All you need to know about Chemoembolization

Chemoembolization is one of the latest treatment methods with minor side effects, and this method has seen qualitative leaps in Turkey for the efficiency of doctors and devices.

What is chemoembolization?

Chemoembolization (a method used in chemotherapy) or what is called transarterial chemoembolization (TACE) is a type of chemotherapy and modern therapeutic (or palliative) method which includes both chemotherapy and coagulation to relieve the symptoms of the tumor and reduce it by killing Tumor cells, similar to Radioembolization (interventional treatment), but the difference here is that we inject chemicals that kill cancer cells instead of small particles loaded with radioactive isotopes, and this chemical method is often used in Liver cancer treatment (HCC), whether it is primary (it started in the liver) or has spread to it from other organs.

Chemoembolization in Turkey and the injection of microparticles to block the arteries feeding the hepatic tumor
Chemoembolization and injection of microparticles to block the arteries feeding the hepatic tumor with the addition of chemotherapeutic drugs.

Chemoembolization is a minimally invasive procedure that is performed by a radiologist and is almost similar to angiography in terms of mechanism.

Embolization is done by injecting embolizing materials that block the blood vessels feeding the tumor, and prevent the spread of the chemotherapy effect to other areas.
We can use chemoembolization alone, or we can combine it with other treatments such as radiotherapy, as Studies Survival improvement in hepatocellular carcinoma patients when radiotherapy combined with chemoembolization, chemotherapy or radiofrequency ablation…

What are the advantages of chemoembolization therapy?

Chemoembolization has several advantages that distinguish it from other conventional treatment methods of treatment, including:

  • It prevents the delivery of oxygen carried in the blood to the tumor, which contributes to shrinking the size of the tumor and killing cancer cells.
  • Because the chemical dose will be injected directly into the tumor, a larger dose of chemotherapy can be given in chemoembolization than the dose used in standard chemotherapy.
  • Arterial blood clots and the perfusion of cancer in this procedure prevents the chemotherapy from spreading to nearby areas.
  • Symptoms in this chemotherapy are significantly less and lighter because of what we mentioned above.

When do we use TACE chemoembolization?

Doctors often resort to this method when other methods have failed or patients are too ill to undergo more aggressive treatments (such as surgery).
Chemoembolization is most useful for patients whose disease is mostly confined to the liver, whether the tumor begins in the liver or has spread (metastatic cancer) from another organ.

Cancers that can be treated with chemoembolization include:

  • Hepatocellular carcinoma
  • Bile duct cancer
  • Some of the cancers that give hepatic metastases:
    • Colon Cancer
    • Breast cancer
    • Carcinoid tumors and other neuroendocrine tumors
    • Pancreatic islet tumors
    • Melanoma of the eyeball

How do patients prepare for chemoembolization in Turkey?

Your doctor will recommend several tests, including blood tests and liver function tests. A CT scan or MRI of your liver may also be done before chemoembolization.

The doctor prescribes some sedative medications and stops any medication the patient is taking that may interfere with the process (including Aspirin).

After the results of the tests appear, the doctor must make sure that there is no blockage in the hepatic blood flow (portal vein obstruction), cirrhosis of the liver, or any blockage in the bile ducts.

The patient will be asked to stop eating or drinking after midnight the night before the chemoembolization treatment, patients usually stay in the hospital from 1-4 nights after the operation, the operation is performed by the interventional radiologist in the department of interventional radiology, antibiotics and sedative medications are given IV.

How is Chemoembolization (TACE) performed in Turkey?

In the treatment of chemical blood clotting (chemoembolization) in Turkey, the efforts of the best doctors will combine with the elite nurses and the best modern medical devices to operate the process of chemotherapy coupled with chemoembolization in the best way possible and achieve the best results at the lowest possible cost, and Bimaristan Medical Center remains your first choice the best treatment in Turkey.

X-rays will be taken to map the pathway of the blood vessels feeding the tumor. The patient may be given a drug called Allopurinol, which helps protect the kidneys from chemotherapy and byproducts produced by dying tumor cells.

The interventional radiologist will place a small catheter (a transcatheter tube) in one of the groin arteries and perform an arterial gram to specifically monitor the arteries in the liver.
In the process of chemical chemoembolization, the doctor may use local anesthesia, and the process of chemoembolization does not require intubation of the patient, however, some patients may need general anesthesia and local anesthesia is not sufficient.

The doctor will make a very small skin incision at the site.
Using X-ray guidance, a doctor inserts a thin catheter through the skin into the arterial pathway, either in the groin or in the wrist, and then pushes it into the liver. contrast material is injected through the catheter and another series of X-ray images are taken.
Once the catheters are placed in the arterial branches that feed the tumor, anticancer drugs and embolizing agents are mixed together and injected.

Catheter imaging of the liver arteries before and after chemoembolization
Imaging before and after chemoembolization and showing hepatic arteries

Additional x-rays will be taken to make sure that the chemotherapy treatment has reached the cancer and the arterial thrombosis of the cancer is complete.
When the procedure is complete, the doctor will remove the catheter and apply pressure to stop any bleeding. Sometimes, the doctor may use a closure device to block the small opening where the catheter was inserted. This will allow you to heal more quickly. There are no visible stitches on the skin.

Your doctor may provide you with medications to help prevent nausea and pain and antibiotics to help prevent infection and sepsis after the procedure. The patient is expected to be discharged from the operating room after treatment with a blood clotting agent after 6 hours depending on which artery was used.

Chemoembolization is a rather new process. If you have any questions about this process and its cost, do not hesitate tous, Bimaristan center is your family is in Turkey.

Complications and Side Effects of Chemoembolization (TACE)

After the procedure, patients may have varying degrees of pain, fever and nausea, these symptoms may last from a few hours to a few days, and can be treated easily as the operating doctor prescribes medications that help get rid of these symptoms, the patient may also notice slight hair loss, but rarely.

Serious complications of chemoembolization are rare.
In less than 3% of procedures, a tumor treated with chemoembolization may become infected and an abscess may form.

One case of hepatic failure due to arterial chemoembolization (TACE) was reported among 100 surgeries.

Post-operative care in Turkey

The patient should be able to resume his normal daily activities within a week of chemoembolization treatment in Turkey.

During the first month following chemotherapy combined with arterial chemoembolization, the patient should routinely see the doctor, inform him of any problems and monitor the progress of his recovery.
He or she may need a CT or MRI scan and blood tests to determine the size and condition of the cancer being treated.

The liver is divided into two parts: the right hepatic lobe and the left hepatic lobe. If there is a tumor that includes both lobes, this is usually treated in a phased manner. During the first preparation, one of the lobes is treated, the second lobe is usually treated after about a month.
A CT or MRI scan is recommended every three months thereafter to determine how much the tumor has shrunk, and to see if new tumors appeared in the liver
The median time before the second round of chemoembolization TACE (due to a new tumor) is between 10 and 14 months.

TACE Chemoembolization can be repeated several times over many years, as long as it is still technically feasible for the patient to be healthy enough to tolerate the repeated procedures.


Sources

  1. RadiologyInfo
  2. OncoLink
  3. JohnHopkinsMedicine
  4. UCLAHealth

Common Questions

It is a minimally invasive procedure that combines chemotherapy and vascular embolization via the arterial route to achieve the best possible results.

Chemoembolization is used in the event that other treatments fail or the patient is unable to undergo prolonged courses of chemotherapy, and it is better in terms of reducing side effects, increasing the dose of the drug and cutting the blood supply of the tumor.

Chemoembolization is a minimally invasive procedure that does not carry serious complications and does not have many side effects, and due to the significant advancement of post-operative care methods in Turkey, the complications have decreased dramatically.

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