When Lung Cancer Spreads to the Liver: What to Expect

“While historical survival rates have been challenging, recent advancements in targeted therapies and immunotherapies are significantly improving outcomes for many, sometimes extending life by several years,” Dr. Rizk says.

How Lung Cancer Spreads to the Liver

Signs to Watch Out For

Liver metastases can be hard to detect in early stages because symptoms aren’t specific, Rizk says. “Initially, individuals may experience no symptoms at all, or they may have vague complaints like fatigue and loss of appetite, which can be easily attributed to other causes,” he says.

Other symptoms can include nausea, unexplained weight loss, and discomfort in the upper right side of the abdomen (where the liver is located), says Lee Hong, MD, PhD, a medical oncologist at City of Hope Orange County in Irvine, California.

• Jaundice (yellowing of the eyes or skin)
• Bloating
• Swelling of the legs
• Itching
• Fever

“These symptoms can have many causes, so I encourage patients to tell their care team about any new or worsening changes rather than trying to determine the cause themselves,” Dr. Hong says.

How Doctors Diagnose Liver Metastasis

“To diagnose liver metastasis, doctors utilize a comprehensive approach that starts with a physical examination, a review of the patient’s medical history, and blood tests to check for abnormal liver function or specific tumor markers,” Rizk says.

• CT Scan Uses X-rays to create detailed cross-sectional images of the liver, helping doctors identify abnormal growths and determine whether cancer has spread to the organ.
• MRI Uses magnetic fields and radio waves to produce detailed images of liver tissue, which can help distinguish metastatic tumors from healthy tissue.
• PET Scan Uses a small amount of radioactive sugar to highlight areas of increased metabolic activity, helping identify cancer that has spread to the liver and other parts of the body.
• Ultrasound Uses sound waves to create images of the liver and can help detect abnormal areas that may require further evaluation with other imaging tests.

“This combination of diagnostic tools allows physicians not only to confirm the metastasis but also to determine the extent of the disease and develop an appropriate treatment strategy, which may include locating the primary tumor if it hasn’t been identified already,” he says.

Treatment Options for Lung Cancer With Liver Metastasis

Treatment for lung cancer that has spread to the liver focuses on controlling the disease, alleviating symptoms, and improving quality of life through a combination of approaches, Rizk says, which can include:

• Systemic Treatments “The primary treatments are systemic therapies that travel through the bloodstream to target cancer cells throughout the body,” Rizk says. These include chemotherapy, targeted therapy for cancers with specific genetic mutations, and immunotherapy, which helps the body’s own immune system fight the cancer.

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• Localized Treatments Local therapies may be used to specifically target the tumors in the liver, such as stereotactic body radiation therapy to deliver precise radiation, Rizk says. “Other localized options include ablation techniques to destroy cancer cells with high-energy waves and embolization procedures like transarterial chemoembolization to block the tumors’ blood supply while delivering chemotherapy directly,” he says.

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• Surgery Surgical removal is typically not an option for most people with liver metastases. Tumors may involve major blood vessels, other health conditions may make surgery unsafe, and complications from the procedure could delay other treatments. However, surgery may be possible when metastases are detected early or other treatments successfully shrink the tumors.

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• Clinical Trials Clinical trials offer access to newer treatments or treatment combinations that are still being evaluated. Depending on the trial, these therapies may aim to slow or stop tumor growth, shrink metastatic tumors, or improve survival and quality of life. Talk to your doctor about clinical trials you might be eligible for.

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“There’s no single treatment plan for everyone,” Hong says. “Our goal is to find the treatment most likely to control the cancer while helping each patient maintain the best quality of life possible.”

Palliative Care

“For someone with lung cancer that has metastasized to the liver, palliative care offers comprehensive support by actively managing distressing symptoms, like pain, shortness of breath, fatigue, and nausea, while also providing crucial emotional, psychological, and spiritual support to help patients and their families cope with the diagnosis,” Rizk says.

Importantly, palliative care is not the same as hospice and doesn’t mean giving up or stopping cancer treatment, Hong says. “It can be provided alongside cancer care and focuses on helping people feel and function as well as possible,” she says.

Prognosis and Outlook

According to Hong, a person’s outlook can depend on a number of factors, including the type of lung cancer, its specific characteristics, how extensively it has spread, liver function, overall health, and how well the cancer responds to treatment.

That’s why prognosis is so individualized, she says. “We look at how the cancer is responding and how the patient is feeling, and adjust treatment when needed. A population statistic can’t capture everything that may influence one person’s experience.”