Transarterial Chemoembolization (TACE)

Transarterial chemoembolization (TACE) is a minimally invasive treatment for liver cancers. Using imaging guidance, chemotherapy medication and embolic material are delivered into blood vessels to block flow to a liver tumor, preventing growth.

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The University of Cincinnati Cancer Center may not be your only option for receiving TACE for liver cancer, but our experience and wide array of specialists make us the best suited to guide your treatment journey.

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To schedule an appointment, please call the UC Gastrointestinal Cancer team at 513-585-UCCC.

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Answers to Your Questions about Transarterial Chemoembolization

Transarterial chemoembolization (TACE) is a minimally-invasive treatment for liver cancers. The procedure relies on imaging guidance. so that the chemotherapy medication and embolic material are directly delivered into blood vessels that flow into the liver tumor. 

Using this approach, a high concentration of chemotherapy medication is delivered to treat the cancer cells, while the embolic material limits the supply of blood and nutrients to the tumor. Patients will typically experience fewer side effects with TACE than with systemic chemotherapy because the treatment is focused in the liver, thus sparing other organs and parts of the body.

TACE is only used to treat liver cancer. It can be used to treat tumors that develop in the liver such as Hepatocellular Carcinoma (HCC), as well as metastatic liver cancer or cancer that spreads to the liver from elsewhere in the body.

The TACE procedure is performed by a skilled interventional radiologist. The entire procedure is performed by applying a small incision on the wrist or groin through which a catheter is guided into the artery that supplies the liver tumor. 

Once the catheter reaches the tumor site, chemotherapy medication is pushed through. Then, embolic materials, such as microspheres, liquids and/or metallic coils, are delivered into the artery to stop blood flow and any resulting growth of the tumor. Both methods in this process are meant to shrink the tumor while stopping the potential for growth.

This procedure works well for liver cancer because the liver is a unique organ supplied by only two different blood vessels—the hepatic artery and the portal vein.  Normal liver cells receive most of their blood supply from the portal vein. Liver tumors however, receive most of their blood supply from hepatic arteries. For this reason, TACE treatment only affects liver tumors, while sparing the rest of the normal, healthy liver.

TACE is pursued for a few reasons.

Certain tumors may not be accessible for treatment by surgery or radiation therapy, and this treatment can offer fewer risks associated with those options.

The main goal of this procedure is to decrease the size and burden that the liver tumors have on the function of the liver and body. 

This treatment by itself can be a cure, but in many cases, the positive results of this treatment can lead to improved symptoms, potential candidacy and safer application of a separate treatment option for liver cancer, such as a liver transplant.

There are a few side effects associated with the TACE procedure.

TACE blocks the blood supply to the liver tumor, which can also result in inflammation to the surrounding areas.

You may also experience the following after the procedure:

  • Fever

  • Abdominal pain

  • Nausea

  • Fatigue

These symptoms can last anywhere from a few hours to a few days after the procedure.

Some rare, but more serious side effects can occur, but are unlikely. These include infection or liver failure

Embolization can affect the liver in other ways outside of the intentions for using TACE. For this reason, the best candidates for this procedure have some preserved liver function, and therefore may not be a good option for a patient whose liver has been damaged significantly. 

A doctor will run laboratory tests to assess the health and function of your liver prior to determining whether this is an option for you.

The technical success of the TACE is high, and the clinical success depends on the size, number and location of the liver cancer lesions you have. In some cases, you may need more than one session treatment. Your interventional radiology physician may recommend imaging and laboratory tests to guide treatment.

The first step in the process is a clinical consultation with one of our interventional radiologists. Together, you will discuss the details of your healthcare history and the available options for liver-directed therapy. Be sure to discuss any medications you are taking, especially any blood thinners or antiplatelet medications. After the visit, additional imaging studies or laboratory tests may be ordered.

Before the Procedure:

Prior to the procedure, you will receive instructions with regards to food, water and medication. Typically, we ask that you not eat any food after midnight before your procedure. Most medications are permitted to take the day of the procedure, with a sip of water.

During the Procedure:

During the procedure, you will receive intravenous sedation medicine for comfort. After your procedure, you will be monitored for a few hours. Most of our patients will return home after this recovery period, but in some cases, patients require an overnight hospital stay for continued monitoring and treatment. 

After the procedure:

Liver imaging and laboratory tests are typically performed one to three months after a TACE to see how the tumors responded to treatment. You will have a follow-up appointment with your interventional radiology physician to discuss the treatment results and next steps. 

Will I Need More than One Treatment?

If you have tumors that involve multiple areas of the liver, you may need more than one treatment. If there is residual disease after treatment, additional treatment with TACE or other liver directed therapies may be considered.

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