Controlling the symptoms of secondary cancer in the liver
Treatment for secondary cancer in the liver can help to ease your symptoms.
If it’s not possible to use these treatments, or if they’re not effective, there are several other ways of helping you cope with any symptoms. This symptom control treatment is known as palliative therapy or supportive care.
Your doctor may refer you to a palliative care team who can provide expert advice on controlling symptoms and also support you and your family. The palliative care team will often include a doctor and nurses. They are often linked to a local hospice and can visit you and your family at home.
Tiredness and weakness (fatigue)
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Fatigue means feeling exhausted all or most of the time, and it’s a common and difficult problem for people with secondary liver cancer. It can be caused either by the cancer or by coping with other symptoms, such as pain.
Many people with secondary liver cancer find they feel tired and don’t have the energy to do everyday activities. If you feel tired, it’s important to pace yourself and save your energy for the things that matter to you and that you enjoy, instead of chores around the house. Letting other people do these jobs can help you have energy for the things you really want to do.
Just do as much as you feel like, but remember you won’t do yourself any harm by doing too much. You can simply rest and relax a bit more the next day if you need to. Tiredness and weakness can make it harder for you to concentrate or to take part fully in what’s going on around you. So if you have important things to do, try to do them when you feel less tired.
Our section on coping with fatigue has tips to help you cope with cancer-related tiredness.
Some people lose interest in food. This may be a symptom of the cancer or due to treatment. You may be put off even by the sight and smell of food. Small, frequent and simple meals, concentrating on your favourite foods, are likely to be most tempting.
If you don’t feel like eating, your doctor can prescribe supplement drinks or liquid meals, such as Ensure® or Fortisip®. Sometimes medicines such as steroids or a hormone called megestrol acetate (Megace®) can help to increase your appetite. Your doctor can prescribe these.
Our section on eating problems and cancer has lots of ideas about boosting your appetite and maintaining a good diet.
Secondary liver cancer can make you feel sick by changing the chemical balance of your blood. This can often be effectively relieved by anti-sickness tablets (anti-emetics). There are several different types of anti-emetics available and your doctor will find the one that suits you best.
Steroids are often used, as these can help to relieve sickness and make you feel more energetic, as well as improving your appetite.
Secondary cancer of the liver can make the liver grow larger. The enlarged liver stretches the capsule that surrounds it, which causes pain.
Chemotherapy may shrink the enlarged liver and this can help relieve the pain, but there are also several effective types of painkillers available that your doctor can prescribe.
Strong painkillers can cause constipation, so it’s important to try to have a diet high in fibre and to drink plenty of fluids.
Your doctor should also prescribe a laxative with your painkillers to prevent constipation.
Our section on controlling cancer pain gives more information about painkilling drugs and other ways of relieving pain.
Steroids can also help to control pain by reducing swelling around the liver. This helps to reduce the size of the enlarged liver. They are usually given as a short course of treatment lasting a few weeks or months.
Radiotherapy may also be used to relieve your pain. This treatment may cause side effects, depending on the strength of the dose and the length of your treatment.
Our section on radiotherapy has more details about this treatment and its side effects.
Watch our video about controlling pain when you have advanced cancer.
Ascites is the name given to a build-up of fluid in the abdomen, which can make you feel bloated and uncomfortable. You may have less of an appetite and feel breathless as the swelling can prevent your lungs from fully expanding as you breathe.
Ascites can sometimes be reduced by taking water tablets called diuretics, which your doctor can prescribe. These are drugs that encourage the body to get rid of excess fluid as urine, rather than allowing it to collect in the body.
Ascites can also be relieved by inserting a small tube into the abdomen to drain off the excess fluid. This is done in hospital using a local anaesthetic, and can be repeated when necessary. Sometimes this procedure can be done at home by your doctor.
Sometimes the bile duct - the tube that drains bile out of the liver and into the intestine - can become blocked by the cancer. If this happens, bile builds up in the liver and flows back into the blood. It makes the skin turn yellow and feel itchy. This is called jaundice.
The itching may sometimes be relieved by antihistamine tablets or other drugs, which your doctor can prescribe.
Depending on where the blockage has occurred, the jaundice can sometimes be relieved by inserting a narrow tube (stent) into the bile duct to keep it open. This allows the bile to flow normally into the small intestine.
Extremes in body temperature
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As the liver is the major heat-producing organ of the body, people with cancer in the liver sometimes find that they have extreme changes in body temperature. They may feel hot and sweat more, or feel cold and shivery.
Speak to your doctor if you have these changes, as there may be medicines that can help.
Hiccups may occur if the liver is pressing on the nerve that leads to the diaphragm (the muscle layer separating the chest from the abdomen). A number of medicines may help to reduce or stop hiccups, and your doctor can prescribe these for you.
If the itching is due to jaundice, having frequent showers can wash off the bile salts and provide relief. Try to avoid soaps that dry the skin as they may increase itching. You may find moisturising lotions helpful. Your doctor can also prescribe medicines to help relieve itching.
Our section about controlling the symptoms of cancer has detailed information on how to reduce these symptoms.