What is TACE?

TACE, or TransArterial ChemoEmbolization, is a minimally invasive treatment for liver cancer. It is not surgery. TACE blocks the blood vessels that feed the tumor with tiny beads soaked in cancer-killing medicine called chemotherapy.  TACE targets the tumor directly, so it limits damage to the normal liver. 

TACE kills liver cancer in two ways: 

    1. it starves the tumor of blood, and
    2. it poisons the tumor with chemotherapy.



How is TACE done?

TACE is performed by a doctor called an Interventional Radiologist, or IR. The IR inserts a small tube through a blood vessel at the top of the thigh (or wrist).  Moving x-rays help the IR guide the tube into the blood vessels in the liver that feed the tumor.  Next, the IR injects tiny beads soaked in chemotherapy through the tube. The beads block the tumor’s blood supply. This kills the tumor over days and weeks.  Giving the chemotherapy directly to the cancer allows IRs to treat the tumor(s) with high doses while protecting normal tissue.  This reduces side effects from chemotherapy.


TACE IN THE LIVER


  • Figure 1: After numbing the skin, a small tube is placed into the blood vessel at the top of the thigh (shown) or the wrist.
  • Figure 2: Using x-ray guidance, the IR steers the small tube to the blood vessel in the liver that feeds the tumor.

  • Figure 3: Tiny beads soaked in chemotherapy are injected directly into the blood vessels that feed the tumor.


What are the treatment alternatives?

Your treatment options are based on your overall health, lifestyle and the size, location and number of tumors you have.  Possible alternatives include:

  • Alternative 1: not doing any procedure. The advantage of this is avoiding a procedure. The disadvantage of this is that the cancer may continue to grow without treatment.
  • Alternative 2: another minimally invasive, image-guided procedure called TARE. This procedure is similar to TACE, but the beads deliver radiation instead of chemotherapy. The results of these two options are similar.
  • Alternative 3: another minimally invasive, image-guided procedure called tumor ablation.  This procedure involves heating or freezing the tumor to destroy it with a wand placed directly into the tumor.  Only a few tumors in safe locations can be treated in this way.
  • Alternative 4: surgery to cut the tumor out.  This is only for patients with early liver cancer who are healthy enough for surgery.


What are the risks of TACE?

Major Complication Risks

Potential major complications include 

  • liver failure
  • liver infection
  • gallbladder or stomach
  • injury to blood vessels


Minor Complication Risks


Potential minor complications include 

      • abdominal pain 
      • fever
      • nausea
      • fatigue
      • bleeding (only 2%)


Post Procedure

What happens after my TACE procedure?

  1. You will be monitored in the recovery area and given medicine as needed to help with pain or nausea.
  2. Most people feel well enough to go home the same day or after a night in the hospital to recover from the procedure. 
  3. Your doctor will see you in the clinic in about one month to see how you responded to the treatment.



When should I call my doctor or 911?


You have a fever of 100.4°F (38°C) or higher





You have  uncontrollable  pain or vomiting





You have sudden trouble breathing or shortness of breath





You experience new swelling or pain.



You see new skin changes like redness




You have bleeding or new swelling at the treatment site


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