When Non-Small-Cell Lung Cancer Spreads to the Liver

Non-small-cell lung cancer (NSCLC) can spread to other parts of your body, including your liver. When this happens, it's called metastatic or stage IV NSCLC. You may not be able to cure it, but many treatments can ease your symptoms and make you more comfortable.

Symptoms

When your cancer spreads to the liver, you may have symptoms like:

Diagnosis

To figure out whether your NSCLC has spread to your liver or other parts of your body, your doctor may ask you to take some of these tests:

Blood chemistry tests. When cancer spreads to your liver, it can raise levels of liver enzymes or proteins like lactate dehydrogenase (LDH) in your blood. A blood test can reveal these changes.

CT (computed tomography). This powerful X-ray takes detailed pictures inside your body. It can find signs of cancer in your liver and other organs.

PET/CT scan. This test combines CT with a positron emission tomography (PET) scan. It uses a small amount of a radioactive substance called a radiotracer. The tracer builds up in areas of your body where there is cancer. A camera takes pictures to show where the cancer has spread.

Biopsy. Your doctor removes a small tissue sample from your liver and checks it under a microscope for cancer.

Treatment

Surgery usually isn't an option for late-stage NSCLC, but there are several treatments that can slow your cancer and improve your symptoms. You may get one of these or a combination:

Chemotherapy. It uses medicine to kill cancer cells all over your body and stop them from dividing. This treatment can slow your cancer or prevent it from spreading further.

Your doctor may treat your NSCLC with a combination of two chemotherapy drugs. He'll put the medicine through a vein about once every 3 weeks. Then you'll get a break from the medicine to let your body recover.

Each period of treatment and rest is called a cycle. You generally need four to six cycles.

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There can be side effects, such as:

These problems should go away after you stop the treatment. Talk to your doctor about medicine or other ways to get relief while you're getting chemo.

Radiation. This treatment uses high-energy rays to kill cancer cells and stop new ones from forming. It can ease symptoms of your cancer.

You might get side effects that include:

  • Redness in the treated area of skin
  • Hair loss
  • Tiredness

Targeted therapy. Some types of cancer contain genes or other substances that help them grow and survive. Therapies for late-stage NSCLC target proteins that promote the growth of new blood vessels to feed cancer and other proteins that make cancer cells grow faster.

You might get side effects from targeted therapy, such as:

Immunotherapy. This treatment boosts the way your immune system -- the body's defense against germs -- moves against cancer. One type of immunotherapy for NSCLC is called a checkpoint inhibitor.

Checkpoints are markers that help your immune system recognize your own cells so it doesn't attack them. Some cancer cells are able to hide behind checkpoints to avoid detection, but checkpoint inhibitors disable checkpoints on cancer cells so your immune system can find them.

Side effects of immunotherapy include:

  • Tiredness
  • Fever
  • Itching
  • Diarrhea
  • Rash

How to Manage Symptoms

While you get treated for metastatic NSCLC, see a doctor who specializes in palliative care. The goal of this approach is to ease your symptoms and help you feel better.

Some things you can do to manage your symptoms are:

Oxygen therapy. It can help you breathe easier and relieve symptoms like shortness of breath.

Breathing techniques. A program called pulmonary rehabilitation can teach you how to breathe so you take in more oxygen with each breath.

Pain relievers. If your pain is mild, you may be able to use an NSAID like ibuprofen. For more severe pain, you may need a stronger opioid drug like morphine.

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Diet changes. If you've lost your appetite, try to eat several smaller meals throughout the day instead of three big ones. Eat foods that are high in protein and calories, like nuts or ice cream. If you just can't eat, ask your doctor if you should take medicine to improve your appetite.

Relaxation therapies. Techniques like meditation or yoga can help you relax and get relief from anxiety and stress.

Support network. Talk to a psychologist, therapist, social worker, or another member of your medical team to help you manage your emotions. Friends and family can be a big source of help, too.

WebMD Medical Reference Reviewed by Louise Chang, MD on January 06, 2019

Sources

SOURCES:

American Cancer Society: "Non-Small Cell Lung Cancer Signs and Symptoms," "Tests for Non-Small Cell Lung Cancer."

Annals of Palliative Medicine: "Palliative care for patients with locally advanced and metastatic non-small cell lung cancer."

Canadian Cancer Society: "Liver metastases."

Cancer Care: "Ask CancerCare."

Cancer Research UK: "Symptoms of advanced cancer."

Cancer Support Community: "Treatments for Advanced and Metastatic Lung Cancer."

Contemporary Oncology: "Palliative care in patients with lung cancer."

Mayo Clinic: "Lung Cancer: Diagnosis & Treatment."

National Comprehensive Cancer Network: "Guidelines for Patients: Lung Cancer -- Non-Small Cell Lung Cancer."

Radiology Info: "Positron Emission Tomography -- Computed Tomography (PET/CT)."

UpToDate: "Patient education: Non-small cell lung cancer treatment; stage IV cancer (Beyond the Basics)."

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