Chemotherapy for secondary cancer in the liver
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. It’s a common treatment for secondary cancer in the liver.
The drugs used will depend on where the primary cancer started in your body. For example, if you have cancer of the breast that has spread to the liver, you’ll receive chemotherapy designed to treat breast cancer.
Unfortunately, it’s not possible to completely cure a secondary liver cancer with chemotherapy. However, it may slow or stop the growth of the cancer, and may shrink it to reduce symptoms.
Chemotherapy may also be used to shrink secondary liver tumours so they can be removed by surgery. It’s sometimes also used after surgery to stop the cancer coming back.
Giving chemotherapy before an operation is called neo-adjuvant treatment, and giving it after surgery is known as adjuvant treatment.
Chemotherapy drugs are sometimes given as tablets or, more usually, by injection into a vein (intravenously). Intravenous chemotherapy is usually given in the hospital outpatient department, but you may need to spend a few days in hospital.
Chemotherapy is commonly given as cycles of treatment.
Each cycle involves having the chemotherapy drugs for a few days, followed by a rest period of two or three weeks.
This allows your body to recover from any side effects of the treatment. The number of cycles you have will depend on the type of cancer you have and how well it’s responding to the treatment.
Very occasionally, chemotherapy may be given into the hepatic artery, which is the artery that takes blood to the liver.
This is known as intra-arterial or hepatic artery chemotherapy. It allows the drugs to be delivered directly to the liver tumour. It is a very specialised technique and may not be available in your hospital. Another technique for giving chemotherapy is hepatic artery chemoembolisation.
Side effects of chemotherapy
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Chemotherapy can sometimes cause unpleasant side effects, but it can also make you feel better by relieving the symptoms of the cancer. Any side effects that occur can often be well controlled with medicines. The main side effects are described here, along with some ways they can be avoided or reduced. Your doctor or specialist nurse will tell you about the side effects you may experience.
Risk of infection
Chemotherapy can reduce the number of white blood cells, which help to fight infection. White blood cells are produced by the bone marrow. If the number of your white blood cells is low you will be more prone to infections. A low white blood cell count is called neutropenia. This begins seven days after treatment and your resistance to infection is usually at its lowest 10-14 days after chemotherapy. The number of your white blood cells will then increase steadily and usually return to normal before your next cycle of chemotherapy is due.
Contact your doctor or the hospital straight away if:
your temperature goes above 38°C (100.4°F)
you suddenly feel unwell, even with a normal temperature.
You will have a blood test before having more chemotherapy
to check the number of white cells. Occasionally, your treatment may need to be delayed if your number of blood cells (blood count) is still low.
Tips for avoiding infection
Our slideshow offers advice for how to avoid infection if you have reduced immunity.
Bruising and bleeding
Chemotherapy can reduce the production of platelets, which help the blood to clot. Tell your doctor if you have any unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin. You can have a platelet transfusion if your platelet count is low.
Anaemia (low number of red blood cells)
Chemotherapy can reduce the number of red blood cells, which carry oxygen around the body. A low red blood cell count is called anaemia. This may make you feel tired and breathless. Tell your doctor or nurse if you have these symptoms. You may need to have a blood transfusion if the number of red blood cells becomes too low.
Feeling sick (nausea) or being sick (vomiting)
Your doctor can prescribe very effective anti-sickness (anti-emetic) drugs to prevent, or greatly reduce, nausea or vomiting. If the sickness isn’t controlled, or if it continues, tell your doctor; they can prescribe other anti-sickness drugs that may be more effective.
Some anti-sickness drugs can cause constipation. Let your doctor or nurse know if this is a problem.
Your mouth may become sore or dry, or you may notice small ulcers during this treatment. Some people find that sucking on ice may be soothing. Drinking plenty of fluids, and cleaning your teeth regularly and gently with a soft toothbrush, can help to reduce the risk of this happening. Tell your nurse or doctor if you have any of these problems, as they can prescribe mouthwashes and medicine to prevent or clear mouth infections.
You may notice that food tastes different. Normal taste usually comes back after treatment finishes. A dietitian or specialist nurse at your hospital can give you advice about ways of coping with this side effect.
This is another common side effect of some chemotherapy drugs. Your doctor or nurse can tell you if the drugs you’re taking are likely to make your hair fall out. Hair loss is temporary and your hair will grow back once the treatment has finished. Your hair may grow back straighter, curlier, finer, or a slightly different colour than it was before. Your nurse can give you advice about coping with hair loss.
Numbness or tingling in the hands or feet
This is due to the effect of some chemotherapy drugs on nerves and is known as peripheral neuropathy. You may also notice that you have difficulty doing up buttons or similar fiddly tasks.
Tell your doctor if you notice any numbness or tingling in your hands or feet. It is important to report your symptoms to your doctor as they may be controlled by slightly lowering the dose of the drug.
This side effect usually improves slowly, a few months after the treatment has finished. Sometimes symptoms can persist.
Talk to your doctor if this happens.
Feeling tired is a common side effect of chemotherapy, especially towards the end of treatment and for some weeks after it’s over. It’s important to try to pace yourself and get as much rest as you need. Try to balance this with taking some gentle exercise, such as short walks, which will help. If tiredness is making you feel sleepy, don’t operate machinery or drive.
We have more information about most of the side effects mentioned here. Although they may be hard to bear at the time, these side effects will begin to disappear once your treatment is over.
It’s not advisable to become pregnant or father a child while having chemotherapy, as it may harm the developing baby.
It’s important to use effective contraception during treatment and for at least a few months afterwards. You can discuss this with your doctor.
It’s not known whether chemotherapy drugs can be present in semen or vaginal fluids. To protect your partner, it’s safest to either avoid sex or use a condom for about 48 hours after chemotherapy.