TACE (Transarterial Chemoembolization) for Liver Cancer

TACE is one of the most used treatment procedures for Liver Cancer and is generally the standard, first-line of treatment for the majority of liver cancer patients.

It is usually advised for patients with intermediate-stage liver cancer who are not ideal candidates for surgery or liver transplant. TACE can also be combined with other therapies, such as microwave ablation, chemotherapy, or radiation therapy. At Gleneagles Hospitals, TACE is performed by skilled interventional radiologists who utilise advanced imaging technology to deliver the medication precisely.

The procedure is known as Transarterial Chemoembolisation. It is a form of therapy practised in Interventional Radiology. It is applied in the treatment of liver tumours. Liver tumours primarily receive their blood supply from the hepatic artery, while the normal liver receives most of its blood supply from the portal vein and a smaller portion from the hepatic artery.

In TACE, chemotherapy medications are injected into the blood vessels that supply the tumour. Embolic materials are then used to cut off the blood vessels. This therapy:

• Injections of a high dose of chemotherapy medications directly into the tumour
• Prevents the tumour from getting its supply of blood and oxygen
• Death of cancer cells due to a lack of oxygen and nutrient supply

This therapy is very specific and therefore has minimal side effects, which are common in chemotherapy.

TACE is employed in the treatment of:

• Hepatocellular carcinoma or primary liver cancer
• Liver metastases of colorectal cancer or other malignancies
• Patients with multiple tumours in the liver
• Tumours that are not amenable to surgery
• Patients awaiting a liver transplant

It is particularly employed in patients with cancer that is confined to the liver but is not amenable to surgery.

The process involved in TACE is usually carried out in an interventional radiology room. The process involves the following steps:

• Pre-procedure Evaluation: Imaging studies, such as a CT scan or an MRI, are performed to evaluate the tumour's position, size, and blood supply. Blood tests are also conducted to evaluate the functionality of the liver and the blood-clotting ability.

• Administration of Anaesthesia: The procedure is usually carried out under local anaesthesia with mild sedation.

• Insertion of the Catheter: A small catheter is inserted into the artery located in the groin or wrist area. The catheter is then directed into the blood vessel to reach the hepatic artery.

• Targeted Chemotherapy Infusion: The chemotherapy drug is infused directly into the arteries supplying the tumour.

• Embolisation: In this step of the procedure, small particles or beads are injected through the catheter to block the blood vessels supplying the tumour.

• Completion and Monitoring: Once the blood supply is blocked and chemotherapy is administered to the tumour, the catheter is withdrawn, and the patient is monitored for complications and recovery process.

The whole process takes one to two hours.

The benefits of TACE in the treatment of liver cancer are:

• Chemotherapy targeting
• Less systemic toxicity
• Minimally invasive procedure
• Can treat multiple tumours
• Better tumor control
• The procedure can be repeated if necessary

TACE is an effective treatment for patients with intermediate-stage liver cancer.

Although TACE is a safe procedure, complications may occur, including:

• Post-embolisation syndrome, which includes fever, nausea, and abdominal pain
• Temporary worsening of liver function
• Infection
• Bleeding at the site of catheter insertion
• Damage to adjacent blood vessels
• Liver failure

The side effects are usually temporary and can be managed.

After the procedure, patients are typically observed in the hospital for 1 to 2 days. Some patients may also experience a condition known as post-embolisation syndrome, which may show symptoms such as fever, fatigue, nausea, and abdominal discomfort.

The recovery stages include:

• Pain management medication
• Fluid and supportive care
• Follow-up imaging to check the response of the tumour to treatment

Patients normally take a week to two weeks to return to their normal activities, depending on the patient's condition.

TACE has been proven to significantly improve survival rates for patients with intermediate-stage hepatocellular carcinoma. The procedure can shrink the tumours and slow disease progression, and improve the patient’s quality of life.

The success of TACE treatment depends on several factors, which include:

• Size and number of tumours
• Liver function
• Health status of the patient
• Presence of portal vein involvement

In most instances, a series of procedures is required to achieve the best possible outcomes.

Gleneagles Hospitals provides comprehensive care for patients with liver cancer through a team of specialists, including hepatologists, oncologists, surgeons, and interventional radiologists.

The hospital employs the latest imaging technology, embolisation procedures, and treatment protocols to provide the best possible care for patients with liver cancer. Gleneagles Hospitals, with its team of experienced specialists and advanced facilities, aims to provide the best interventional oncology procedures for patients with liver cancer.