Chemoembolisation means having chemotherapy directly to the area of your liver where the cancer is and then blocking off the blood supply to the tumour.
Chemoembolisation is also called trans arterial chemoembolisation (TACE).
You usually have this treatment if you can't have surgery, or to help control the cancer while you are waiting for a liver transplant. You might also have this treatment to shrink a tumour so that it then becomes small enough to remove with surgery.
You may have chemoembolisation with other treatments such as surgery or radiofrequency ablation.
You usually need to stay in hospital overnight or longer.
How you have chemoembolisation
You have this treatment in the x-ray department. You have a local anaesthetic injection and possibly a mild sedative.
The doctor puts a tube called a catheter into the large artery at the top of your leg called the femoral artery. The doctor then threads the catheter along the femoral artery until it reaches the hepatic artery that supplies blood to the liver.
The doctor will check that the catheter is in the right place in the liver. Then they inject the chemotherapy into the catheter. The drugs you are most likely to have are doxorubicin or cisplatin.
The doctor then injects something to block the blood flow to the tumour. This might be tiny plastic beads or a type of gel. Blocking the flow of blood to the cancer (embolisation) helps to kill the cancer cells because it cuts off the tumour's food and oxygen supply. It also helps to keep the chemotherapy drugs in the liver for longer.
Some types of beads release chemotherapy directly to the liver, rather than the doctor adding the chemotherapy and beads separately.
After the treatment, the catheter is taken out. You will need to stay in bed for a number of hours afterwards. This is to help prevent your wound from bleeding.
Chemoembolisation can cause side effects.
You may feel or be sick or could have some pain or a raised temperature after the treatment. These side effects are called post embolisation syndrome, and are common. Your doctor will give you painkillers and anti sickness drugs to control these side effects.
You can also get side effects from the chemotherapy drugs themselves. As most of the chemotherapy is trapped in the liver, these side effects are generally mild compared to having chemotherapy into the bloodstream (systemic chemotherapy).
Rarely, chemoembolisation can cause damage to the liver which may result in liver failure. So this treatment is not usually an option for people with moderate or severe cirrhosis.
Who it is not suitable for
You usually can't have chemoembolisation if your liver or kidneys are not working well, your blood is not clotting normally or there is a blockage in your bile ducts.
As chemoembolisation blocks some blood vessels to the liver, your doctor has to make sure there will still be a good enough blood supply to the liver after the treatment. So, if there is a blockage of the main vein supplying blood from the gut to the liver (portal vein) then your doctor is unlikely to recommend this treatment as it is generally not safe to do.
Having more than one treatment
You may have chemoembolisation more than once if your doctor thinks it will help.
You might have just the embolisation part if you have too many side effects from the chemotherapy. This is called trans arterial embolisation (TAE).