What is Transarterial Chemoembolization (TACE)?
Transarterial Chemoembolization, commonly referred to as
TACE, is a minimally invasive procedure used primarily to treat certain types of
cancer, most notably hepatocellular carcinoma (HCC) or liver cancer. It combines targeted
chemotherapy with embolization, a process that blocks the blood supply to the tumor, thereby enhancing the effectiveness of the treatment.
How Does TACE Work?
TACE works by delivering high doses of chemotherapy directly to the tumor while simultaneously blocking the blood vessels that feed the tumor. This dual approach maximizes the concentration of chemotherapy in the tumor and minimizes systemic exposure, which helps to reduce adverse side effects.
During the procedure, a catheter is inserted through the groin and guided into the hepatic artery, which supplies blood to the liver. Chemotherapy drugs are then injected through the catheter directly into the tumor. Afterward, tiny particles called embolic agents are released to block the blood flow, trapping the chemotherapy within the tumor and starving it of nutrients and oxygen.
What Types of Cancer Can Be Treated with TACE?
TACE is most effective in treating primary liver cancers, such as
hepatocellular carcinoma. It is also used for treating metastatic liver cancers, which are cancers that have spread to the liver from other parts of the body. In some cases, TACE may also be employed for treating other types of tumors, such as neuroendocrine tumors and certain sarcomas.
Who is a Candidate for TACE?
Not all patients with liver cancer are suitable candidates for TACE. Ideal candidates typically have tumors that are not amenable to surgical resection but are still localized within the liver. Other factors that may influence eligibility include the patient's overall liver function, the extent of cancer spread, and the presence of other underlying medical conditions.
Patients with poor liver function, extensive extrahepatic disease, or significant portal vein thrombosis may not be suitable for this procedure. A multidisciplinary team of oncologists, radiologists, and surgeons usually evaluates each case to determine the best treatment approach.
What Are the Benefits of TACE?
The primary benefits of TACE include targeted treatment with minimal systemic side effects and the ability to shrink tumors, making them more amenable to surgical resection or other therapies. Additionally, TACE can improve
quality of life by reducing symptoms such as pain and improving liver function.
Studies have shown that TACE can extend survival in patients with intermediate-stage hepatocellular carcinoma and can be used as a palliative treatment in advanced cases to control symptoms and improve quality of life.
What Are the Risks and Side Effects?
Like any medical procedure, TACE carries certain risks and potential side effects. Common side effects include fever, abdominal pain, nausea, and fatigue. These symptoms, collectively known as post-embolization syndrome, usually resolve within a few days.
More serious complications, although rare, can include liver failure, infection, and damage to the bile ducts or surrounding tissues. It is crucial for patients to be closely monitored during and after the procedure to manage any potential complications promptly.
How Effective is TACE?
The effectiveness of TACE varies depending on several factors, including the size and number of tumors, the patient's liver function, and the extent of cancer spread. While TACE is not a cure, it can significantly reduce tumor size and slow disease progression. In some cases, it may convert an inoperable tumor into one that is operable, potentially leading to a cure through surgical resection.
Multiple TACE sessions may be required to achieve optimal results, and the procedure can be repeated if the tumor recurs or progresses.
What to Expect During and After the Procedure?
Patients undergoing TACE can expect to spend several hours in the hospital. The procedure itself typically takes one to two hours, followed by a recovery period in a monitored setting. Most patients can go home the same day or the following day.
Post-procedure care includes managing any side effects, monitoring liver function, and follow-up imaging studies to assess the response to treatment. Patients are advised to avoid strenuous activities for a few days and to follow their healthcare provider's instructions regarding medications and follow-up appointments.
Conclusion
Transarterial Chemoembolization is a valuable tool in the arsenal against liver cancer and certain other malignancies. By delivering targeted chemotherapy directly to the tumor and blocking its blood supply, TACE offers a potent, localized treatment option with fewer systemic side effects. As with any medical intervention, a thorough evaluation by a multidisciplinary team is essential to determine the best treatment course for each individual patient.
