Published: Jun 8, 2023

Secondary liver cancer can sound confusing. It is not the same as cancer that starts in the liver.

Secondary liver cancer means cancer started somewhere else in the body and then spread to the liver.

Doctors may also call it liver metastases, liver Mets, metastatic liver cancer, or cancer that has spread to the liver.

The liver is a common site for cancer to spread. This is because the liver filters blood from many parts of the body.

Secondary liver cancer may cause no symptoms at first. Some people only find out after a scan or blood test. Others may notice tiredness, weight loss, belly pain, swelling, nausea, jaundice, or poor appetite.

This guide explains secondary liver cancer symptoms, causes, diagnosis, treatment, supportive care, red flags, and questions to ask your cancer team.

For more help, visit our Cancer Awareness & Prevention Hub, Liver Health & Detox Hub, Medical Tests & Screenings Hub, and Health Hub.

Medical note: This article is for education only. It does not diagnose or treat cancer. If you have yellow skin or eyes, severe belly pain, black or bloody stools, vomiting blood, confusion, fainting, severe weakness, severe breathlessness, chest pain, or symptoms that feel like an emergency, seek urgent medical care now.

Quick Answer: What Is Secondary Liver Cancer?

Secondary liver cancer is cancer that has spread to the liver from another body part.

It is not named after the liver. It is named after where it started.

For example:

• Bowel cancer that spreads to the liver is still bowel cancer.
• Breast cancer that spreads to the liver is still breast cancer.
• Lung cancer that spreads to the liver is still lung cancer.
• Pancreatic cancer that spreads to the liver is still pancreatic cancer.

These matter because treatment usually targets the original cancer type.

Secondary Liver Cancer vs Primary Liver Cancer

These are different conditions.

Type	Meaning	How is it treated
Primary liver cancer	Cancer starts in the liver	Treatment is based on the liver cancer type and liver function
Secondary liver cancer	Cancer starts elsewhere and spreads to the liver	Treatment is based on the original cancer and liver spread

If breast cancer spreads to the liver, doctors treat it as metastatic breast cancer. If bowel cancer spreads to the liver, doctors treat it as metastatic bowel cancer.

Why does cancer spread to the Liver?

The liver has a rich blood supply. Blood from the digestive system flows through the liver.

Cancer cells can travel through blood or lymph fluid. If they reach the liver, they may grow there.

Cancers that may spread to the liver include:

• Bowel cancer
• Colon cancer
• Rectal cancer
• Breast cancer
• Lung cancer
• Pancreatic cancer
• Stomach cancer
• Oesophageal cancer
• Melanoma
• Kidney cancer
• Neuroendocrine tumours
• Ovarian cancer
• Prostate cancer

Not every cancer spreads to the liver. Each person is different.

Can Secondary Liver Cancer Have No Symptoms?

Yes. Secondary liver cancer may not cause symptoms for a long time.

It may be found during:

• Routine cancer follow-up
• CT scan
• MRI scan
• Ultrasound
• PET scan
• Blood tests
• Tests for a different symptom

This is why follow-up after cancer treatment is important.

Common Secondary Liver Cancer Symptoms

Symptoms can be mild at first. They can also look like other health problems.

Possible symptoms include:

• Feeling generally unwell
• Tiredness
• Weakness
• Poor appetite
• Unexplained weight loss
• Feeling sick
• Vomiting
• Pain or discomfort in the right upper belly
• Pain in the right shoulder
• Swollen belly
• Fluid in the belly, called ascites
• Yellow skin or yellow eyes, called jaundice
• Itchy skin
• Dark urine
• Pale stools
• Fever or high temperature
• Hiccups that do not settle
• Confusion in severe liver problems

These symptoms do not always mean cancer. But they should be checked if they are new, persistent, or linked with a past cancer diagnosis.

1. Tiredness and Weakness

Tiredness is common in cancer. It may feel different from normal tiredness.

You may feel:

• Drained
• Weak
• Heavy
• Sleepy in the day
• Unable to do normal tasks
• Tired even after rest

Fatigue can also happen from anemia, infection, poor sleep, stress, depression, thyroid disease, liver disease, kidney disease, or treatment side effects.

Tell your cancer team if fatigue is getting worse.

2. Poor Appetite

Secondary liver cancer can reduce appetite. You may feel full fast. Food may not taste good. Nausea can also make eating hard.

Tell your care team if you are eating less. A dietitian may help.

Simple steps may include:

• Small meals
• Soft foods
• High-protein snacks
• Food you can tolerate
• Drinks between meals
• Nausea medicine is prescribed

3. Unexplained Weight Loss

Weight loss without trying should be checked.

It may happen because:

• You eat less
• The body uses more energy
• Cancer affects metabolism
• Treatment causes nausea
• Pain makes eating harder
• The liver is under stress

Weight loss is important. Do not wait until it becomes severe.

4. Nausea or Vomiting

Nausea means feeling sick. It can happen with cancer, liver problems, medicines, chemotherapy, infection, or digestive issues.

Tell your doctor if nausea stops you from eating or drinking.

Seek urgent care if vomiting will not stop, you cannot keep fluids down, you vomit blood, you have black stools, or you feel confused or very weak.

5. Right upper belly pain

The liver sits on the upper right side of the belly. Secondary liver cancer can stretch the liver's covering or press on nearby areas.

Pain may feel:

• Dull
• Aching
• Heavy
• Sharp in some cases
• Worse after eating in some people
• Linked with swelling or fullness

Right upper belly pain can also come from gallbladder disease, liver inflammation, stomach problems, muscle strain, or other causes.

New or worsening pain should be checked.

6. Right shoulder pain

Liver irritation can sometimes cause pain felt in the right shoulder. This is called referred pain.

Shoulder pain is not cancer. It is often muscle, joint, tendon, or posture-related.

But right shoulder pain with belly pain, weight loss, jaundice, or known cancer history should be discussed with a doctor.

7. Swollen Belly or Ascites

Ascites means fluid builds up in the belly.

You may notice:

• Belly swelling
• Tight clothes
• Feeling full fast
• Shortness of breath from pressure
• Weight gain from fluid
• Belly discomfort

Ascites can happen with cancer, liver disease, heart disease, kidney disease, infection, and other problems.

Your care team may treat ascites with medicines, fluid drainage, salt guidance, or cancer treatment, depending on the cause.

8. Jaundice

Jaundice means yellow skin or yellow eyes. It can happen when bile flow is blocked or the liver is not working well.

Jaundice may come with:

• Dark urine
• Pale stools
• Itchy skin
• Nausea
• Poor appetite
• Tiredness
• Yellow eyes
• Yellow skin

Jaundice should be checked quickly. It can happen from cancer, gallstones, liver disease, infection, or medicine effects.

9. Itchy Skin

Itching can happen when bile salts build up in the body.

It may feel worse at night. It may affect sleep.

Tell your doctor if the itching is strong. Treatments may help.

Do not scratch until skin breaks. Broken skin can get infected.

10. Dark Urine and Pale Stools

Dark urine may look tea-colored. Pale stools may look clay-colored or gray.

These can happen when bile flow is blocked.

Get medical advice quickly if dark urine and pale stools happen with yellow eyes, yellow skin, itching, or belly pain.

11. Fever or high temperature

Some people may have a fever or high temperature.

Fever can also be a sign of infection, including a serious infection during cancer treatment.

If you are having chemotherapy or your immune system is low, follow your cancer team’s fever advice. Some fevers need urgent care.

12. Hiccups That Do Not Settle

Hiccups can happen for simple reasons. But long-lasting hiccups can happen if the diaphragm or nearby nerves are irritated.

Tell your doctor if hiccups last a long time, stop you from eating, affect sleep, or happen with pain or swelling.

13. Confusion or Sleepiness

Severe liver problems can sometimes affect brain function. This can cause confusion, sleepiness, behaviour changes, or trouble staying awake.

Seek urgent medical care for additional confusion, severe sleepiness, fainting, or a sudden change in alertness.

Red Flags: Get Medical Help Quickly

Get urgent medical advice if you have:

• Yellow skin or yellow eyes
• Dark urine with pale stools
• Severe belly pain
• Swollen belly with shortness of breath
• Vomiting blood
• Black or bloody stools
• Fever during chemotherapy
• Confusion
• Fainting
• Severe weakness
• Chest pain
• Severe breathlessness
• Rapid weight loss

If you already have cancer, ask your team which symptoms need same-day advice.

How Secondary Liver Cancer Is Diagnosed

Doctors use your cancer history, symptoms, blood tests, scans, and sometimes a biopsy.

Tests may include:

• Liver function blood tests
• Full blood count
• Kidney function tests
• Tumour marker tests in some cancers
• Ultrasound scan
• CT scan
• MRI scan
• PET scan
• Biopsy in some cases
• Genetic or biomarker testing in some cancers

Not every person needs every test.

For more test education, visit our Medical Tests & Screenings Hub.

What do liver blood tests show?

Liver blood tests can give clues about liver stress or bile flow.

They may include:

• ALT
• AST
• ALP
• GGT
• Bilirubin
• Albumin
• Clotting tests

Abnormal liver blood tests do not always mean cancer. They can also happen from fatty liver, alcohol-related liver disease, hepatitis, gallstones, medicines, infection, and other causes.

Scans and medical review are often needed.

Can a biopsy be needed?

Sometimes, yes.

A biopsy means a small tissue sample is taken and checked under a microscope.

A biopsy may help confirm:

• Whether it is cancer
• Where the cancer likely started
• What type of cancer is it
• Whether certain treatments may work

But a biopsy is not always needed if scans and cancer history already give enough information.

Staging and Treatment Planning

Secondary liver cancer usually means the original cancer is advanced or metastatic.

Doctor's plan treatment based on:

• The original cancer type
• How much cancer is in the liver
• Whether cancer is in other organs
• How well the liver is working
• Your symptoms
• Your general health
• Past treatment
• Biomarker or gene results
• Your goals and preferences

Your care is usually planned by a team. This may include cancer doctors, surgeons, radiologists, nurses, dietitians, and palliative care specialists.

Secondary Liver Cancer Treatment

Treatment is personal. It depends on the cancer that has spread to the liver.

Treatment may aim to:

• Shrink cancer
• Slow cancer growth
• Control symptoms
• Improve the quality of life
• Help someone live longer
• Remove cancer in selected cases

Chemotherapy

Chemotherapy uses medicines to kill cancer cells or slow cancer growth.

It may be given through a vein or as tablets, depending on the cancer type.

Chemotherapy may be used for many cancers that spread to the liver, such as bowel, breast, lung, pancreatic, stomach, or ovarian cancer.

Side effects depend on the medicine used.

Targeted Therapy

Targeted therapy attacks certain cancer cell changes.

It may be used when the cancer has specific markers or gene changes.

Your doctor may order biomarker testing to see if targeted therapy is an option.

Immunotherapy

Immunotherapy helps the immune system find and attack cancer cells.

It may help some cancers that spread to the liver, such as some lung cancers, melanomas, bowel cancers with certain markers, and others.

It is not right for everyone. Testing and cancer type guide this choice.

Hormonal Therapy

Hormonal therapy may be used for cancers that use hormones to grow.

This is most common for:

• Breast cancer
• Prostate cancer

It may help control cancer spread in some people.

Surgery

Surgery to remove liver metastases is possible for some people, but not everyone.

It may be considered when:

• There are only a few liver tumours
• The rest of the liver can work well
• Cancer is controlled elsewhere
• The original cancer type responds well to surgery
• The person is fit enough for surgery

Surgery is more often considered for bowel cancer that has spread to the liver, and sometimes for neuroendocrine tumours or other selected cancers.

Ablation

Ablation uses heat, cold, or other energy to destroy cancer cells.

It may be used for small liver tumours in selected people.

Types may include:

• Radiofrequency ablation
• Microwave ablation
• Cryoablation in some cases

Embolisation

Embolization blocks blood flow to cancer areas in the liver.

Types may include:

• Chemoembolization, also called TACE
• Radioembolization, also called SIRT or selective internal radiotherapy

These are not used by everyone. They may be considered in selected cases.

Radiotherapy

Radiotherapy uses high-energy beams to treat cancer cells.

For secondary liver cancer, some people may have targeted radiotherapy, such as stereotactic radiotherapy.

Radiotherapy may help control cancer growth or symptoms in selected cases.

Palliative and Supportive Care

Palliative care is support for symptoms and quality of life. It is not only end-of-life care.

It can help with:

• Pain
• Nausea
• Appetite loss
• Weight loss
• Ascites
• Itching
• Tiredness
• Sleep problems
• Anxiety
• Family support
• Care planning

You can have palliative care while also having cancer treatment.

Managing Pain

Pain should be treated. Do not wait until it becomes severe.

Pain treatment may include:

• Pain medicines
• Anti-inflammatory medicines if safe
• Opioid medicines in some cases
• Nerve pain medicines in some cases
• Radiotherapy in selected cases
• Drainage of fluid if ascites causes pressure
• Palliative care support

Tell your team if pain medicine does not work or causes side effects.

Managing Nausea

Nausea can often be helped.

Your team may suggest:

• Anti-sickness medicine
• Small meals
• Cold foods if smells trigger nausea
• Fluids between meals
• Treating constipation
• Changing cancer treatment timing if needed

Call your care team if vomiting stops you from drinking.

Managing Ascites

Ascites can make the belly feel tight and heavy.

Treatment may include:

• Drainage through a small tube
• Salt advice in some cases
• Water tablets in selected cases
• Treating the cancer
• Palliative care support

Get urgent advice if belly swelling comes with fever, severe pain, confusion, or breathlessness.

Managing Itching and Jaundice

Itching from bile buildup can be very distressing.

Your team may consider:

• Medicines for itching
• Skin care
• Cool showers
• Loose clothing
• Treatment for bile duct blockage, if possible
• Stent placement in selected cases

Do not start herbs or supplements for jaundice without medical advice. Some can harm the liver.

Food and Nutrition

Eating can be hard with secondary liver cancer.

Ask a dietitian if you have weight loss, poor appetite, nausea, or trouble eating.

Helpful steps may include:

• Small meals often
• High-protein snacks
• Food you enjoy
• Soft foods
• Nutritional drinks if advised
• Nausea control
• Constipation treatment
• Family help with meals

Do not start a strict “anti-cancer” diet without medical advice. The body needs energy and protein during cancer care.

Can Secondary Liver Cancer Be Cured?

Sometimes treatment can remove or control liver metastases for a long time, especially in selected cases such as some bowel cancers that spread only to the liver.

But many cases are not curable. Treatment may still help.

Treatment may:

• Shrink cancer
• Slow growth
• Ease symptoms
• Improve quality of life
• Help someone live longer

Ask your cancer team about the goal of your treatment. The goal may be cure, long-term control, symptom relief, or comfort care.

Life Expectancy and Prognosis

Prognosis means what may happen over time.

It depends on many things, such as:

• The original cancer type
• How much cancer is in the liver
• Whether cancer is in other organs
• How fast is it growing?
• How well the liver works
• Your general health
• Available treatment options
• How cancer responds to treatment

Online statistics can be hard to apply to one person. Your cancer team knows your case best.

Questions to Ask Your Cancer Team

• Where did the cancer start?
• How much cancer is in my liver?
• Is cancer in other parts of my body?
• What is the goal of treatment?
• Can treatment remove all visible cancer?
• Is surgery possible?
• Is ablation possible?
• Is radiotherapy possible?
• Do I need chemotherapy?
• Do I need targeted therapy?
• Do I need immunotherapy?
• Do I need biomarker testing?
• How is my liver working?
• What symptoms should I report quickly?
• Can I see a dietitian?
• Can I meet the palliative care team?
• Should I get a second opinion?

What Not to Do

• Do not ignore jaundice.
• Do not ignore fast weight loss.
• Do not stop cancer treatment without talking to your team.
• Do not start liver detox supplements without medical advice.
• Do not use herbs instead of cancer treatment.
• Do not drink alcohol unless your team says it is safe.
• Do not take pain medicines that may harm the liver without advice.
• Do not skip scans or follow-up visits.
• Do not suffer with pain, nausea, itching, or swelling in silence.
• Do not assume palliative care means giving up.

Simple 7-Day Support Plan

This is not a treatment plan. It is a support plan to discuss with your care team.

Day 1: Know the Name

Ask where the cancer started. This helps explain the treatment plan.

Day 2: Track Symptoms

Write down pain, appetite, nausea, weight, swelling, itching, and energy levels.

Day 3: Review Medicines

Ask which pain medicines, supplements, or over-the-counter drugs are safe for your liver.

Day 4: Ask About Nutrition

If eating is hard, ask for dietitian support.

Day 5: Ask About Treatment Goals

Ask if the goal is cure, control, symptom relief, or comfort.

Day 6: Build a Help List

Choose who can help with meals, visits, transport, and notes.

Day 7: Plan Follow-Up

Ask when your next scan, blood test, or care review should happen.

FAQ

What is secondary liver cancer?

Secondary liver cancer means cancer started somewhere else in the body and spread to the liver. It is also called liver metastases or metastatic cancer in the liver.

Is secondary liver cancer the same as primary liver cancer?

No. Primary liver cancer starts in the liver. Secondary liver cancer starts in another organ and spreads to the liver.

What are the symptoms of secondary liver cancer?

Symptoms may include tiredness, poor appetite, weight loss, nausea, right upper belly pain, right shoulder pain, swollen belly, ascites, jaundice, itching, dark urine, pale stools, fever, and hiccups.

Can secondary liver cancer have no symptoms?

Yes. It may cause no symptoms for a long time and may be found during routine scans or blood tests after another cancer.

What cancers spread to the liver?

Cancers that may spread to the liver include bowel, breast, lung, pancreatic, stomach, oesophageal, melanoma, kidney, ovarian, prostate, and neuroendocrine tumours.

How is secondary liver cancer diagnosed?

Diagnosis may include liver blood tests, tumour markers, ultrasound, CT scan, MRI scan, PET scan, biopsy, and biomarker testing in some cases.

How is secondary liver cancer treated?

Treatment depends on the original cancer and may include chemotherapy, targeted therapy, immunotherapy, hormonal therapy, surgery, ablation, embolization, radiotherapy, and supportive care.

Can secondary liver cancer be cured?

Sometimes selected cases can be treated with surgery or local liver treatments. Many cases are not curable, but treatment may control cancer, ease symptoms, improve quality of life, and help someone live longer.

What is ascites in secondary liver cancer?

Ascites is fluid buildup in the belly. It may cause swelling, tightness, fullness, discomfort, and breathlessness from pressure.

When should I seek urgent care?

Seek urgent care for jaundice, severe belly pain, vomiting blood, black stools, confusion, fainting, severe breathlessness, chest pain, fever during chemotherapy, or severe weakness.

Related Reading

• Cancer Awareness & Prevention Hub
• Liver Health & Detox Hub
• Medical Tests & Screenings Hub
• Digestive Health & Gut Hub
• Health Hub
• Pancreatic Cancer: Symptoms, Causes, Treatment, and Early Warning Signs
• Lung Cancer Symptoms NHS: Expert Insights and Advice
• How I Knew I Had Colon Cancer: Warning Signs to Know
• Bowel Cancer and Stomach Noises: What to Know
• Cancer Prevention: Practical Steps That Support Lower Risk
• How to Differentiate Gallbladder and Liver Pain
• Stomach Pain After Eating: Causes, Quick Fixes, and When to Worry

Key Takeaway

Secondary liver cancer means cancer has spread to the liver from somewhere else in the body.

It is not the same as primary liver cancer. It is treated based on the cancer that started first.

Symptoms may include tiredness, poor appetite, weight loss, nausea, right upper belly pain, right shoulder pain, swelling, ascites, jaundice, itching, dark urine, pale stools, fever, and hiccups.

Some people have no symptoms for a long time. It may be found on routine scans or blood tests.

Treatment may include chemotherapy, targeted therapy, immunotherapy, hormonal therapy, surgery in selected cases, ablation, embolization, radiotherapy, and supportive care.

Do not ignore jaundice, severe pain, confusion, fever during chemotherapy, vomiting blood, black stools, chest pain, or severe breathlessness. Get urgent medical help.

 

Sources

• Cancer Research UK — Secondary Liver Cancer
• Cancer Research UK — What Is Secondary Liver Cancer?
• Cancer Research UK — Treatment for Secondary Liver Cancer
• Macmillan Cancer Support — Secondary Liver Cancer
• Macmillan Cancer Support — Symptoms of Secondary Cancer in the Liver
• Macmillan Cancer Support — Treatment for Secondary Cancer in the Liver
• American Cancer Society — Liver Metastases
• Cleveland Clinic — Metastatic Liver Cancer
• NHS — Liver Cancer Symptoms