What is Transarterial Chemoembolization (TACE)?
As one of the methods of treating liver cancer, Transarterial Chemoembolization, also referred to as TACE, works to control the growth of cancerous tumors and potentially shrink the tumor directly.
During TACE treatment, the doctor will inject chemotherapy and embolic agents through a blood vessel directly leading into the tumor. First, the chemotherapy drugs are injected directly into the tumor, followed by the embolic agents meant to cut off the blood supply to the tumor, which “traps” the chemotherapy drugs. Cutting the blood supply allows the chemotherapy drugs to work directly with the tumor, potentially killing more cancer cells.
Common Uses of TACE
Cancers that use TACE as a form of treatment include:
- Primary liver cancer (hepatoma or hepatocellular carcinoma)
- Primary cancer of the liver’s bile ducts (cholangiocarcinoma)
- Secondary liver cancer that has spread from:
- Colon cancer
- Breast cancer
- Carcinoid tumors
- Pancreatic islet cell tumors
- Ocular melanoma
- Other vascular tumors
For those patients who can receive a liver transplant, TACE can help control cancer growth while you wait for your new liver.
Benefits of TACE
On average, six out of every ten patients can find success from TACE. The combination of chemotherapy and embolization can stop liver tumors from growing and potentially cause them to shrink. You can expect results for an average of 10 to 14 months. However, doctors commonly repeat this treatment if the tumor begins to grow over time.
It is common for patients to use TACE in conjunction with other treatments, including surgery, ablation, or radiation therapy, depending on the quantity, type, and location of the tumor(s). It can also be used as a standalone treatment if your doctor recommends it.
TACE may also help prevent the tumor’s growth in the liver, potentially preserving liver function and helping you maintain your quality of life.
Preparing for TACE
In the days before your TACE procedure, you will visit the interventional radiologist who will perform the procedure. During this visit, you should prepare to:
- Get your blood tested to determine kidney and liver functionality as well as check blood clotting
- Get a CAT scan or MRI of the liver
- Discuss all current medications that you are taking, including supplements
- Tell your doctor about any known allergies, especially to contrast materials, medications, local anesthetics, and general anesthesia
- Let the doctor know if you could be pregnant
Additionally, you will learn how to prepare for the procedure, which medications you might want to avoid, and instructions about fasting (no food or liquids after midnight) since you will receive a sedative before the procedure.
This minimally invasive liver cancer treatment is performed in our comfortable outpatient setting. The treatment is relatively painless. The goal of the treatment is to kill your tumor so that it can shrink and more importantly not spread to other areas of your liver or outside your liver. It is usually performed under conscious sedation whereby a light sedative will make you feel relaxed, sleepy, and comfortable for the procedure. You may or may not remain awake, depending on how deeply you are sedated.
The procedure consists of the following steps:
1. You will be taken into the treatment room and positioned on the angiography table.
2. The nurses will connect you to heart rate, blood pressure, and pulse monitors.
3. Nausea and pain medications may be administered through an IV at that time or shortly after the procedure is completed.
4. The doctor will clean your groin and cover the area with a drape.
5. You may feel a slight pinch when the needle is inserted into the artery in the groin, but the skin incision site will have been well numbed using local anesthetic to minimize any pain. Minimal pressure may be felt when the catheter is inserted into the artery. However, you will not feel serious discomfort.
6. Angiography (X-ray-based) images using contrast material will be used to map the path of the blood vessels.
7. The doctor will inject contrast dye through the catheter and take multiple sets of images to guide the catheter directly to the arterial branches responsible for supplying blood to the tumor.
8. Once the catheter reaches the tumor, the doctor will inject the embolic agents and chemotherapy drugs directly into the tumor.
9. Once the procedure is completed, the catheter is removed, and pressure will be applied to stop any bleeding at the catheter insertion site.
10. A closure device is often used to seal the small hole in the artery which will allow you to move around more quickly. No stitches will be used. The tiny opening in the skin is covered with a dressing.
What to Expect After TACE
TACE is usually completed within 90 minutes. You can expect to stay in bed in the recovery room for four to six hours. You may experience some side effects, which are typically controlled with medication. During this time, your vital signs will be checked, including heart rate, blood pressure, breathing rate, temperature, and the incision area for bleeding and/or swelling.
The most common side effect that you may experience is pain, but you may also experience nausea, vomiting, or fever. You will be sent home with prescription medicines for these side effects. It is normal to experience these symptoms for up to one to two weeks after the procedure.
After a month, you will return to see the doctor for a follow-up clinic visit, have blood tests and a CT scan or MRI to determine how effective the treatment was and how well the tumor is responding to the treatment. If the tumor responded well to the treatment, follow-up imaging and clinic visits will occur every 3 months.
How We Care for You
We strive to provide treatment options that give you the best possible survival rate and quality of life at USA Oncology Centers. We perform various minimally invasive liver cancer treatments, including transarterial chemoembolization (TACE), radioembolization (Y-90 SIRT), and others. Our interventional oncologists will develop a treatment plan that is specific to your liver cancer location and stage.
The information in blog articles is for information purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please always consult a licensed healthcare professional for advice on any specific medical condition or any changes to your healthcare decisions.
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