Exploring TACE (Transarterial Chemoembolization): Targeted Therapy for Intermediate-Stage Liver Cancer

By Dr. Shahnawaz B. Kaloo in Interventional Radiology

Jun 28 , 2023 | 2 min read

TACE is recommended for treating intermediate-stage liver cancer (hepatocellular carcinoma or HCC).
Liver cancer (HCC) is graded into early, intermediate, and advanced stages. In the early stage of cancer, surgical excision or RFA (radiofrequency ablation) is often used. However, a majority of patients diagnosed with liver cancer are already in the intermediate or advanced stage of the disease at the time of first presentation. These patients are often treated with TACE or TARE.
TACE is a minimally invasive treatment which involves targeted delivery of anti-cancer medicines directly into the cancer. TACE blocks the blood supply to the cancer, thus depriving the cancer of nourishment. TACE is done via angiography, i.e. a catheter is inserted into a blood vessel (usually through the femoral artery in the groin) and then guided towards the liver under the guidance of X-rays in an angiography suite. Once the catheter reaches the liver, it is further guided into the blood vessel supplying the cancer. Chemotherapeutic medicines and embolic particles are injected through the catheter precisely into the particular blood vessel. The chemotherapy medication kills cancer, and the embolic particles block the blood vessel and thus stop the supply of nutrients and oxygen to the cancer. The process is done under local anaesthesia and is usually completed in an hour.
After TACE is performed, the patient is shifted back to their room. After a few hours of the procedure, water and food are given to the patient. Post-procedure, patients may experience mild pain, discomfort or fever, which is treated with oral or intravenous medication. Most patients are discharged by the 3rd day of the treatment.
One month after TACE, some blood tests and a scan (usually Triple phase Contrast CT or MRI) are done to assess the treatment results. A majority of the patients should have excellent responses to the treatment.

Frequently Asked Questions

What precautions are to be observed after TACE?

The puncture site is monitored for bleeding or hematoma formation after the procedure. Patients must stay in bed for 6 to 8 hours if the puncture is done in the groin. Patients can walk right after the treatment if the puncture site is the wrist.
Are there any side effects of TACE?

TACE is a well-tolerated treatment; most patients experience mild side effects like pain, nausea, vomiting or fever. Rarely, patients may develop jaundice, infection or bleeding, which may need prolonged hospital stays.
Does TACE cause chemotherapy-like side effects?

No, most of the time, TACE causes only mild side effects. This is because the highest concentration of anti-cancer medicine is given to the area where cancer is present. That means the body will have the least side effects related to the medicine.
Is TACE a one-time treatment, or does it need multiple cycles of treatment?

Unlike chemotherapy which needs repeated treatment cycles, TACE is commonly required once only. However, if new cancer arises in the liver, it can be repeated.
What is the success rate of TACE?

TACE is used to downstage cancer and improve the patient's survival. Generally speaking, TACE stops tumour growth in approximately 70% of patients. TACE, if combined with RFA (Radiofrequency ablation) or microwave ablation, often becomes a curative treatment (the patient becomes cancer free). Besides, TACE is commonly performed before Liver Transplant to help reduce the chances of cancer recurrence after the liver transplant.
Who can help me learn more about TACE treatment?

You may consult any Interventional Radiologist and learn more about this procedure. You can also write to us; we will happily answer your queries.