Introduction

Chemoembolization, medically referred to as Transarterial Chemoembolization (TACE), is a sophisticated, minimally invasive cancer treatment that plays a vital role in managing liver tumors. It combines two powerful therapeutic strategies—localized chemotherapy and embolization (blocking blood flow)—to target and treat cancerous tumors more effectively while minimizing damage to healthy tissue.

TACE is most commonly used for hepatocellular carcinoma (HCC), which is the primary form of liver cancer. It is also used in selected cases of metastatic liver cancer, such as cancer that has spread to the liver from the colon, breast, or neuroendocrine tumors. This treatment is especially helpful for patients who are not suitable candidates for surgery or liver transplantation due to various medical conditions or advanced tumor stages.

How TACE Works

The procedure involves delivering chemotherapy drugs directly into the blood vessels feeding the tumor. Once the drugs are administered, tiny particles known as embolic agents are used to block the artery. This serves a dual purpose:

Concentrated Chemotherapy Delivery: By delivering the chemotherapy straight to the tumor site, TACE ensures a high concentration of the drug in the tumor, maximizing its impact.

Cutting Off Blood Supply: Embolization starves the tumor of oxygen and nutrients by blocking its blood supply, slowing or halting its growth.

Because the drugs are trapped within the tumor for an extended period, transarterial chemoembolization allows for a prolonged therapeutic effect with significantly fewer side effects than conventional systemic chemotherapy, which affects the whole body.

Why TACE is Gaining Popularity

TACE is gaining popularity as a targeted and personalized cancer treatment, especially in countries like India where access to interventional radiology is growing. Its minimally invasive nature means that most patients experience shorter hospital stays, quicker recoveries, and a better quality of life after the procedure.

Moreover, TACE can be used as:

• A palliative treatment to relieve symptoms and improve life expectancy
• A bridging therapy for patients awaiting liver transplantation
• An adjuvant therapy alongside other cancer treatments like immunotherapy or oral chemotherapy

With success rates improving due to advancements in medical imaging and delivery techniques, transarterial chemoembolization (TACE) is now considered a standard of care for intermediate-stage liver cancers according to international cancer treatment guidelines.

More Info About TACE (Transarterial Chemoembolization)

TACE is a localized treatment strategy that offers a significant advantage over systemic therapies in specific cancer cases. Here's more in-depth information about how it works and what to expect:

Procedure Overview:

Pre-procedure Evaluation: Blood tests, liver function tests, CT/MRI scans

During the Procedure:

• Local anesthesia and sedation are administered.
• A catheter is inserted through the groin into the hepatic artery.
• Chemotherapy drugs are injected directly into the blood vessels feeding the tumor.
• Embolic agents are introduced to block the artery and trap the drug inside the tumor.

Duration: 1 to 2 hours

Hospital Stay: Typically 1–2 days

Benefits of TACE:

• High concentration of chemotherapy to the tumor
• Minimal impact on healthy tissues
• Slows tumor progression
• Can be repeated multiple times
• Serves as a pre-operative bridge to surgery or transplantation

Risks and Side Effects:

• Nausea, vomiting, fever, fatigue (Post-Embolization Syndrome)
• Temporary liver function changes
• Infection or bleeding at the catheter site
• Rarely, damage to healthy liver tissue

Follow-Up:

Post-TACE follow-up includes blood tests and imaging (CT or MRI) to monitor tumor response. Patients are advised to avoid strenuous activities for a few days and maintain a healthy liver-friendly diet.

Others – When is Chemoembolization Recommended?

Chemoembolization is not suitable for all patients. It is recommended based on individual medical profiles, tumor characteristics, and liver function.

Indications for TACE:

• Primary liver cancer (Hepatocellular carcinoma)
• Secondary liver tumors (e.g., metastases from colon, breast, or neuroendocrine tumors)
• Patients ineligible for surgery due to poor liver reserve or comorbidities
• Patients awaiting liver transplant (TACE used as a bridge therapy)
• Tumors that are localized and not involving major liver blood vessels

Contraindications:

• Advanced liver cirrhosis
• Complete blockage of the portal vein
• Poor overall health or renal dysfunction
• Allergy to contrast dyes used in imaging

TACE is often part of a multimodal treatment plan, used alongside systemic therapies or immunotherapy depending on cancer staging and progression.