Treatment for metastatic bowel cancer
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.
Find out about having surgery for bowel cancer that has spread to the liver
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.
and 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.
Get more information about treatment options for bowel cancer that has spread
Stereotactic radiotherapy gives from 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.
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 . 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.
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.
Read more about chemoembolisation (TACE)
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 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 . Your doctor puts a thin needle into each tumour. They use a or an 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 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.
Find out more about radiofrequency ablation
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 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.
Find a clinical trial for people living with bowel cancer
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.
Find out more about coping and support when you have metastatic bowel cancer
Last reviewed: 30 Jun 2025
Next review due: 30 Jun 2028
Metastatic bowel cancer is cancer that has spread from the back passage (rectum) and large intestines (colon) to other parts of the body, such as the liver.
You might have a number of tests to check for bowel cancer. This includes a test that looks for tiny traces of blood in a sample of poo (FIT) and a test to look at the inside of your bowel (colonoscopy).
The aim of treatment for metastatic bowel cancer is usually to reduce symptoms, make you feel better and sometimes help you live longer.
If you have metastatic bowel cancer there is information and support available to you, your family and friends.
Bowel cancer means cancer that starts in the colon (large bowel) or back passage (rectum). It is also known as colorectal cancer.
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