Liver Metastasis from Colon Cancer Treatments

Colon cancer that spread to the liver is considered to be stage IV. The liver is a common site for metastasis because part of the blood supply leaving the intestine actually connects directly into the liver instead of first being directed to the lungs. Nearly 50 percent of patients with colorectal cancer have cancer cells that have spread to the liver from the colon.

Surgery

• The first-line treatment for liver metastases from colon cancer is surgery. Only a small number, or 11 percent to 30 percent, of patients are deemed suitable candidates for surgery. To be a good candidate for surgery, a patient should only have a small portion of the liver involved, have three or fewer tumors (all clustered near each other) and no tumors near large blood vessels or other organs.

  If surgery is performed, newer techniques have improved the five-year survival rate to between 25 percent and 40 percent.

  If resection is not possible due to blood vessels, the patient may be deemed a good candidate for cryosurgery. In this procedure, a surgeon will freeze and destroy the tumor. The five-year survival rate is around 20 percent.

Radiofrequency Ablation

• Radiofrequency ablation is considered a safe technique with a lower than 1 percent mortality rate, according to the National Cancer Institute, and may provide for long-term tumor control. In this technique, heat is used with a special probe and tiny electrodes that kill cancer destroy the tumors in the liver. The probe is sometimes inserted through the skin, while other times it is placed through a cut in the abdomen.

Embolization

• Embolization is a newer technique in which blood clots are purposely created within blood vessels in the tumor, and in blood vessels that feed the liver tumor. Sometimes chemotherapy drugs are also infused into the artery of the liver.

Chemotherapy

• Currently there are seven chemotherapy drugs approved for use in colon cancer that has spread to the liver. They are capecitabine, 5-FU irinotecan, bevacizumab, cetuximab, oxaliplatin and panitumumab. Sometimes more than one drug is used at a time, and sometimes the chemotherapy drugs are put directly into the artery leading to the liver as this appears to be more effective than intravenous chemotherapy.

Targeted Therapy

• Targeted treatments are newer procedures that kill cancer cells yet do little damage to surrounding noncancerous tissue. Targeted therapy techniques are also referred to as immunotherapies because they help the patient fight the cancer by aiding the patient's immune system response. One of these immunotherapies is antiangiogenesis therapy, in which the tumor is starved by administering a drug that stops the production of new blood vessels. Another targeted therapy is epidermal growth factor receptor, or EGFR, inhibitors, which shrink tumors by blocking the EGFR protein that helps colorectal cancers grow.