17 doctors weighed in:

Can high levels of bilirubin alone cause liver failure in a metastic liver cancer pt?

17 doctors weighed in
Dr. Cynthia Archer
Internal Medicine
4 doctors agree

In brief: Let's reframe the ?

The issue isn't the amount of bilirubin causing problems with the liver. The liver is likely infiltrated with tumor mets and therefore is not able to process bilirubin.
The elevated bilirubin can have multiple causes but is a symptom of the liver failure rather than the cause. It can also be a symptom of obstruction of the biliary system in the liver by tumor or simply inactivity (cholestasis).

In brief: Let's reframe the ?

The issue isn't the amount of bilirubin causing problems with the liver. The liver is likely infiltrated with tumor mets and therefore is not able to process bilirubin.
The elevated bilirubin can have multiple causes but is a symptom of the liver failure rather than the cause. It can also be a symptom of obstruction of the biliary system in the liver by tumor or simply inactivity (cholestasis).
Dr. Cynthia Archer
Dr. Cynthia Archer
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Dr. Herman Hammerstead
Surgery - Trauma
3 doctors agree

In brief: No

This is just a biologic marker of severe hepatic dysfunction

In brief: No

This is just a biologic marker of severe hepatic dysfunction
Dr. Herman Hammerstead
Dr. Herman Hammerstead
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Dr. Jan Lei Iwata
Ophthalmology
3 doctors agree

In brief: It's usually the

result of liver failure,bnot the cause of liver failure.
In metastatic disease to the liver, the hepatocytes are no longer working properly in conjugating the free bilirubin, so it's backing up & accumulating. Serum bilirubin is considered a true test of liver function, as it reflects the liver's ability to take up, process, and secrete bilirubin into the bile. This is compromised in liver mets.

In brief: It's usually the

result of liver failure,bnot the cause of liver failure.
In metastatic disease to the liver, the hepatocytes are no longer working properly in conjugating the free bilirubin, so it's backing up & accumulating. Serum bilirubin is considered a true test of liver function, as it reflects the liver's ability to take up, process, and secrete bilirubin into the bile. This is compromised in liver mets.
Dr. Jan Lei Iwata
Dr. Jan Lei Iwata
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1 comment
Dr. Herman Hammerstead
The TRUE Liver functions test are the products made by the liver. Pro-time and Albumin are the only true liver functions........Telfer Reynolds, MD
Dr. Matthew Fero
Internal Medicine - Oncology
2 doctors agree

In brief: Metastatic cancer...

is often found in the liver, especially if the primary lesion was located in the GI tract.
Liver failure for any reason will cause the bilirubin to rise. High bilirubin is a sign of liver impairment but not a cause of it. High bilirubin may also occur as a result of hemolysis (RBC destruction).

In brief: Metastatic cancer...

is often found in the liver, especially if the primary lesion was located in the GI tract.
Liver failure for any reason will cause the bilirubin to rise. High bilirubin is a sign of liver impairment but not a cause of it. High bilirubin may also occur as a result of hemolysis (RBC destruction).
Dr. Matthew Fero
Dr. Matthew Fero
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Dr. Myron Arlen
Surgery - Oncology
1 doctor agrees

In brief: Probably not

Bilirubin is derived from the breakdown of haem in the red blood cells within the reticuloendothelial system prior to its reaching the liver The bilirubin is in an unconjugated form which has to bind to albumin where it then reaches the liver cells where it is conjugated.
to become water soluble. In metatstatic liver disease elevated bilirubin by itself will not effect cell function.

In brief: Probably not

Bilirubin is derived from the breakdown of haem in the red blood cells within the reticuloendothelial system prior to its reaching the liver The bilirubin is in an unconjugated form which has to bind to albumin where it then reaches the liver cells where it is conjugated.
to become water soluble. In metatstatic liver disease elevated bilirubin by itself will not effect cell function.
Dr. Myron Arlen
Dr. Myron Arlen
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1 doctor agrees

In brief: Out of sequence

Elevated Bilirubin is the RESULT of liver failure, not the cause.
The liver is meant to process and hid rid of bilirubin in Bile. As the liver is failing for any reason (cancer, scarring from cirrhosis etc.) the bilirubin can't get processed and secreted into the bile so it backs up and goes back into the blood stream.

In brief: Out of sequence

Elevated Bilirubin is the RESULT of liver failure, not the cause.
The liver is meant to process and hid rid of bilirubin in Bile. As the liver is failing for any reason (cancer, scarring from cirrhosis etc.) the bilirubin can't get processed and secreted into the bile so it backs up and goes back into the blood stream.
Dr. Andrew Hoffman
Dr. Andrew Hoffman
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Dr. Reza Shirazi
Radiation Oncology
1 doctor agrees

In brief: Not by itself

metastatic cancer to liver can cause liver dysfunction.
Typically liver function tests become abnormal. Depending on the location it can cause pressure on bile duct drainage and often causes bile elevation, at times recurrent infection in bile system, jaundice, Liver dysfunction can lead to bleeding problems, pain, etc. Hope this helped.

In brief: Not by itself

metastatic cancer to liver can cause liver dysfunction.
Typically liver function tests become abnormal. Depending on the location it can cause pressure on bile duct drainage and often causes bile elevation, at times recurrent infection in bile system, jaundice, Liver dysfunction can lead to bleeding problems, pain, etc. Hope this helped.
Dr. Reza Shirazi
Dr. Reza Shirazi
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