Liver Cancers

Colorectal Liver Metastasis (CRLM)

What is Colorectal Liver Metastasis?

Colorectal liver metastasis occurs when cancer from the colon or rectum spreads to the liver. This is the most common site of metastasis for colorectal cancer because of the liver’s role in filtering blood from the digestive tract. Early detection and treatment are crucial for a positive outcome.

Symptoms of CRLM

Often, CRLM causes no symptoms until the disease progresses. However, as tumors grow, symptoms may include:

• Abdominal pain or discomfort

• Fatigue or weakness

• Jaundice (yellowing of the skin and eyes)

• Weight loss

• Loss of appetite

Treatment Options

Surgical Resection: Removing part of the liver where the tumors are located. This is the preferred treatment when the metastases are limited and surgically removable.

Ablation: For smaller tumours, heat or cold can be used to destroy cancer cells.

Chemotherapy: Sometimes used before or after surgery to shrink tumors or prevent recurrence.

Hepatocellular Carcinoma (HCC)

What is Hepatocellular Carcinoma?

Hepatocellular carcinoma is the most common type of primary liver cancer, often arising in individuals with chronic liver diseases like cirrhosis or hepatitis B or C. Early-stage HCC can often be treated with surgery, but advanced cases may require additional therapies.

Symptoms of HCC

In the early stages, HCC may not cause symptoms, but as the cancer grows, patients may experience:

• Upper right abdominal pain

• Jaundice

• Unexplained weight loss

• Nausea or vomiting

• A swollen abdomen due to fluid buildup (ascites)

Treatment Options

Surgical Resection: Removing the cancerous part of the liver.

Liver Transplant: If the tumor is small and meets certain criteria, a liver transplant may be an option.

Ablation or Embolisation: Used for smaller tumors or in patients who cannot undergo surgery. These treatments destroy the tumor or block its blood supply

Cholangiocarcinoma (Bile Duct Cancer)

What is Cholangiocarcinoma?

Cholangiocarcinoma is a rare cancer that forms in the bile ducts, which carry bile from the liver to the gallbladder and small intestine. It is typically more difficult to treat because it is often diagnosed at a later stage.

Symptoms of Cholangiocarcinoma

• Jaundice: Yellowing of the skin and eyes

• Itchy Skin: Due to bile buildup

• Abdominal Pain: Often in the right upper quadrant

• Dark Urine and Pale Stools

• Unexplained Weight Loss

Treatment Options

• Surgical Resection: Removing the cancer if it is caught early and is operable.

• Liver Transplant: In select cases, for early-stage cholangiocarcinoma.

• Chemotherapy/Radiation: These are often used to control the disease or as palliative treatment for advanced cases.

What Patients Should Do After Surgery?

For liver cancer surgery, whether it’s for CRLM, HCC, or cholangiocarcinoma, recovery care is essential. Here's what patients can expect and what they should do post-surgery:

1. Rest and Recovery

• Patients will need to rest after surgery, with gradual increases in activity. The recovery time can vary, but it often takes 4-8 weeks to return to full activity after liver resection

• Avoid heavy lifting or strenuous exercise during this period.

2. Managing Pain

• Post-surgery pain can be managed with medications prescribed by the doctor. Soreness around the incision sites is common, especially if a large portion of the liver was removed.

• Walking is encouraged to prevent blood clots, but patients should move at a comfortable pace

3. Diet

• Patients may need to start with a light diet (soups, broths, and soft foods) and gradually return to normal meals. It’s important to maintain a healthy diet to help the liver regenerate and heal.

• Stay hydrated, and avoid alcohol or overly fatty foods, as these can strain the liver.

4. Follow-Up Care

• Routine follow-up appointments are necessary to monitor liver function and check for any signs of cancer recurrence. Blood tests and imaging (CT scans, MRIs) are commonly used in post-surgery follow-up.

• Discuss any persistent symptoms such as jaundice, abdominal pain, or weight loss with your doctor immediately.

5. When to Call the Doctor

Contact your doctor if you experience fever, increasing pain, jaundice, or signs of infection around the incision site.