WHAT IS TACE?
- Hepato cellular carcinoma (HCC) is the most common type of primary liver cancer. This type of tumour grows a large number of blood vessels. These blood vessels get most of their blood supply from the hepatic artery, while the rest of the liver tissue gets blood from the portal vein. Because of this, doctors can block the hepatic artery to cut off the blood supply to the tumour without affecting the rest of the liver.
- Embolization is a treatment that blocks or slows down the blood supply to tissues or an organ. It can be used to block the flow of blood to a tumour so the cancer cells die. When the material used to block the blood supply also delivers chemotherapy drugs to the tumour, it is called chemo embolization.
- Trans arterial chemo embolization (TACE) is a specific type of chemo embolization that blocks the hepatic artery to treat liver cancer.
- Doctors may offer TACE to treat liver tumours that are larger than 5 cm, but it may take 2 or 3 treatments to shrink these tumours. Treatment is usually given a month apart so that you have time to recover from the first TACE treatment.
How TACE is done?
- TACE is done using specialized x ray equipment (Fluoroscopy) in the cath lab. A thin tube (called a catheter) is inserted from leg/wrist artery until it reaches the liver artery feeding the tumour.
- Chemotherapy drug is mixed with an oily liquid called lipiodol or drug eluting beads (DEB) and injected through the catheter.
- Lipiodol or DEB lengthens the amount of time that the drugs are held in the liver.
- Following this the blood supply to the tumour is blocked by appropriate embolizing agent (gelatin sponge).
Follow-up after TACE
- You may have a CT scan 2 or 3 months after TACE. It is done to see how much the tumours have shrunk and to look for any new tumours in the liver.
- Many people will need another TACE procedure because liver tumours often grow back in 10–16 months. TACE can be repeated as many times as needed, as long as you are still healthy enough to have it done.
- Depending on the number and type of tumours, TACE may be used as the sole treatment or may be combined with other treatment options such as surgery, chemotherapy, radiation therapy, or ablation.
What are the benefits vs. risks?
Benefits
- Minimally invasive.
- In about two-thirds of cases treated, TACE can stop liver tumours growth or cause them to shrink.
- When cancer is confined to the liver, most deaths that occur are due to liver failure caused by the growing tumour, not due to the spread of cancer throughout the body. TACE can help prevent this growth of the tumour, potentially preserving liver function and maintaining a relatively normal quality of life..
Risks
- Because TACE is a local treatment given to the liver, there are fewer side effects from the chemotherapy drugs than if they are given as a systemic therapy. Side effects will depend mainly on the size of tumour being treated, the amount of scarring in the liver (called cirrhosis) and overall health
- TACE for liver cancer may cause post-embolization syndrome, which is a group of symptoms that includes: fever, mild pain, nausea and vomiting.
- Less commonly (<5%) TACE can also cause:
- Abnormal liver function
- Infection
