evaluation to determine the most appropriate treatment. The treatment may vary between patients, and will be tailored to best fit each individual’s specific needs. Frequently, combinations of treatments, rather than a single type of treatment will be required, and you will meet with a team of specialists to discuss these different options during your evaluation.
The most common treatment used for metastatic liver lesions is systemic chemotherapy. In this treatment, anti-cancer medications may be delivered intravenously, or by ingestion of an oral preparation containing the anti-cancer drug. Cancer cells vary widely in their response to systemic chemotherapy, and some cancers respond well to chemotherapy, while others may be unaffected. This type of treatment is commonly offered for patients who have large malignant tumors that cannot be removed surgically, or patients who have cancer spread to other organs in addition to the liver.
Transarterial Chemoembolization (TACE)
Some patients may be more appropriate for a specialized form of chemotherapy, TACE, which uses special catheters to deliver chemotherapeutic drugs directly into the artery supplying the liver. This procedure focuses the anti-cancer effect on the metastatic lesions in the liver, and tends to have fewer side effects commonly seen with systemic chemotherapy. TACE has the added advantage of being able to partially block the blood supply to the area of the cancer, depriving the blood supply needed by the cancer cells for nutrients and oxygen. For most individuals TACE is well-tolerated, with few side-effects, and can frequently be performed as an outpatient procedure.
Patients with small metastatic tumors may be best treated with radiofrequency ablation (RFA). With this procedure, a specially designed probe is radiographically guided into the liver tumor, and radiofrequency energy is used to destroy tumor cells. During the procedure, tumor cells are heated to more than 50° C. Most commonly, this procedure is done using laparoscopic surgery (small incisions on the abdomen), or performed in the radiology suite, using CT guidance. In some instances, open surgery may be required to perform this procedure. RFA may be used for patients who have unresectable metastatic liver lesions, or are too ill to undergo surgical resection, and may be used in combination with other forms of treatment.
Why Choose Us
Hepatobiliary and pancreas diseases – disorders of the liver, bile ducts, gallbladder and pancreas – form a complex set of medical problems whose treatment often requires equally challenging minimally invasive or surgical procedures. At Precision Vascular & Interventional, we have been leaders in hepatobiliary and pancreas disorders. Our doctors are closely involved in clinical research and surgical innovation. Annually, our physicians provide care to some 2,500 hepatobiliary and pancreas patients. For patients requiring hospitalization, we have a dedicated critical care liver unit, hospitalists who specializes hepatobiliary and pancreatic disease, physician assistants, on-call anesthesia staff and a specialized O.R. nursing team. At Precision Vascular & Interventional, our focus is on providing experienced, personalized care for all patients.