How Bad Is It When Bowel Cancer Has Spread to the Liver and Lungs?

When bowel cancer spreads to the liver or lungs, it means the cancer has reached an advanced stage. This situation is called secondary or metastatic bowel cancer. While the outlook is more serious than early-stage bowel cancer, treatments are available that can slow progression, relieve symptoms, and sometimes extend life.

This guide explains what happens when bowel cancer spreads, what it means for your health, and the options for care and support.

What does it mean when bowel cancer spreads?

Bowel cancer starts in the large intestine or rectum. Over time, cancer cells can break away and travel through blood or lymph to other parts of the body.

The liver and lungs are the two most common places bowel cancer spreads to. Doctors call this secondary liver cancer or secondary lung cancer, but the original source is still bowel cancer.

Learn how to monitor your liver health with the at-home liver tests guide.

Why the liver and lungs?

The liver and lungs filter large amounts of blood, which makes them common landing points for cancer cells traveling through the bloodstream.

• The liver processes blood from the digestive system, so cancer cells from the bowel often reach it first.

• The lungs receive blood from the heart, so they are another frequent site of spread.

How serious is bowel cancer that spreads to the liver and lungs?

Metastatic bowel cancer is considered stage 4 cancer, the most advanced stage. This usually means:

• The cancer is harder to remove completely with surgery

• Treatment focuses on control rather than cure

• Outcomes depend on how far the cancer has spread and how well it responds to treatment

Although advanced, many people still live for years with the right treatment plan.

Because bowel cancer often affects kidney function during treatment, see the kidney function test at home guide.

What symptoms might you notice?

When bowel cancer spreads, symptoms depend on where the cancer has gone:

Liver symptoms:

• Pain or swelling in the upper right abdomen

• Jaundice (yellowing of skin or eyes)

• Nausea or loss of appetite

Lung symptoms:

• Persistent cough

• Shortness of breath

• Chest pain

• Fatigue

You may also continue to experience bowel-related symptoms such as bleeding, changes in stool, or abdominal pain.

Urinary infections can complicate cancer treatment, so our UTI tests guide is a useful resource.

What treatments are available?

Even at stage 4, treatment options exist. Your doctor may suggest one or a combination of:

• Chemotherapy: To shrink or slow cancer growth

• Targeted therapy: Medicines that block cancer growth pathways

• Immunotherapy: Treatments that help your immune system fight cancer (suitable for some genetic types of bowel cancer)

• Surgery: In select cases, surgeons may remove cancer spots in the liver or lungs if they are limited in number

• Radiation: To relieve symptoms such as pain or breathing problems

Treatment goals may include extending life, controlling symptoms, and improving quality of life.

Can surgery help if bowel cancer has spread?

Sometimes surgery is possible. For example, if only a few tumors are in the liver or lungs, doctors may remove them. In certain cases, this approach has led to long-term survival.

However, if cancer has spread widely, surgery is less likely to be effective. Your healthcare team will decide based on scans, blood tests, and your overall health.

What is the outlook?

Outcomes vary from person to person. Factors include:

• How many tumors are in the liver or lungs

• Whether the cancer has spread to other parts of the body

• Your general health and fitness

• How well the cancer responds to treatment

While stage 4 bowel cancer is serious, treatments can extend life for months or years. Some people live 5 years or longer, especially if surgery to remove metastases is possible.

Since blood sugar control influences cancer recovery and liver health, explore understanding high glucose in urine.

How can you support your liver and lungs during treatment?

Medical treatment is the main tool, but healthy habits support your body:

• Eat a balanced diet with plenty of protein and whole foods

• Stay physically active within your ability

• Avoid alcohol and smoking, which strain the liver and lungs

• Follow your doctor’s advice for managing side effects

When should you see your doctor?

Contact your healthcare team if you notice:

• New or worsening pain

• Difficulty breathing

• Yellowing skin or eyes

• Unexpected weight loss

• Fatigue that does not improve

Early attention helps manage symptoms more effectively.

For ongoing at-home tracking, the Ribbon Checkup urine test helps monitor multiple markers that may reflect stress on the liver, kidneys, or urinary system.

Key takeaway

When bowel cancer spreads to the liver and lungs, it means the cancer is advanced. While cure is less likely, treatments can still help control the disease, ease symptoms, and extend life.

Your doctor will guide you through the best options for your situation, and healthy lifestyle choices can support your overall well-being during treatment.

Supporting your liver and kidneys during treatment is vital. Track your health with the Ribbon Checkup Kidney health Test.

 

References

References

• Cervantes, A., Arnold, D., Ciardiello, F., et al. (2023). Metastatic colorectal cancer: ESMO Clinical Practice Guidelines. Annals of Oncology. https://www.annalsofoncology.org/article/S0923-7534%2822%2904192-8/fulltext 

• Engstrand, J., Nilsson, H., Strömberg, C., Jonas, E., & Freedman, J. (2022). Treatment intention and outcome in patients with simultaneously presenting liver and lung metastases from colorectal cancer. Journal of Surgical Oncology. https://www.sciencedirect.com/science/article/pii/S0748798322001287

• Hu, D., et al. (2021). Colorectal cancer liver metastases: An update of treatment. ScienceDirect. https://www.sciencedirect.com/science/article/pii/S2666262021000188

• Morris, V. K., et al. (2023). Treatment of metastatic colorectal cancer: ASCO guideline. Journal of Clinical Oncology. https://ascopubs.org/doi/abs/10.1200/JCO.22.01690 

• Patel, R. K., et al. (2023). Updated management of colorectal cancer liver metastases. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC10598050/ 

• Van Cutsem, E., et al. (2016). ESMO consensus guidelines for the management of metastatic colorectal cancer. Annals of Oncology. https://www.annalsofoncology.org/article/S0923-7534%2819%2934754-4/fulltext 

• Yang, C., et al. (2025). Liver metastasis of colorectal cancer: Mechanism and management. Oncology Reports. https://www.spandidos-publications.com/10.3892/or.2025.8963 

• Zeineddine, F. A., et al. (2023). Survival improvement for patients with metastatic colorectal cancer. npj Precision Oncology. https://www.nature.com/articles/s41698-023-00353-4

• “Kow, A. W. C.” (2019). Hepatic metastasis from colorectal cancer. Journal of Gastrointestinal Oncology. https://jgo.amegroups.org/article/view/32297/html

• “Limited Liver or Lung Colorectal Cancer Metastases.” (2021). PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC8157146/

 

Frequently Asked Questions

Q: What does it mean when bowel cancer spreads to the liver and lungs?

A: It means the cancer has reached stage 4, also called metastatic bowel cancer. The original cancer cells travel through blood or lymph and settle in the liver or lungs.

Q: Why are the liver and lungs common sites for spread?

A: Both filter large amounts of blood, making them natural sites for cancer cells from the bowel to lodge and grow.

Q: What symptoms should I watch for if bowel cancer spreads?

A: Symptoms may include abdominal pain or swelling, jaundice, appetite loss, cough, shortness of breath, chest pain, fatigue, or bowel changes.

Q: What treatments are available for metastatic bowel cancer?

A: Options include chemotherapy, targeted therapy, immunotherapy, radiation, and in some cases surgery to remove limited metastases.

Q: Can surgery help if the cancer has spread?

A: Yes, in select cases where only a few tumors are in the liver or lungs, surgery may be possible and improve long-term survival.

Q: What is the outlook for stage 4 bowel cancer?

A: While cure is less likely, treatments can extend life for months or years. Some patients live 5 years or longer, especially if surgery is an option.

Q: How can I support my liver and lungs during treatment?

A: Adopt healthy habits such as eating a balanced diet, staying active, avoiding alcohol and smoking, and following medical advice for side effect management.