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CION Cancer Clinics
Jaundice and liver metastases: why it happens and what can be done | CION Cancer Clinics
Cancer that has spread to the liver can cause jaundice, but many people with liver metastases never turn yellow. When it happens, either a bile duct is being squeezed or too much of the liver has been replaced. Other causes, such as gallstones or a medicine, are common too. This page explains how doctors tell these apart, what can be done, and which signs mean going to hospital today. At CION Cancer Clinics, a multidisciplinary tumour board weighs your liver function and your scans before recommending any treatment.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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On this page
- Can cancer that has spread to the liver turn the eyes yellow?
- Why would someone with liver metastases become yellow?
- How do doctors work out the cause of the jaundice?
- What do the words on the blood and scan reports mean?
- What do families often get wrong about jaundice and cancer?
- What can this page not tell you?
- Common questions about jaundice and liver metastases
The short answer
Can cancer that has spread to the liver turn the eyes yellow?
Yes, it can, but it is not the usual first sign, and many people with liver metastases never become jaundiced. When it does happen, there are two main reasons. Either something is squeezing the bile ducts so bile cannot drain, or so much of the liver has been replaced that it can no longer clear a yellow waste product called bilirubin.
Which kind of liver cancer this page is about
This page is about secondary liver cancer, also called liver metastases. That means a cancer that began somewhere else, such as the bowel, breast, stomach, pancreas or lung, and then spread to the liver. If your report says hepatocellular carcinoma (HCC, a cancer that starts in the liver cells), read why jaundice happens in liver cancer instead. If the spread came from the bowel, the colon cancer pages cover it in detail.
Why the cause matters so much
The two kinds of jaundice are handled in completely different ways. A blocked duct can often be opened, and the yellow colour then fades. A liver that is failing because of widespread disease is a much harder problem. Working out which one is happening is the first job of your team, and it is usually done quickly.
Yellow eyes in someone with cancer are not always caused by the cancer. Other causes are common and treatable.Four possible reasons
Why would someone with liver metastases become yellow?
Doctors think through each of these, because the answer decides what happens next.
A blocked bile duct
A tumour near the centre of the liver, or swollen lymph glands at the point where the ducts leave it, can press on the main bile duct. Bile backs up into the blood. This is often called obstructive jaundice.
Often comes with
- Dark, tea-coloured urine
- Pale, clay-coloured stools
- Itching all over the body
Too much of the liver replaced
When metastases fill a large part of the liver, the healthy tissue left cannot keep up with its work. Bilirubin rises slowly, and other blood tests such as albumin (a protein the liver makes) may fall.
This kind cannot be fixed with a stent.The first cancer itself
Some cancers sit right next to the bile duct. A cancer in the head of the pancreas, the gallbladder or the bile duct can block it directly, whether or not there are spots in the liver as well.
Something that is not the cancer
Gallstones, a viral hepatitis, an infection, or liver irritation from a medicine can all cause jaundice. Chemotherapy, immunotherapy and some herbal products can inflame the liver. These causes are checked before anyone assumes the cancer is growing.
Not sure whether this applies to you?
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When jaundice cannot wait
If the yellow colour comes on suddenly with a fever, shivering, or pain under the right ribs, go to hospital today. This can mean a blocked bile duct has become infected, which is dangerous and needs antibiotics and drainage quickly. Go today too if the person becomes confused or very drowsy, or vomits blood. Slowly deepening yellow without fever still needs a call to your oncology team this week.
What the team does next
How do doctors work out the cause of the jaundice?
Blood tests
Bilirubin, the liver enzymes, albumin and clotting tests show how yellow you are and whether the pattern looks more like a blockage or like the liver itself struggling.
A scan of the bile ducts
An ultrasound is usually first, because it shows quickly whether the ducts inside the liver are widened. Widened ducts point to a blockage. A CT or an MRI scan, arranged by CION through diagnostic partners, shows exactly where the blockage sits.
A tumour board review
The scans and blood results are reviewed by medical, surgical and radiation oncologists together, with the radiologist. They decide whether a drainage procedure is likely to help.
Opening the duct, if it is blocked
A thin tube called a stent can be placed through an endoscope (ERCP), or a drain can be passed through the skin into the liver. CION coordinates these through accredited partner hospitals. The page on stenting or drainage to relieve jaundice explains both.
Then the cancer treatment plan
Many cancer medicines are cleared by the liver, so treatment often waits until the bilirubin falls. The team re-checks the blood before restarting.
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On your report
What do the words on the blood and scan reports mean?
- Bilirubin
- A yellow waste product from old red blood cells. The liver clears it into bile. When it builds up in the blood, the eyes and skin turn yellow.
- Direct or conjugated bilirubin
- Bilirubin the liver has already processed. A high level of this kind often points to bile not draining out of the liver.
- Dilated intrahepatic ducts
- The small bile ducts inside the liver look widened on the scan. It is a sign that something further down is blocking them.
- Hilar or porta hepatis lesion
- A tumour or gland near the point where the main ducts and blood vessels enter the liver. Spots here are more likely to block bile than spots at the edge.
- ALP and GGT
- Two liver enzymes that rise when bile flow is slowed. They often go up before the eyes turn yellow.
Commonly believed
What do families often get wrong about jaundice and cancer?
"Jaundice means the cancer has reached its last stage."
Not always. A small tumour in the wrong place can block a duct while most of the liver works well. When a stent opens that duct, many people feel much better and can go on with treatment.
"Herbal drops or a special diet will clear the yellow."
Jaundice from a blocked duct needs the duct opened. Herbal remedies cannot do that, and some can add liver injury to a liver that is already under strain. Tell your oncologist about anything you are taking, without worrying about being judged.
"Stop all protein so the liver can rest."
Cutting protein makes weakness and muscle loss worse. Most people with jaundice need good nutrition, including protein. Ask the team before changing the diet.
"If there is no itching, it cannot be serious."
Itching varies a great deal between people. Some are very yellow and barely itch. The blood test and the scan decide how serious it is, not the itch.
Being straight with you
What can this page not tell you?
It cannot tell you why your own eyes or your parent's eyes have turned yellow. The same colour can come from a blocked duct, from widespread disease, from a medicine or from an infection. Only blood tests and a scan, read by a doctor who knows the full history, can separate them.
It cannot tell you what the jaundice means for the outlook
That depends on the cause, on which cancer started the spread, on how much healthy liver remains, and on how the cancer responds to treatment. Your oncologist can talk this through with you once the cause is known. Please do not read a single bilirubin number online and draw a conclusion from it.
Who this does not apply to
If nobody has told you that you have cancer, and you simply have yellow eyes, this is not the page to start with. Most jaundice in adults is not cancer. Read about jaundice that is not cancer and see a doctor this week.
If you are already on treatment and notice yellow eyes, call your oncology team. They would rather hear early.Questions we are asked
Common questions about jaundice and liver metastases
Is jaundice common with liver metastases?
It is not the usual first sign. Many people with spots in the liver have normal bilirubin for a long time, because the healthy part of the liver does the work. Jaundice is more likely when a tumour sits near the main bile ducts, or when the liver is heavily involved.
Can the yellow colour go away again?
Often, if the cause is a blocked duct that can be opened with a stent or a drain. The eyes usually clear gradually as the bilirubin falls. Jaundice from widespread disease is less likely to reverse, although sometimes it improves if the cancer responds to treatment. Your team will watch the blood tests to see which way it is going.
Can chemotherapy be given while I am jaundiced?
Usually the team waits, because many medicines are cleared by the liver and could build up to harmful levels. Some medicines can be given at adjusted amounts. Your oncologist decides this using your blood results, and will usually re-check the bilirubin before each treatment.
What is the difference between a stent and a drain?
A stent is a small tube placed inside the duct, usually through an endoscope passed down the mouth, so bile flows into the bowel. A drain goes through the skin into the liver, sometimes with a bag outside. Which one suits you depends on where the blockage is.
Why is the itching so bad at night?
Itching from bile often feels worse in the warmth of bed and when there is nothing else to distract you. Cool showers, loose cotton clothes and a moisturiser help a little. Medicines can help more. See itching from jaundice and what helps.
Could my cancer medicine be causing the jaundice?
It can happen. Some chemotherapy, targeted and immunotherapy medicines can inflame the liver. That is one reason the team checks liver blood tests regularly. Do not stop any medicine on your own; call your team, who may pause it while they find the cause.
Does jaundice mean the cancer has spread further?
Not necessarily. It may mean a single tumour or gland is pressing in an awkward place. It may also be from gallstones or a medicine. A new scan, compared with the old ones, is what shows whether the cancer has grown.
Where can we get the cause checked quickly?
If there is fever, confusion or severe pain, go to the nearest hospital today. Otherwise call your treating oncologist this week. If you want a second opinion, CION can review the reports, arrange the scans through partners and plan the next step. One helpline serves every centre.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- Cancer Research UK — Secondary liver cancer
- NHS — Jaundice
- Merck Manual Consumer Version — Jaundice in Adults
- Macmillan Cancer Support — Secondary cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Blockage jaundice vs liver-failure jaundiceThe two causes side by side, and why they are treated differentlyStenting or drainage to relieve jaundiceWhat the procedure to open a blocked duct involvesLiver function when the liver is full of metastasesWhen the problem is the liver itself, not a blockageWhy treatment often waits until the jaundice settlesWhy chemotherapy may be paused for a while
Talk to us
Turned yellow during cancer treatment and not sure why?
Send us the latest blood reports and scans, and an oncologist will look at what may be causing the jaundice and what the next step should be. One helpline serves every CION centre.