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Colorectal metastases

What are colorectal liver metastases?
Colorectal cancer is the second commonest cancer in women and the third commonest cancer in men in the United Kingdom. Up to 40% of patients with colorectal cancer will develop secondary tumours (metastases) in their liver. These can be present when a patient first presents with their primary colorectal cancer or may appear in the liver at a later date (usually within 3 years). The liver is the commonest site of secondary tumours in patients with colorectal cancer and hence after an operation for colon cancer patients should be screened regularly with blood tests and CT scans to ensure these are not developing Many patients with colorectal liver metastases have no other secondary tumours and can be considered for an operation to remove the affected area of the liver.

What are the symptoms?
Occasionally patients with very advanced disease can present with jaundice, weight loss, anorexia (loss of appetite) and pain below the ribs on the right side of the abdomen. However patients rarely get any symptoms from their liver metastases, although patients can have them when the present with symptoms of their primary colorectal tumour which would include passing blood when opening your bowels and a change in bowel habit.

How are they diagnosed?
Liver metastases will be present on staging CT scan in up to 20% of patients when they initially present with their primary colorectal cancer. It is usual practice to operate on the primary tumour before deciding how to treat the liver tumours, although rarely both tumours can be dealt with during the same operation. Most patients with colorectal liver metastases that develop after the primary tumour has been removed have no idea that they are present as they feel perfectly well. For this reason it is important that, following an operation for bowel cancer, patients are screened regularly to ensure that secondary tumours have not appeared. Many patients with liver metastases diagnosed on a CT scan will have an additional scan on their liver (an MRI scan) if liver surgery considered as a treatment option.

Is there anywhere I can seek additional information?
You can get additional information on this subject from:
Cancerbackup on 0808 800 1234 or www.cancerbackup.org.uk
Cancer Research UK at www.cancerhelp.org.uk
Association of Upper GI Surgeons at www.augis.org.uk

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