Cancer surgery when you have liver disease or cirrhosis | CION Cancer Clinics

Cirrhosis makes cancer surgery riskier, and how much riskier depends mostly on how well your liver is still working. People whose liver is coping well may be able to have an operation with careful planning. People whose liver is failing often cannot, and other treatments are considered instead.

What cirrhosis is

Cirrhosis is scarring of the liver after years of damage, most often from alcohol, hepatitis B or C, or fat building up in the liver. The scarring stops the liver doing its jobs well and pushes up pressure in the veins that run through it.

Why it matters during an operation

The liver makes the proteins that help blood clot, clears medicines and anaesthetic drugs, and helps fight infection. With cirrhosis, bleeding is more likely, drugs last longer in the body, and infections and slow wound healing are more common. Fluid can also build up in the belly.

Liver disease without cirrhosis

Fatty liver or hepatitis without scarring usually adds far less risk. Your team still wants to know about it, because it affects which medicines are safe and how the anaesthetic is planned.

Many people do not know they have cirrhosis until a scan done for the cancer shows it. If your report mentions a small, coarse or nodular liver, or an enlarged spleen, ask what it means before the operation is planned. Tell the team about any past jaundice, vomiting of blood, black stools or heavy drinking, even if it was years ago.

The decision belongs to your surgeon, anaesthetist and liver specialist together. They weigh how well your liver works, how big the operation is, where in the body it is, and whether other treatments could control the cancer with less strain on the liver.

When surgery is less likely to be offered

Surgery is usually approached with great caution, or not offered, when cirrhosis is advanced: jaundice, fluid in the belly that keeps coming back, episodes of confusion, or a high MELD score. Operations on the liver itself or the upper belly carry more risk than surgery elsewhere. In those situations radiotherapy, chemotherapy, a smaller procedure or focusing on comfort may be discussed. Those are real options, not a lesser choice.

Questions worth asking

What is my Child-Pugh class and MELD score? How do they change the risk of this operation? Is there a treatment that puts less strain on my liver?

This page cannot tell you your own risk. It depends on test results and examination only your team can put together.