Embolization is the injection of substances to block or reduce the blood flow to cancer cells in the liver. The liver is a unique organ with dual blood supplies. Most normal liver cells are fed by branches of the portal vein, whereas cancer cells in the liver are usually fed by branches of the hepatic artery. Doctors can exploit this difference to treat the cancer. Blocking the branch of the hepatic artery feeding the tumor helps kill off the cancer cells, but it leaves most of the healthy liver cells unharmed because they get their blood supply from the portal vein. Embolization is an option for some patients with tumors that cannot be removed by surgery. It can be used for tumors that are too large to be treated with ablation (usually larger than 5cm across). For some tumors (typically in the 3 to 5 cm range), these treatments may be used together.
Trans-arterial chemoembolization (or TACE) combines embolization with chemotherapy. In this procedure a catheter is put into an artery through a small puncture in the inner thigh under local anesthesia and threaded up into the hepatic artery in the liver. A dye is usually injected into the bloodstream at this time to help the doctor monitor the path of the catheter via angiography, a special type of x-ray. Once the catheter is in place, the chemotherapy drug is directly injected into the artery. With this technique, the chemotherapy targets the tumor while sparing the patient many side effects of traditional chemotherapy that is given to the whole body. Following chemotherapy, our interventional radiologist will embolize (cut off) the blood supply to the tumors. In this manner, the tumor is treated using two different techniques. If necessary, TACE can be performed multiple times to achieve the desired response in the tumor. This type of treatment requires one day hospital stay.
Chemoembolization is considered to be a relatively safe and effective method for treating unresectable liver tumors. The overall risk of the procedure is related to the general underlying health of the patient. People with jaundice, severe cirrhosis or kidney failure have an increase chance of complications. The majority of the patients experience some side effect which may include pain, nausea, vomiting or fever. Various drugs can be administered that will control these symptoms and keep you comfortable. These symptoms will stop after 3-5 days. Studies show that with the hepatocellular cancer patients undergoing there treatment may experience tumor shrinkage as well as an increase in the survival rate.
