If bowel cancers spread to other parts of the body the most common place for them to go is to the liver.

Using a special scan for guidance, it is possible to thread a fine tube (cannula) through an artery in the arm or leg into the hepatic artery, which is the major blood vessel supplying the liver. It is sometimes also done via an operation. It is then possible to deliver chemotherapy through the cannula.This is known as hepatic artery infusion chemotherapy. It is hoped that giving chemotherapy directly into the liver would be more effective than normal chemotherapy.

Over the years, trials have shown that this approach results in a greater proportion of people having shrinkage of their secondary  bowel cancer in the liver. Despite this, however, it does not seem to have any great effect on increasing life expectancy. This is probably because, although it is more active against the liver secondaries, it is no more effective in controlling secondary tumours in other parts of the body.

In addition, there are quite a few complications that can occur with hepatic artery infusions. Some of these can be serious and they include inflammation of the liver (chemical hepatitis), damage to the gall bladder, duodenal ulcers and haemorrhages.

Because of the risk of side effects and the lack of any clear improvement in survival times, this approach is not common  for people who have liver secondaries from bowel cancer.

The one situation where this may occasionally be advised is where there has been complete removal of all visible secondaries from the liver at an operation. Recent research has suggested that hepatic artery infusion of chemotherapy may reduce the chance of the cancer returning, but the value of this approach remains uncertain and further research is continuing.

Incidentally, another way of giving chemotherapy directly to the liver is to put a tube into a different blood vessel, the portal vein, which also goes into the liver, and to give the drugs by this route. This approach has usually been used for people who have early cancer with the hope of preventing secondary tumours in their liver.