Colorectal cancer is cancer that develops in your large intestine (colon) or rectum. It’s the second most common type of cancer in women and the third most common in men.

Colorectal cancer can spread to other parts of your body through your bloodstream or lymphatic system. The liver is the most common place for colorectal cancer to spread.

Read on to learn how colorectal cancer can spread to the liver.

About 70% of people with colorectal cancer develop metastatic liver cancer. Metastatic liver cancer means that the cancer didn’t originate in the liver but spread from somewhere else, like the colon or rectum.

The portal vein in the large intestine connects to the bile duct in the liver, which is why colorectal cancer often spreads to the bile duct. If the colon or rectum becomes cancer-ridden, it is easy for damaged cells to get transported to the liver through the bloodstream.

The cancer cells can still grow and spread even though they originated in the colon. If these cells continue to grow, they can cause tumors that can impact the liver and make it hard for it to function.

About 14% to 18% of people with colorectal cancer have metastasized cancer at their first medical consultation. However, this number is closer to 35% when a A computed tomography (CT) Scan. is used to detect whether the cancer has spread to the liver.

Research suggests that colorectal cancer may spread early during the disease and possibly years before the cancer is detected.

Colorectal cancer is divided into stages I to IV depending on how advanced the cancer is. It’s known as stage IV if the cancer has spread to the liver or another distant organ, such as the lungs or brain.

The primary test for diagnosing colorectal cancer is a colonoscopy with a biopsy. A biopsy is a small tissue sample of the colon lining that’s taken during a colonoscopy. The tissue sample is then sent for lab analysis to determine if it contains cancer cells. A biopsy is needed to make a definitive cancer diagnosis.

If the cancer has spread to another organ, it is time to use an image test. The types of tests used may include:

If you have colorectal cancer that has spread to your liver, you may be able to have surgery to remove it. Chemotherapy is a common treatment for colorectal cancer.


The surgery to remove cancer from the colon may include some.

  • hemocolectomy, which involves removing part of the colon that contains the cancer and a small section of normal colon on either side and then reattaching the colon; lymph nodes are also removed to check for cancer cells
  • total colectomy, which is a less common procedure that involves removing the entire colon

You may need to have surgery to shrink the cancer in your colon and/or liver. Chemotherapy is used to destroy cancer cells after surgery. This is a type of cancer treatment.

Surgery to remove cancer in your liver is usually only possible if the cancer is contained in a small portion of your liver. Surgery is only an option in about 20% to 30% of people with metastatic colon cancer. According to research, 39% to 58% of people who have liver surgery live for at least 5 years after the procedure.

Your surgeon will remove as much of the cancer as possible from your colon and liver. At different times, these surgeries may be done at the same time. Your doctor will tell you which option is best for you.

Ablation and embolization

Small tumors can be removed with embolization or a similar procedure.

Ablation is used to destroy tumors less than 4 centimeters (cm) (1.6 inches) across in size. Ablation techniques that are used for cancer cells in the liver include:

  • radiofrequency ablation is the most common ablation method that uses high-energy radio waves to heat and destroy cancer cells
  • ethanol ablation involves a concentrated injection of alcohol into tumors to kill off cancer cells
  • microwave ablation uses electromagnetic waves to heat and destroy cancer
  • cryosurgery involves the use of cold gasses to freeze and destroy cancer cells

Embolization is a procedure where a substance is injected into an arteriovenous malformation. The aim of this procedure is to remove the cancer cells from the liver.

Embolization is an option for people with tumors that are larger than 5 cm across, that cannot be treated with surgery or ablation, and who still have adequate liver function.


Chemo is used to treat colorectal cancer at all stages. It may be used in a number of ways.

  • As neoadjuvant chemotherapy: Chemo may be necessary before surgery to help shrink cancerous tumors. Sometimes this is done in combination with radiation. Chemo treatment at this point in time helps make the cancer easier to remove during surgery. Neoadjuvant chemo is usually given for a total of 3 to 6 months, depending on what types of chemo drugs are used.
  • As adjuvant chemotherapy: In this instance, chemo drugs are given after surgery. The goal with adjuvant chemo is to destroy any cancer cells that may have been left behind after the cancer was surgically removed, or to target any cancer cells that are too small to be detected with imaging tests. Like neoadjuvant chemo, this treatment usually also lasts for 3 to 6 months.
  • For advanced cancers: Chemo drugs can help shrink tumors that have spread to distant organs like the liver, lungs, brain, and other areas. Although it won’t cure colorectal cancer, it can help ease symptoms that may be causing discomfort, and can help prolong a person’s life.

Many chemotherapy options are available. According to the American Cancer Society, some of the most common chemo treatment combinations include:

  • FOLFOX: folinic acid, fluorouracil, and oxaliplatin
  • FOLFIRI: fluorouracil, leucovorin, andirinotecan.
  • capecitabine and oxaliplatin are drugs.
  • FOLFOXIRI: fluorouracil, oxaliplatin, and irinotecan.

Other treatments

New types of targeted drugs are being developed that can focus on the cell changes that allow colorectal cancer to grow.

Unlike chemo drugs, which destroy both cancerous cells and healthy cells, targeted therapy drugs only go after cancer cells. These targeted therapies can be used together with chemotherapy or on their own.

Another treatment area that’s expanding for colorectal cancer, including cancer that has spread to the liver or elsewhere, is immunotherapy. This involves the use of medicines to help your own immune system detect and destroy cancer cells.

The 5-year relative survival rate for colon cancer in the United States is 64%, while the relative survival rate for rectal cancer is 67%. When cancer reaches distant organs, the 5-year survival rate drops to 14% for colon cancer and 17% for rectal cancer.

The 5-year relative survival is a measure of how many people with a disease are still alive five years later.

Resources for colorectal cancer

Dealing with colorectal cancer can be difficult. If you or a loved one is looking for support, here are some resources that might be helpful.

Your blood or lys lymph system can be a conduit for colorectal cancer to spread. The most common organ that colorectal cancer spreads to is the liver because of the rich blood supply between the large intestine and the liver.

Treatment for colorectal cancer that has spread to the liver can be a combination of surgery, chemotherapy, and targeted therapy. Chemo drugs can be used for colorectal cancer. Your oncologist will work with you to find the best treatments for you.