Monitoring Colon Cancer That Spreads to the Liver

Medically Reviewed by Gabriela Pichardo, MD on February 13, 2022
4 min read

Even when it can't be cured, people are living longer than ever with colon cancer that gets into the liver. In part, that's because there are more ways to fight it. But another reason is that when your doctors keep close tabs on it, they can make smarter choices about the care you need.

Cancer's complex, and treatment for it is getting more and more specific to each person's case. So doctors need as much info as possible to guide you through it.

That means there's no one-size-fits-all approach to monitoring. You'll keep getting the tests you already know about, like imaging, blood tests, and physical exams. Your team of doctors will study the results to:

  • Figure out where things stand now
  • Choose the best treatments
  • Follow up with more tests so you can track progress and make any changes you need


Your doctors use images taken at different times to look for changes in the size, shape, and other features of tumors. They also want to see if any new ones have shown up.

CT scans tend to be used most often because you can get images of the belly, chest, and pelvis all in one shot. Typically, you'll take a contrast dye, either by mouth or IV, to get clearer results.

Your doctor might use an MRI to plan surgery or to find out for sure if a growth is cancer or not.

Doctors sometimes use PET scans as well. In some cases, they can show more clearly how treatment affects a tumor.

Expect them often, about every 3-6 months, to see how you're reacting to treatment and when you might need to make some changes.

Your doctors will typically track:

Carcinoembryonic antigen (CEA). It's a substance made by some tumors. When it goes up, it could mean cancer has come back. When it goes down, it may be a sign that treatment worked. If your tumors don't make CEA, this won't be a useful test for you.

Complete blood count (CBC). This general test measures different things about your blood. Your doctor will be especially interested in your levels of:

  • Platelets. They're an important part of your blood that helps it to clot. Checking the levels of platelets can tell you if you have a greater chance of a blood clot.
  • Red blood cells and hemoglobin. Low levels mean you have anemia, a common problem as cancers advance.
  • White blood cells. If your numbers are too high or too low, it could be a sign of infection.

Kidney function tests. Cancer and some treatments can put a strain on your kidneys, so you get these tests regularly. They measure the levels of wastes your kidneys normally handle. If the numbers are off, your doctors may need to adjust the treatment you're getting.

Liver function tests. These check how your liver's holding up by measuring the levels of certain proteins and enzymes. Your doctor will look at how the numbers change over time to make sure that your liver can still do its job and that the care you're getting doesn't cause serious liver damage. 

It may not be high-tech, but a physical exam has a lot of value. Your doctor will feel for pain or bulges, check your skin, and ask about your symptoms.

That last part is important. Tell your doctor about any changes or new problems you're seeing, even if they seem minor. It's useful insight, but that's not all. Certain issues could be emergencies, such as:

  • Chest pain
  • Severe jaundice, where your skin turns yellowish and itchy
  • Shortness of breath


There's no way to predict how things will go for you, but you can expect some differences based on whether your cancer can be cured or not.

When the cancer's curable. It's as important as ever to stick to your doctor's advice for follow-ups. The main reason is to check for signs that cancer has returned.

You'll have a routine something like this:

  • For the first 2 years after a cure, you get a physical exam, blood tests, and CT scan every 3-6 months. And you'll get a colonoscopy within a year.
  • In years 2-5, testing may spread out a bit to every 6-12 months.
  • After 5 years, you may still need yearly testing.

When the cancer isn't curable. You can expect follow-up visits roughly every 3 months to check on how well your treatment is working. The tests you need depend on the type of care you get and how you respond to it.

If you're in a clinical trial to test a new kind of treatment, you might have follow-ups as often as every 2 months.