Transarterial Chemoembolization (TACE)

Overview

Chemoembolization, also referred to as transarterial chemoembolization (TACE), is a cancer treatment method aimed at obstructing a tumor’s blood supply. During this procedure, a combination of substances is introduced into the vessel that supplies blood to the tumor:

• Chemotherapy drugs: These medications are employed to halt abnormal cell growth directly at the tumor site.
• Embolic agents: These agents, which can include oils or small plastic particles, are used to trap the chemotherapy in place within the vessel.

Chemoembolization differs from standard chemotherapy in several ways:

• Direct delivery: Chemoembolization delivers the chemotherapy drugs directly to the tumor, while standard chemotherapy circulates throughout the entire body via the bloodstream.
• Increased drug concentration: Chemoembolization administers a higher concentration of chemotherapy drugs compared to systemic chemotherapy. This localized delivery reduces the likelihood of experiencing severe side effects associated with systemic treatments.

Reasons for undergoing the procedure

This therapy is suitable for both adults and children diagnosed with liver cancer, specifically hepatocellular carcinoma. It is frequently the initial course of treatment for individuals with tumors that are deemed inoperable due to their size. Additionally, it is utilized for various other cancers that have metastasized to the liver, such as breast cancer, carcinoid tumors, colon cancer, neuroendocrine tumors, ocular melanoma, and sarcoma.

Risk

The following risk of transarterial chemoembolization (TACE) includes:

• Blood clots in children.
• Infections
• Damage to the kidneys, particularly in those with diabetes.
• Liver damage, which may occur from misplacement of the embolic agent and chemotherapy medications.
• Mild side effects from chemotherapy, such as nausea, anemia, and hair loss.
• The possibility that further chemoembolization treatments will be required because the effects are temporary.

Before the procedure

Chemoimbolization is administered by an interventional radiologist. This physician performs a variety of operations using tiny tubes called catheters and real-time imaging.

Some tests assist healthcare providers in the planning of your treatment. Among these are:

• Imaging test that may includes computed tomography (CT) scan and magnetic resonance imaging (MRI).
• Blood tests to evaluate kidney function and look for problems with clotting.

Patient will receive medication such as antibiotics to reduce the risk of infection, medication to prevent nausea, and medication that will protect the kidneys from the substances that may release from the dying tumor cells.

During the procedure

The following occurs during a TACE procedure:

• Children have general anesthesia, which involves injecting medications to numb their pain and induce sleep. Adults are given sedatives, which are tranquilizers and aids for sleeping.
• In a blood vessel close to your wrist or groin, the interventional radiologist makes a tiny incision.
• They make an incision and install a catheter.
• They direct the catheter to the tumor with real-time imaging, or fluoroscopy.
• They insert a unique dye into the catheter. The dye helps to highlight the specific features of the tumor and surrounding blood vessels.
• An embolic agent and a combination of chemotherapeutic medications are injected into the tumor by the interventional radiologist.
• The interventional radiologist removes the catheter after the treatment is finished. They apply a bandage to the wound. Closure devices or stitches are not required.

Outcome

Chemoembolization may be the only essential treatment for certain individuals. It’s one of several therapies in other situations. The best treatments for you will be determined in collaboration with your interventional radiologist. Other kinds of treatment could include:

• Ablation.
• Radiation therapy.
• Systemic chemotherapy, which consists of bloodstream-borne cancer-fighting medications that kill aberrant cells.
• Surgery to remove the tumor in the event that it returns.

The following benefits of TACE may include:

• A high rate of success. In about 70% of cases, chemotherapy is used to inhibit the growth of the tumor.
• Liver function was preserved. The effectiveness of this medication rarely compromises the liver’s function.
• Faster recovery compared with conventional treatments for cancer. In a few weeks, you should feel better.

Many patients have pain, nausea, vomiting, and a low-grade temperature following the TACE surgery. We call this syndrome postembolization. Until these symptoms go away, you will need to spend a day or two in the hospital.

It is recommended to contact your healthcare provider if you experience the following after the procedure:

• Do not experience a reduction in nausea or vomiting.
• Easily get confused or move uncontrollably.
• Experience chills and sweats in addition to fever.
• Show symptoms of liver failure, such as jaundice, or yellowing of the skin or eyes.