TACE

TACE is a minimally invasive treatment for liver cancer that combines chemotherapy and embolization (blocking blood flow to the tumour). It helps to shrink the tumour and slow its growth by cutting off its oxygen and nutrients by delivering chemotherapy directly into the tumour’s blood supply. This treatment is often used for larger or multiple tumours and can also be used as a bridge to surgery or combined with systemic therapy that helps control the cancer in the body.

The treatment for liver cancer depends on factors like the size and location of the tumour, your overall health, and whether the cancer has spread. You might need one or more of these treatments:

Alternative 1 – Surgery:
This could mean either removing part of the liver (partial hepatectomy) or replacing the liver with a healthy one from a donor (liver transplant). Not everyone will be able to have surgery.

Alternative 2 – Ablation:
A minimally invasive procedure where a thin wand is inserted through the skin to destroy the tumour using heat or freezing. This works best for small tumours and may cure the cancer.

Alternative 3 – Transarterial Radioembolization (TARE):
A minimally invasive procedure that delivers tiny radioactive beads directly into the tumour’s blood supply to shrink it.

Alternative 4 – Radiation Therapy:
External Beam Radiation Therapy (EBRT): a series of treatments that use radiation beams from outside the body to destroy the tumour.

Interventional oncology treatments use imaging techniques (like ultrasound and CT scans) to target the areas causing pain, such as the nerves or tumours. These treatments can include:

🔹 Nerve blocks and injections
🔹 Neurolysis, which works by destroying the nerves causing the pain
🔹 A (percutaneous) ablation uses heat or cold to treat painful tumours
🔹 Augmentation procedures for the bones and the spine

1. After numbing the skin with local anesthesia, the doctor inserts a thin needle followed by a small wire into an artery in the groin or wrist.
2. A flexible tube (catheter) is then guided through the artery until it reaches the blood vessels that supply the tumor in the liver.
3. Once in position, a special mixture of chemotherapy and tiny blocking particles is injected. These particles cut off the tumor’s blood supply, helping the chemotherapy stay in place for longer.
4. At the end of the procedure, the catheter is carefully removed, and the opening where it was inserted is closed.

After the procedure, you will be monitored in the recovery area. If you experience any pain or nausea, medications will be given to help you feel more comfortable.

Many patients go through post-embolization syndrome, which can cause mild pain, nausea, or fever. These symptoms usually don’t last long and can be easily managed with medication.

Usually, patients can go home within 24-48 hours after the procedure.

Follow up:

• A few weeks after treatment, your doctor will do blood tests to check how your liver and kidneys are working .
• 1 to 3 months later, a CT or MRI scan will show how well the treatment worked.
• Your doctor will go over the results with you and talk about the next steps based on your progress.

Regular follow-ups are important to make sure that the tumour has been effectively treated and to monitor for any signs of recurrence.

❗Contact your doctor immediately if you have:

• Pale or cold legs
• Bleeding from the groin or wrist
• Significant shortness of breath
• Frequent diarrhoea
• Uncontrollable abdominal pain or cramping
• Fever of 38°C (100.4°F) or higher.

Author: Prof. Roberto Iezzi

Image source: https://www.cirse.org/wp-content/uploads/2020/08/Transarterial-chemoembolisation.pdf

This page contains general medical information. The information is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment