the Interventional Initiative - TARE in the Liver

What is TARE?

TARE or TransArterial Radioembolization is a minimally invasive treatment for liver tumors. It is not surgery. TARE treats liver tumors by injecting tiny radioactive beads directly into the blood vessels that feed the tumor. Because the tiny beads delivers radiation therapy directly to the tumor(s), there is less damage to the normal liver and surrounding organs. TARE is performed by a doctor called an Interventional Radiologist, or IR.

How is TARE done?

TARE requires two separate procedures. The first procedure is like a test run. First, the IR maps out your liver’s blood supply to see which vessels are feeding the tumor(s). Then the IR injects beads to see if they go to the lungs or other places that could be hurt by radiation. The second procedure is the actual treatment. In it, the IR delivers the radioactive beads to the vessels feeding the tumor(s). After the treatment, the IR puts a small bandage over the pinhole in your skin.

TARE IN THE LIVER

Figure 1: The first procedure provides a "road map" showing the blood supply to the liver tumors.

Figure 2: During the second procedure, the doctor guides the tiny tube into the blood vessel feeding the tumor(s)and injects radioactive beads.

Figure 3: The radioactive beads destroy the tumor over time with the concentrated radiation.

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 TACE. This procedure is similar to TARE, but the beads deliver chemotherapy instead of radiation 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 TARE?

Major Complication Risks

Potential major complications include

liver failure
liver infection
gallbladder, stomach or lung damage
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 TARE 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. Once in a while, people may spend a night in the hospital to recoverfrom the procedure.

3. Because the procedure involves radioactive beads, we recommend the following precautions for the week following yourtreatment:

● Avoid close contact with children, pregnant women, or animals

● No public transportation with more than 2 hours next to a person

4. After several months, you will have another MRI or CT in to see how you responded to the treatment. The IR will then see youin the clinic to discuss the next steps.

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 and/or pain in your leg or hand.

You see new skin changes like redness

You have bleeding or new swelling at the treatment site