Stomach cancer, also known as gastric cancer, originates in the cells lining the stomach. While it can remain localized, it may eventually spread to other parts of the body, a process called metastasis. The liver is a frequent destination for these cells.
How Stomach Cancer Spreads to the Liver
Stomach cancer cells can detach from the primary tumor and spread. One route is through the lymphatic system, a network of vessels carrying fluid and immune cells. Cancer cells can enter these vessels and move into lymph nodes before potentially reaching the bloodstream.
Another pathway is hematogenous spread, where cancer cells enter the bloodstream. The stomach’s blood supply drains directly into the portal vein system, which carries blood to the liver. This anatomical connection makes the liver a common first site for stomach cancer metastasis, as it acts as a large filter for blood flowing from the digestive organs. The liver’s unique environment also provides a hospitable setting for cancer cells to establish and grow.
Signs and Symptoms of Liver Involvement
When stomach cancer spreads to the liver, it can cause a range of symptoms as the liver’s normal functions become impaired. One common sign is jaundice, characterized by a yellowing of the skin and the whites of the eyes, resulting from a buildup of bilirubin. Individuals may also experience discomfort or pain, often located in the upper right side of the abdomen.
Other general symptoms include unexplained weight loss, persistent tiredness, and a decreased appetite. Nausea and vomiting may also occur, along with a feeling of being full after eating only a small amount of food. Additionally, fluid can accumulate in the abdomen, leading to a swollen appearance known as ascites, and some individuals may report itchy skin.
Diagnosing Liver Metastasis
Confirming the spread of stomach cancer to the liver involves a combination of imaging techniques and laboratory tests. Imaging studies are frequently used to visualize the liver and detect any abnormal growths. Common imaging modalities include computed tomography (CT) scans, magnetic resonance imaging (MRI), and positron emission tomography (PET) scans. These scans provide detailed cross-sectional images that can reveal the presence, size, and location of liver tumors.
Blood tests also provide important clues about liver health. Liver function tests (LFTs) measure various enzymes and proteins that can indicate liver damage or dysfunction. Tumor markers, such as carcinoembryonic antigen (CEA) or carbohydrate antigen 19-9 (CA19-9), may also be elevated when cancer is present. While imaging and blood tests can suggest metastasis, a liver biopsy is often performed for definitive confirmation.
Treatment Approaches
Treating stomach cancer that has spread to the liver primarily involves systemic therapies that circulate throughout the body to target cancer cells. Chemotherapy is a common approach, using drugs to kill rapidly dividing cancer cells or slow their growth. These agents can be given alone or in combination regimens, aiming to shrink tumors and manage symptoms.
Targeted therapies represent another important treatment option, focusing on specific molecular pathways or proteins that are essential for cancer cell survival and growth. For example, some targeted drugs interfere with growth signals or the formation of new blood vessels that feed tumors. Immunotherapy is also increasingly used, working by boosting the body’s own immune system to recognize and destroy cancer cells. These treatments can help control the disease, alleviate symptoms, and potentially extend life. Palliative care is an important component of treatment, focusing on managing symptoms and improving the patient’s overall well-being throughout their illness.
Prognosis and Quality of Life
The outlook for individuals with stomach cancer that has spread to the liver can vary significantly. Factors influencing prognosis include the extent of the spread, the patient’s overall health, and how well the cancer responds to treatment. While a cure is often not possible at this advanced stage, treatment aims to control the disease and improve quality of life.
Supportive care measures are important for managing symptoms, which can include fatigue, pain, and loss of appetite. Multidisciplinary teams, including oncologists, palliative care specialists, and nutritionists, work together to provide comprehensive care. This collaborative approach helps patients navigate the complexities of their condition and maintain the best possible quality of life.