Chemoembolisation (TACE)
What is chemoembolisation?
Chemoembolisation is a treatment used for primary liver cancer (also called hepatocellular carcinoma or HCC), or secondary liver cancer.
In chemoembolisation, a chemotherapy drug is injected directly into the liver. This means the tumour gets a stronger dose of the drugs. You will then have an injection into the blood vessels that carry blood to the liver (arteries). The injection blocks the arteries and cuts off the blood supply to the tumour (embolisation).
Chemoembolisation is sometimes called TACE (trans-arterial chemoembolisation) or CT-ACE (computerised tomography-guided arterial chemoembolisation).
The drugs most often used are doxorubicin and cisplatin
How chemoembolisation is given
You may need to stay in hospital for a couple of nights. Before the treatment, the nurse or doctor will usually give you a mild sedative to help you relax. They then inject some local anaesthetic into the skin at the top of your leg (your groin) to numb the area. After this, the doctor makes a tiny cut in the skin. They put a fine tube called a catheter through the cut and into a blood vessel in your groin (the femoral artery).
The doctor passes the catheter up along the artery until it reaches the blood vessels that take blood to the liver and tumour. You have an x-ray of the blood vessels at the same time. This is called an angiogram. A dye is put into the blood vessel through the catheter. This shows the blood supply on the x-ray so the doctor sees exactly where the catheter is. After this, they slowly inject the chemotherapy into the liver through the catheter. The doctor then injects a gel or tiny plastic beads to block the blood supply to the tumour. The beads may contain a chemotherapy drug.
You can have chemoembolisation several times. It is sometimes given with radiofrequency ablation. Your doctor can explain this treatment to you in more detail.
Side effects of chemoembolisation
Chemoembolisation can cause side effects such as:
- a high temperature
- pain in the upper right side of the abdomen
- feeling sick (nausea)
- feeling very tired (fatigue).
You will be given anti-sickness drugs and painkillers until the side effects get better. This usually takes 1 to 2 weeks.
It is unusual for chemotherapy given in this way to cause side effects outside of your liver. Serious complications are rare, but sometimes it can damage the liver.
About our information
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References
Below is a sample of the sources used in our primary liver cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
Melloul E, Hübner M, Scott M, et al. Guidelines for perioperative care for liver surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations. World J Surg. 2016; 40: 2425–2440. Available from: doi.org/10.1007/s00268-016-3700-1 [accessed Feb 2020]
NICE. Lenvatinib for untreated advanced hepatocellular carcinoma: Technology appraisal guidance (TA 551) [Internet]. 2018. Available from: www.nice.org.uk/guidance/TA551 [accessed Feb 2020]
NICE. Liver disease. Quality standard (QS 152) [Internet]. 2017. Available from: www.nice.org.uk/guidance/QS152 [accessed Feb 2020]
NICE. Liver cancers overview [Internet]. 2019. Available from: pathways.nice.org.uk/pathways/liver-cancers/liver-cancers-overview [accessed Feb 2020]
NICE. Regorafenib for previously treated advanced hepatocellular carcinoma. Technology appraisal guidance (TA555) [Internet]. 2019. Available from: www.nice.org.uk/guidance/ta555 [accessed Feb 2020]
Vogel A, Cervantes A, Chau I, et al. Hepatocellular carcinoma: ESMO Clinical practice guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2018; 29 (S4): iv238–iv255. Available from doi.org/10.1093/annonc/mdy510 [accessed Feb 2020]
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Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Dr Paul Ross, Consultant Medical Oncologist.
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