TACE

What is TACE?

• TACE (Trans-arterial Chemoembolization) is a procedure used to treat liver cancer (especially hepatocellular carcinoma or HCC). It involves delivering chemotherapy directly to the tumor while also blocking the blood supply to the tumor, cutting off the nutrients the cancer cells need to grow.
• How it Works: Tumors in the liver can grow new blood vessels that feed off the hepatic artery, while the rest of the liver is nourished by the portal vein. TACE targets and blocks the hepatic artery, starving the tumor of blood and oxygen. This process works because the healthy liver tissue still receives adequate blood supply from the portal vein.

When is TACE Offered?

• Eligibility for TACE: TACE is typically offered to patients with good liver function, no ascites (fluid in the abdomen), and no blood clots in the portal vein. It is suitable for those whose liver cancer:
  • Cannot be surgically removed
  • Cannot be treated with ablation therapy
  • Has not spread to the major blood vessels in the liver or to other parts of the body
• Bridging Therapy: TACE may be used to keep liver tumors small while waiting for a liver transplant, a process known as bridging therapy.
• Tumor Size and Location: TACE can be used for tumors larger than 5 cm, although multiple treatments may be necessary. If cancer is in both lobes of the liver, each lobe is treated one at a time, usually with a one-month gap between treatments to allow for recovery.

How TACE is Performed

• Procedure Location: TACE is performed in an x-ray department at the hospital under either local anesthesia or general anesthesia.
• Catheter Insertion: The doctor inserts a thin, flexible tube (catheter) into an artery in the groin and guides it up to the hepatic artery. A dye is injected to help the doctor see the artery and tumor clearly under an x-ray.
• Blocking the Artery: Once the tumor’s blood vessels are identified, the doctor injects a material (often a gelatin sponge, sometimes soaked in chemotherapy drugs) into these arteries to block the blood supply. The chemotherapy drug is delivered directly to the tumor to kill cancer cells.
• DEB-TACE: A newer version, DEB-TACE, uses special beads filled with chemotherapy drugs. These beads slowly release the drug over time, offering an alternative that may cause fewer side effects.

Side Effects of TACE

TACE may cause both short-term and long-term side effects. Here are the most common ones:

• Post-Embolization Syndrome (common within the first few days):
  • Fever
  • Pain in the upper-right abdomen (under the ribs)
  • Nausea and vomiting
  • Fatigue
  • Loss of appetite

• Other Possible Side Effects:
  • Bruising or bleeding at the catheter insertion site
  • Hair loss (temporary)
  • Reduced ability to fight infections
  • Abnormal liver function (liver enzymes may rise)
  • Inflammation of the gallbladder or bile ducts
  • Abscess formation at the site of the treated tumor
  • Liver failure, particularly in patients with advanced cirrhosis

Patient Education and Care after TACE

• Monitor for Severe Symptoms: Seek medical help if you experience:
  • Severe abdominal pain
  • Uncontrolled bleeding or bruising
  • Persistent fever (above 101°F / 38.3°C)
  • Swelling in the legs or abdomen
  • Shortness of breath
  • Signs of liver dysfunction such as dark urine, pale stools, or yellowing of the skin/eyes
• Long-term Care Considerations

  Recovery usually takes 7 to 10 days. Following discharge:

  • Limit your activities and get plenty of rest.
  • Do not drive for 24 hours.
  • Begin to resume your normal activities the day after you leave the hospital.
  • No physical exertion or heavy lifting for the next three days.
  • You may bathe or shower at any time but submerging in a bath tub or swimming pool shouls be avoided for a week.
  • Slowly increase your physical activity.
  • Depending on your job and its demands, you may return to work.
  • Check your temperature twice a day for five days.
• Follow-up Imaging: The patient will typically undergo imaging studies (e.g., CT scan, MRI) 4–6 weeks postTACE to assess the response of the tumor to the treatment and to check for any complications like tumor recurrence or liver damage.

Disclaimer: Some portions of this content may be derived from publicly available sources on the internet.