Other treatments for bowel cancer that has spread to the liver

There are different types of treatment for bowel cancer that has spread to the liver. Bowel cancer that has spread to the liver is also called secondary liver cancer.

Treatments include specialised ways of giving chemotherapy, radiotherapy or heat to destroy cancer cells. You might have these treatments to help your symptoms or to shrink the cancer. Or in some cases they might get rid of the secondary cancer.

You might have one of these treatments if you can’t have surgery to remove the secondary cancer. 

How your doctor decides about treatment

Your doctor will consider different factors when deciding if a treatment is suitable for you. Some factors are:

  • your general health 
  • how quickly your cancer came back after other treatments 
  • whether you have secondary cancer anywhere else that cannot be removed 

Your doctor will talk to you about the possible benefits and risks of these treatments. If your bowel cancer has spread anywhere else in your body, your doctor is not very likely to suggest these treatments. They might suggest a treatment that reaches your whole body instead.

Chemotherapy Open a glossary item and immunotherapy Open a glossary item circulate throughout the body and so treat all areas of the cancer. Targeted cancer drugs work by targeting the differences that help a cancer cell to survive and grow.

Stereotactic ablative radiotherapy (SABR)

Stereotactic radiotherapy gives radiotherapy Open a glossary itemfrom many different angles around the body. The beams meet at the tumour. This means the tumour receives a high dose of radiation and the tissues around it receive a much lower dose. This lowers the risk of side effects.

Selective Internal Radiation Therapy (SIRT)

This is a type of internal radiotherapy (brachytherapy). It is also called radioembolisation.  

You have a thin tube called a catheter put into your arm or groin Open a glossary item. The catheter goes into the hepatic artery that supplies blood to the liver. The doctor sends tiny beads called microspheres down the catheter. These get stuck in the small blood vessels around the cancer.

The microspheres contain a radioactive substance that gives a dose of radiation to the cancer. The radiation from the microspheres damages the cancer and the cancer’s blood supply. This means that the cancer can’t get the nutrients it needs. The radiation also damages the cancer cells. 

The range of radiation from the beads is very small. So it causes very little damage to the surrounding healthy tissue. Most of the radiation from the microspheres is gone within 2 weeks. But the effect on controlling the cancer lasts longer. The microspheres stay in the liver permanently but are harmless.

Transarterial chemoembolisation (TACE)

Chemoembolism involves giving a chemotherapy drug into an artery. For bowel cancer that has spread to the liver, your team usually use chemotherapy coated tiny beads. The doctor puts a thin tube called a catheter into a large artery in your leg or arm.

They thread the catheter into the main artery that carries blood to the liver. They then inject the chemotherapy coated beads. The beads cut off most of the blood flow to the liver, which cuts off the supply of oxygen and nutrients to the cancer. This damages the cancer cells.

The chemotherapy mixture also stays in the area of the cancer for some time, so the cancer cells get a high dose of the treatment. You may need to stay in hospital overnight or longer for this treatment.

Heat therapy

Doctors can use heat to destroy bowel cancer that has spread to the liver. You might have microwave ablation. Less commonly you might have radiofrequency ablation.

Microwave ablation

Microwave ablation uses microwave energy to produce heat and kill cancer cells. You can have this treatment for more than one secondary liver cancer. It’s usually used to treat smaller cancers.

You are likely to have a general anaesthetic Open a glossary item. Your doctor puts a thin needle into each tumour. They use a CT scan Open a glossary item or an ultrasound scan Open a glossary item to make sure the needles are in the right place. Then they connect the needles to a microwave generator. The microwaves are released through the needles to destroy the cancer cells.

You might need to have the treatment repeated. The most common side effects include pain and a high temperature. Your doctor or nurse will give you instructions on what to do if you get a high temperature or have any pain.

Radiofrequency ablation (RFA)

Radiofrequency ablation uses radio waves to destroy cancer cells in the liver by heating them to high temperatures.

Most people have a general anaesthetic. Your doctor pushes a thin needle through the skin and into the centre of each tumour. They use a CT scan or ultrasound scan to make sure the needles are in the right place. Then they pass radio waves through the needle to heat the tumours and destroy them.

RFA is usually used for small tumours which are less than 3cm in size. But they can treat tumours up to 5cm. It takes about an hour or sometimes a little longer. You might go home the same day or more likely the next day.

You might need to have the treatment repeated. The main side effects are pain and a high temperature for a few days. Your doctor or nurse will give you painkillers to take at home. They will also give you instructions on what to do if you get a high temperature.

Other types of treatment

Your doctor may suggest another treatment. These treatments include:

  • radiofrequency assisted surgery – using radio waves during an operation to kill the cancer cells and then remove them

  • cryotherapy – freezing the cancer cells

  • laser therapy – using a laser to destroy the cancer cells

  • alcohol injection – injecting alcohol into the cancer to destroy the cells

We have information on some of these treatments in our other treatments section.

Research into bowel cancer that has spread

Research is going on all the time into improving treatment for bowel cancer that has spread. Doctors are also interested in helping people to cope with symptoms.

Coping

Treatment for metastatic bowel cancer can keep it under control, relieve symptoms and give you a good quality of life. Lots of information and support is available to you, your family and friends.

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    A Cervantes and others

    Annals of Oncology, 2023. Volume 34, Issue 1

  • Colorectal cancer 
    The National Institute for Health and Care Excellence (NICE), 2020. Updated December 2021

  • Selective internal radiation therapy for unresectable colorectal metastases in the liver
    The National Institute for Health and Care Excellence, 2020

  • Stereotactic Ablative Radiation Therapy for Colorectal Liver Metastases

    RL McDermott and others

    Clinical Colorectal Cancer, 2023. Volume 22, Issue 1

  • Nonsurgical local treatment strategies for colorectal cancer liver metastases

    A Venook and others

    UpToDate website

    Accessed July 2023

  • A survey of liver ablation amongst UK interventional radiologists

    EW Johnson and others

    Clinical Radiology, 2023. Volume 78, Issue 7

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. If you need additional references for this information please contact patientinformation@cancer.org.uk with details of the particular issue you are interested in.

Last reviewed: 
30 Jun 2025
Next review due: 
30 Jun 2028

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