What is transarterial chemoembolization (TACE)?
Chemoembolization is a procedure that allows a dose of chemotherapy drugs to be administered directly to your tumor. This procedure allows for the chemo drugs to be given to the tumor and lessens the side effects associated with chemotherapy. TACE is most often used to treat liver tumors.
How is TACE done?
An anesthetic (numbing medicine) will be applied to your skin. Dr. Christenson will make a small incision in your groin then thread a catheter (small plastic tube) from your groin into the artery in your liver that carries blood to the tumor. Chemotherapy is sent through the catheter into the tumor. Then tiny beads are injected into the artery. These beads travel to the tumor and block the blood supply.
You will have a specific treatment plan that will be discussed with you prior to the procedure. The most common treatment schedule is as follows:
Week 1: Chemoembolization Round #1: The liver has 2 lobes. In the first round of chemoembolization to the liver, TACE is done on 1 lobe.
Week 3 or 4: You will have a clinic visit or phone consult to see how you are feeling and how TACE is affecting you.
Week 4 or 5: Chemoembolization Round #2 (if needed) : TACE will be done on the other lobe of your liver if your tumors are in both lobes. If the tumor is only in 1 lobe you will have radiology imaging (MRI or CT) and blood test. These test will tell us how your liver is responding to TACE.
Week 8 or 9: Chemoembolization Round #3 (if needed): TACE will be done to the most affected parts of your liver. If you do not need more TACE you will have MRI or CT scans to find out how your liver is responding to TACE.
What chemotherapy drugs are used?
Most people receive doxorubicin (Adriamycin).
What are the risks of TACE?
The most common complications are:
- Liver function gets worse
What needs to be done to get ready for the TACE?
Before your TACE you will be given a sedative medication through your IV. The medication may make you sleepy and will help to reduce any discomfort you may have during the procedure.
For some people staying awake for the procedure may be difficult or not possible. These people may need anesthesia (medicines to make you sleep during the procedure). Let us know right away if you:
- Have needed anesthesia for basic procedures in the past
- Have sleep apnea or chronic breathing problems (you might use a CPAP or BiPAP device while sleeping)
- Use high doses of narcotic painkiller
- Have severe heart, lung, or kidney disease
- Cannot lie flat for about 2 to 3 hours because of back or breathing problems
- Have a hard time lying still during medical procedures
Preparing for your Procedure
- Do not eat or drink starting at 10 pm the day before your procedure.
- Take all of your medicines on the day of your procedure. Do NOT skip them unless we instruct you do to so.
- Bring a list of all of your medicines you take with you to Surgery Plus.
- If there is a delay in getting your procedure started it is usually because we need to treat other people with unexpected or emergency problems. Thank you for your patience if this occurs.
- A nurse or medical assistant will give you a hospital gown to put on and a bag for your belongings. Please do not bring valuable items with you.
- You may use the restroom at any time, just let the nurse know.
- An intravenous (IV) line will be started. You will be given fluids and medicine through the IV
- Dr. Christenson will talk with you about the procedure and ask you to sign a consent form if that has not already been done. You may ask any questions you have at any time.
What happens after the procedure?
- You will stay overnight in the hospital after your procedure so we can monitor you.
- You will need to rest in bed for 2 to 6 hours. The nurse will monitor the puncture site in your groin for bleeding.
- Some people will have a CT the day after their TACE. This scan will help show how well the chemotherapy drug has spread through the tumor (or tumors).
- Most people can go home the day after their procedure.
When You Get Home
Most people have some side effects after chemoembolization. These side effects may include:
- Slight fever or chills that can last about a week
- You may shower or bathe as soon as you wish after your procedure.
- Avoid strenuous activity including heavy lifting (anything over 20 lbs) for 3 days after your procedure.
- You will most likely have fatigue and a loss of appetite for 2 weeks or longer. These are normal after TACE.
- Most people can return to their normal activities within 1 week.
FOR MORE INFORMATION
If you would like more information on interventional radiology, please visit the following websites:
- Eastern Radiological Associates www.erabillings.com
- St. Vincent Healthcare www.svh-mt.org
- RadiologyInfo www.radiologyinfo.org